Hasegawa O, Suzuki Y, Komiyama A, Arita T, Matsumoto S
Department of Neurology, Yokohama City University School of Medicine, Japan.
No To Shinkei. 1995 Dec;47(12):1179-82.
We investigated the relationship between blood levels of HbA1, an indicator of diabetic control, and the polyneuropathy index (PNI), an indicator of diabetic polyneuropathy. A total of 175 patients with non-insulin-dependent diabetes mellitus were followed for more than 3 years and were subjected to a series of motor conduction studies every 1 to 3 years. The PNI was calculated as a mean percentage of normal values for 12 indices derived from the conduction velocity and long-distance latency in motor conduction studies of 4 nerves. The mean follow-up period was 5.0 years, and during that time the mean decrease in the PNI was 2.7%. There was a significant negative correlation between mean HbA1 levels (X) and the percent changes in PNI per year (Y), and the equation for the regression line was Y = -0.102X + 0.37 (r = 0.283, p < 0.001). The higher the HbA1 level during this period, the larger the decline in PNI was. In patients with low initial PNI levels the change in PNI tended to be small in spite of high HbA1 levels. Likewise, in patients with high initial PNI levels the decrease in PNI tended to be large despite relatively good control of their HbA1 levels. However, since there were many patients whose HbA1 levels were not correlated with the reduction in PNI, there may be some unknown factors, possibly genetic, that play a role in the progression of polyneuropathy in diabetic patients.
我们研究了糖尿病控制指标糖化血红蛋白（HbA1）的血液水平与糖尿病性多发性神经病变指标多发性神经病变指数（PNI）之间的关系。共有175例非胰岛素依赖型糖尿病患者接受了3年以上的随访，并每1至3年进行一系列运动传导研究。PNI的计算方法是，取4条神经运动传导研究中传导速度和长距离潜伏期得出的12项指标的正常值平均百分比。平均随访期为5.0年，在此期间PNI的平均下降率为2.7%。平均HbA1水平（X）与每年PNI的百分比变化（Y）之间存在显著负相关，回归线方程为Y = -0.102X + 0.37（r = 0.283，p < 0.001）。在此期间HbA1水平越高，PNI的下降幅度越大。初始PNI水平较低的患者，尽管HbA1水平较高，PNI的变化往往较小。同样，初始PNI水平较高的患者，尽管HbA1水平控制相对较好，PNI的下降幅度往往较大。然而，由于有许多患者的HbA1水平与PNI的降低无关，可能存在一些未知因素，可能是遗传因素，在糖尿病患者多发性神经病变的进展中起作用。
