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糖尿病患者的糖尿病周围神经病变的早期检测:一项横断面研究。

Early Detection of Diabetic Peripheral Neuropathy in Diabetic Patients: A Cross-Sectional Study.

机构信息

Department of Community Medicine/Public Health Sumatera Utara, Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia.

Department of Pediatrics, Universitas Sumatera Utara, Medan, Indonesia.

出版信息

Curr Diabetes Rev. 2024;21(2):e280324228439. doi: 10.2174/0115733998297210240325062747.

Abstract

BACKGROUND

Diabetic Peripheral Neuropathy (DPN) is a chronic complication in Type 2 Diabetes Mellitus (T2DM) patients and is characterized by paresthesia, pain, and hypoesthesia of the extremities. The Diabetic Neuropathy Symptom-Score (DNS) is a quick, inexpensive, and easy-to-perform tool to detect DPN in clinical practice. Biochemical markers like Nitric Oxide (NO) and Vascular Endothelial Growth Factor (VEGF) play a role in the early detection of DPN. This study aims to investigate the relationship between risk factors and these biomarkers. So, it is expected to improve the prevention and treatment of diabetic neuropathy more effectively.

METHOD

A cross-sectional method was used for this study. The sample size was 85 patients with T2DM who visited several primary healthcare in Medan, selected by consecutive sampling method based on eligibility criteria. Data collected included DNS, assessment of NO, VEGF, Glycated Hemoglobin (HbA1c), plasma blood glucose (PBG), and lipid profile. The collected data were analyzed using an independent T-test.

RESULT

The results showed that most T2DM patients, namely 73 people (85.9%), experienced DPN. From the bivariate analysis results, the risk factors associated with the prevalence of DPN in T2DM patients were found to be increased levels of total cholesterol, HbA1c, NO, and VEGF (p < 0.05). Meanwhile, blood pressure, fasting BGL, HDL-C, LDL-C, and triglycerides were not related to the occurrence of DPN in this study (p> 0.05).

CONCLUSION

DNS can be used as a quick and easy initial screening tool implemented in clinical practice for screening DPN. Diabetic patients with DPN tend to have lower NO and increased VEGF; besides, NO levels are also associated with the progression of DPN. Furthermore, education, blood sugar control, and physical exercise, especially leg exercises, can prevent progressive DPN.

摘要

背景

糖尿病周围神经病变(DPN)是 2 型糖尿病(T2DM)患者的一种慢性并发症,其特征为四肢感觉异常、疼痛和感觉减退。糖尿病神经病变症状评分(DNS)是一种快速、廉价且易于在临床实践中进行的检测 DPN 的工具。生化标志物如一氧化氮(NO)和血管内皮生长因子(VEGF)在 DPN 的早期检测中发挥作用。本研究旨在探讨危险因素与这些生物标志物之间的关系。因此,有望更有效地预防和治疗糖尿病性神经病。

方法

本研究采用横断面方法。样本量为 85 名在棉兰几家初级保健中心就诊的 T2DM 患者,采用连续抽样法根据入选标准选择。收集的数据包括 DNS、NO、VEGF、糖化血红蛋白(HbA1c)、血浆血糖(PBG)和血脂谱评估。使用独立 T 检验分析收集的数据。

结果

结果表明,大多数 T2DM 患者(73 人,85.9%)患有 DPN。从双变量分析结果中发现,与 T2DM 患者 DPN 患病率相关的危险因素是总胆固醇、HbA1c、NO 和 VEGF 水平升高(p<0.05)。而血压、空腹 BGL、HDL-C、LDL-C 和甘油三酯与本研究中 DPN 的发生无关(p>0.05)。

结论

DNS 可作为一种快速简便的初始筛查工具,在临床实践中用于筛查 DPN。患有 DPN 的糖尿病患者的 NO 水平较低且 VEGF 水平升高;此外,NO 水平还与 DPN 的进展有关。此外,教育、血糖控制和体育锻炼,尤其是腿部锻炼,可以预防进行性 DPN。

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