Albers J W, Brown M B, Sima A A, Greene D A
Department of Biostatistics, University of Michigan Medical Center, Ann Arbor 48109-0316, USA.
Neurology. 1996 Jan;46(1):85-91. doi: 10.1212/wnl.46.1.85.
We evaluated nerve conduction measures at baseline from 429 patients enrolled in a multicenter diabetic neuropathy study. We defined neuropathy by using recently proposed recommendations but included only patients who had measurable sural and peroneal responses and quantitative vibration thresholds. Patients with type II diabetes were older than type I patients (54.5 versus 39.1 years), were heavier (body mass index [BMI] of 30.9 versus 25.5 kg/m2, and in general had lower evoked amplitudes. The effects of diabetes type upon nerve conduction measures disappeared when age and BMI were included in regression models. The men had lower amplitudes and conduction velocities and longer latencies than the women. The effect of gender was greatly reduced when height was included in the regression models, but gender continued to be a significant predictor of median sensory amplitude, most conduction velocities, and most latencies in these models. The relationships between nerve conduction measures and age, sex, and anthropometric factors were similar for patients with type II, but not those with type I, diabetes to the relationships reported for normal subjects. This may be a result of greater homogeneity with respect to degree of neuropathy for type II patients than for type I patients. These findings are important in designing and interpreting clinical studies of diabetic neuropathy.
我们评估了429名参与多中心糖尿病神经病变研究的患者在基线时的神经传导指标。我们采用最近提出的建议来定义神经病变,但仅纳入了那些有可测量的腓肠神经和腓神经反应以及定量振动阈值的患者。II型糖尿病患者比I型患者年龄更大(分别为54.5岁和39.1岁),体重更重(体重指数[BMI]分别为30.9和25.5kg/m²),并且一般诱发波幅更低。当年龄和BMI纳入回归模型时,糖尿病类型对神经传导指标的影响消失。男性的波幅、传导速度更低,潜伏期更长。当身高纳入回归模型时,性别的影响大幅降低,但在这些模型中,性别仍然是正中神经感觉波幅、大多数传导速度和大多数潜伏期的显著预测因素。对于II型糖尿病患者,神经传导指标与年龄、性别和人体测量学因素之间的关系与正常受试者报告的关系相似,但I型糖尿病患者并非如此。这可能是因为II型患者神经病变程度的同质性高于I型患者。这些发现对于设计和解释糖尿病神经病变的临床研究很重要。