评估小神经纤维功能作为1型糖尿病（T1DM）儿童和青少年周围神经病变的早期标志物。

Assessment of small nerve fiber function as an early marker of peripheral neuropathy in children and adolescents with type 1 diabetes mellitus (T1DM).

作者信息

Stavroula Argyropoulou, Panagiotis Kokotis, George Paltoglou, Chrysanthi Boutziouka, Georgia Karamatzianni, Spyridon Karanasios, Irine-Ikbale Sakou, Kyriaki Karavanaki

机构信息

Diabetes and Metabolism Unit, 2nd Department of Pediatrics, National and Kapodistrian University of Athens, "P&A Kyriakou" Childrens Hospital, Athens, Greece.

Laboratory of Clinical Neurophysiology, First Department of Neurology, National and Kapodistrian University of Athens, "Aeginitio" University Hospital, Athens, Greece.

出版信息

Endocrine. 2025 Jan;87(1):116-125. doi: 10.1007/s12020-024-03991-1. Epub 2024 Aug 10.

DOI:10.1007/s12020-024-03991-1

PMID:39127819

Abstract

PURPOSE

This study aimed to assess subclinical peripheral diabetic neuropathy (PDN) in adolescents with type 1 diabetes mellitus (T1DM).

METHODS

Subjects included 53 T1DM patients (age (mean ± SE): 15.8 ± 0.54 years, disease duration: 6.0 ± 0.51 years and HbA1c: 7.9 ± 0.19%), and 37 healthy gender matched controls (age: 15.6 ± 0.52 years). PDN was assessed by vibration perception threshold (VPT) and by quantitative sensory testing (QST). In controls, 95% confidence intervals were calculated.

RESULTS

Among patients, VPT prevalence of abnormality ranged from 60-73.4% on different sites. Higher VPT was found in patients on all examined sites (p < 0.01). In controls, VPT correlated with height (r = 0.48, p = 0.05). Regarding QST prevalence of abnormality, cold detection threshold (CDT) ranged 7.3-39.0%, cold pain threshold (CPT) ranged 22.22-29.63%, hot detection threshold (HDT) ranged 34.14-63.41%, and hot pain threshold (HPT) ranged 15.79-36.84%. In patients, CPT correlated with BMI (r = 0.42, p = 0.05) and diabetes duration, (r = 0.40, p = 0.05), HPT correlated with age (r = 0.36, p = 0.05) and height (r = 0.35, p = 0.05), while in controls with BMI (r = 0.51, p = 0.05). No correlation of VPT or QST with HbA1c was observed.

CONCLUSION

Adolescents with T1DM in this study, although asymptomatic, showed a high prevalence of impaired indices of PDN, highlighting potential clinical implications of early identification of PDN.

摘要

目的

本研究旨在评估1型糖尿病（T1DM）青少年的亚临床周围糖尿病神经病变（PDN）。

方法

研究对象包括53例T1DM患者（年龄（均值±标准误）：15.8±0.54岁，病程：6.0±0.51年，糖化血红蛋白：7.9±0.19%），以及37例性别匹配的健康对照者（年龄：15.6±0.52岁）。通过振动觉阈值（VPT）和定量感觉测试（QST）评估PDN。在对照组中，计算95%置信区间。

结果

在患者中，不同部位VPT异常患病率在60 - 73.4%之间。在所有检查部位，患者的VPT均较高（p < 0.01）。在对照组中，VPT与身高相关（r = 0.48，p = 0.05）。关于QST异常患病率，冷觉检测阈值（CDT）在7.3 - 39.0%之间，冷痛阈值（CPT）在22.22 - 29.63%之间，热觉检测阈值（HDT）在34.14 - 63.41%之间，热痛阈值（HPT）在15.79 - 36.84%之间。在患者中，CPT与体重指数（BMI）相关（r = 0.42，p = 0.05）和糖尿病病程相关（r = 0.40，p = 0.05），HPT与年龄相关（r = 0.36，p = 0.05）和身高相关（r = 0.35，p = 0.05），而在对照组中与BMI相关（r = 0.51，p = 0.05）。未观察到VPT或QST与糖化血红蛋白之间的相关性。