Harris M, Eastman R, Cowie C
NIDDK/NIH, Bethesda, MD 20892.
Diabetes Care. 1993 Nov;16(11):1446-52. doi: 10.2337/diacare.16.11.1446.
To ascertain the prevalence and determinants of sensory neuropathy symptoms through structured interview of a representative sample of people with diabetes in the U.S. population.
The 1989 National Health Interview Survey consisted of a representative sample of 84,572 persons in the U.S. > or = 18 yr of age. A household respondent identified all people in the household believed to have diabetes (n = 2829). Subjects who could not be personally interviewed (n = 129) and individuals who stated they did not have diabetes (n = 295) were excluded. A detailed questionnaire was administered to 99.3% of the remaining 2405 subjects. Questions on symptoms of sensory neuropathy included whether during the past 3 mo the subjects had experienced numbness or loss of feeling, pain or tingling, or decreased ability to feel hot or cold. The neuropathy questions were also administered to a representative sample of 20,037 subjects who were not known to have diabetes.
Prevalence of symptoms of sensory neuropathy was 30.2% among people with IDDM. This prevalence was 36.0% for men with NIDDM and 39.8% for women with NIDDM, compared with 9.8 and 11.8% for nondiabetic men and women, respectively. In logistic regression, factors independently related to symptoms of sensory neuropathy in people with NIDDM included duration of diabetes, hypertension, hyperglycemia, and glycosuria. Long duration of NIDDM (> or = 20 yr) was associated with a twofold increased risk of symptoms of sensory neuropathy compared with those with 0-4 yr of diabetes. Hypertension was associated with a 60% higher likelihood of symptoms. Diabetic individuals whose blood glucose was high all or most of the time or whose urine tests showed glucose all of the time were > 2 times as likely to have symptoms of sensory neuropathy than those who did not report hyperglycemia or glycosuria. Age, sex, ethnicity, cigarette smoking, and height were not determinants of sensory neuropathy.
Symptoms of sensory neuropathy affect 30-40% of diabetic patients in the U.S. Men and women are affected equally. Prevalence of these symptoms increases with longer duration of diabetes; hypertension and hyperglycemia predispose to symptoms of sensory neuropathy.
通过对美国人群中具有代表性的糖尿病患者样本进行结构化访谈，确定感觉神经病变症状的患病率及其决定因素。
1989年美国国家健康访谈调查涵盖了年龄≥18岁的84,572名具有代表性的美国人。由一名家庭受访者确定家庭中所有被认为患有糖尿病的人（n = 2829）。无法进行个人访谈的受试者（n = 129）以及表示自己没有糖尿病的个体（n = 295）被排除在外。对其余2405名受试者中的99.3%进行了详细问卷调查。关于感觉神经病变症状的问题包括在过去3个月内受试者是否经历过麻木或感觉丧失、疼痛或刺痛，或感觉冷热的能力下降。还对20,037名未知患有糖尿病的受试者的代表性样本进行了神经病变问题调查。
胰岛素依赖型糖尿病（IDDM）患者中感觉神经病变症状的患病率为30.2%。非胰岛素依赖型糖尿病（NIDDM）男性的这一患病率为36.0%，NIDDM女性为39.8%，相比之下，非糖尿病男性和女性的患病率分别为9.8%和11.8%。在逻辑回归分析中，与NIDDM患者感觉神经病变症状独立相关的因素包括糖尿病病程、高血压、高血糖和糖尿。与糖尿病病程为0 - 4年的患者相比，NIDDM病程长（≥20年）与感觉神经病变症状风险增加两倍相关。高血压与症状出现的可能性高60%相关。血糖一直或大部分时间高或尿检一直显示有葡萄糖的糖尿病个体出现感觉神经病变症状的可能性是未报告有高血糖或糖尿者的两倍多。年龄、性别、种族、吸烟和身高不是感觉神经病变的决定因素。
感觉神经病变症状影响美国30% - 40%的糖尿病患者。男性和女性受影响程度相同。这些症状的患病率随糖尿病病程延长而增加；高血压和高血糖易引发感觉神经病变症状。
