Tóth Marianna, Szőke Annamária, Arányi Zsuzsanna
Dept. of Neurology, Vaszary Kolos Hospital, Esztergom, Hungary.
Dept. of Neurology, Semmelweis University, Budapest, Hungary.
Clin Neurophysiol Pract. 2023 May 24;8:115-122. doi: 10.1016/j.cnp.2023.04.004. eCollection 2023.
A prospective ultrasound study to analyze nerve size and its modifying factors in type 1 and type 2 diabetes mellitus.
The cross-sectional areas (CSAs) of motor and sensory nerves in both upper and lower limbs were measured at 14 measurement points, using high resolution ultrasound in 26 patients with type 1 and 76 patients with type 2 diabetes, and in 50 control subjects. All diabetic patients underwent electrophysiological assessment to check for the presence of polyneuropathy.
Significant mild/moderate diffuse nerve enlargement was demonstrated in type 2 diabetes, more pronounced at compression sites versus non-compression sites, and on the upper limbs versus lower limbs (p value for pooled DM2 v. control group: <0.001). In type 1 diabetes, nerve enlargement was found only at one compression site (median nerve wrist; p = 0.002). No significant difference was found between patients with or without polyneuropathy.
The primary predictors of nerve size in diabetes are anatomical location (i.e. compression sites versus non-compression sites, upper versus lower limbs) and type of diabetes. Changes occur before the electrophysiological signs of polyneuropathy are detected.
Nerve ultrasound may contribute to early recognition of the neuropathic complications of diabetes.
一项前瞻性超声研究，旨在分析1型和2型糖尿病患者的神经大小及其影响因素。
使用高分辨率超声，在26例1型糖尿病患者、76例2型糖尿病患者和50例对照者的上下肢14个测量点测量运动和感觉神经的横截面积（CSA）。所有糖尿病患者均接受电生理评估以检查是否存在多发性神经病。
2型糖尿病患者出现明显的轻度/中度弥漫性神经增粗，在受压部位比非受压部位更明显，在上肢比下肢更明显（2型糖尿病合并对照组的p值：<0.001）。在1型糖尿病患者中，仅在一个受压部位（正中神经腕部）发现神经增粗（p = 0.002）。有无多发性神经病的患者之间未发现显著差异。
糖尿病患者神经大小的主要预测因素是解剖位置（即受压部位与非受压部位、上肢与下肢）和糖尿病类型。这些变化在检测到多发性神经病的电生理征象之前就已发生。
神经超声可能有助于早期识别糖尿病的神经病变并发症。
