Sakai Mayu, Kato Takehiro, Ishihara Takuma, Takao Ken, Hirose Tokuyuki, Kubota Sodai, Kubota-Okamoto Saki, Imaizumi Toshinori, Takahashi Yoshihiro, Mizuno Masami, Hirota Takuo, Horikawa Yukio, Sakaguchi Hirokazu, Tsunekawa Shin, Yabe Daisuke
Department of Occupational Health, Gifu University Graduate School of Medicine, Gifu, Japan.
Department of Diabetes, Endocrinology and Metabolism Gifu University Graduate School of Medicine, Gifu, Japan.
Front Clin Diabetes Healthc. 2025 Jul 16;6:1590407. doi: 10.3389/fcdhc.2025.1590407. eCollection 2025.
AIMS/INTRODUCTION: Diabetic retinopathy (DR) often remains asymptomatic until it reaches advanced stages, when delayed treatment can lead to irreversible visual impairment. To promote timely ophthalmology visits, this study investigated the utility of a simple nerve conduction device, DPNCheck, as a predictor of DR severity. Previous research has established a relationship between diabetic neuropathy (assessed by conventional nerve conduction studies) and DR progression; however, the specialized equipment and expertise required limit its practicality. In contrast, DPNCheck is a simpler alternative that quantifies neuropathy severity through the severity of the estimated modified Baba classification (eMBC).
Using electronic medical records (EHRs), we identified individuals with diabetes who underwent DPNCheck and subsequent ophthalmologic assessment for DR. Based on age and sural nerve conduction data, an eMBC was calculated. Meanwhile, DR severity was scored using a modified Davis classification, defining four stages (DR severity scores 0-3).
Of 181 individuals extracted from our hospital's EHRs, 146 were eligible for analysis. Ordinal logistic regression showed that eMBC was significantly associated with DR stage, independent of diabetes duration and HbA1c. Receiver operating characteristic (ROC) curve analyses yielded eMBC cut-off values of 1.11, 1.51, and 1.51 to predict DR severity scores of ≥1, ≥2, and ≥3, respectively. Sensitivities ranged from 0.67 to 0.78, and specificities from 0.66 to 0.81. An eMBC of 1.51 or above was strongly associated with preproliferative or proliferative DR, indicating a need for urgent ophthalmology referral.
DPNCheck, a simple nerve conduction measurement device, may help predict DR severity and facilitate timely ophthalmologic care.
目的/引言：糖尿病视网膜病变（DR）在发展到晚期之前通常没有症状，而延迟治疗可能导致不可逆转的视力损害。为了促进及时的眼科就诊，本研究调查了一种简单的神经传导装置DPNCheck作为DR严重程度预测指标的效用。先前的研究已经确定了糖尿病神经病变（通过传统神经传导研究评估）与DR进展之间的关系；然而，所需的专业设备和专业知识限制了其实用性。相比之下，DPNCheck是一种更简单的替代方法，它通过估计的改良巴巴分类法（eMBC）的严重程度来量化神经病变的严重程度。
利用电子病历（EHRs），我们确定了接受DPNCheck检查及随后进行DR眼科评估的糖尿病患者。根据年龄和腓肠神经传导数据，计算出eMBC。同时，使用改良的戴维斯分类法对DR严重程度进行评分，定义了四个阶段（DR严重程度评分0 - 3）。
从我院电子病历中提取的181例患者中，146例符合分析条件。有序逻辑回归显示，eMBC与DR分期显著相关，独立于糖尿病病程和糖化血红蛋白。受试者操作特征（ROC）曲线分析得出，eMBC的截断值分别为1.11、1.51和1.51，用于预测DR严重程度评分≥1、≥2和≥3。敏感性范围为0.67至0.78，特异性范围为0.66至0.81。eMBC为1.51或以上与增殖前期或增殖期DR密切相关，表明需要紧急转诊至眼科。
DPNCheck，一种简单的神经传导测量装置，可能有助于预测DR严重程度并促进及时的眼科护理。
