Association between Pulse Wave Velocity and Nerve Conduction Study in Diabetic Patients

Abstract

Background/Aims: Brachial-ankle pulse wave velocity (baPWV) is a marker of vascular stiffness and is reported to be associated with diabetic neuropathy; however, the relationship between baPWV and nerve conduction study (NCS) has yet to be examined. Methods: Between January 2006 and December 2008, we investigated this relationship in diabetic patients. To this end, we reviewed the medical records of 100 diabetic patients for whom both baPWV and NCS had been examined. Results: The mean age of patients was 55.4 ± 10.6 years, and the mean duration of diabetes mellitus was 6.3 ± 7.3 years. A statistically significant inverse correlation between baPWV and NCS was observed, especially in the lower extremity sensory NCS [superficial peroneal sensory nerve action potential (SNAP), r = –0.466, p <0.05; sural SNAP, r = –0.384, p <0.01]. A multiple linear regression analysis also demonstrated a significant association between baPWV and some parameters of NCS (SNAP of sural nerve, and nerve conduction velocity of peroneal and sural nerves). Conclusion: These results indicate that the degree of systemic arterial stiffness is associated with peripheral nerve status in diabetic patients, but it is unclear what this signifies and further study is needed.

Arterial stiffness in diabetes mellitus

“…In a study of 692 type 2 DM, Ha et al showed that PWV was significantly correlated with peripheral neuropathy as determined with monofilament testing [59]. Other studies that have directly measured nerve conduction have found similar results [60]. Yokoyama et al assessed diabetic neuropathy as determined by presence of symptoms, absent ankle reflexes, HR variability, and vibratory perception.…”

Arterial stiffness is elevated in normotensive type 2 diabetic patients with peripheral neuropathy

“…Similarly, in our population of type 2 diabetic patients, PN was associated with hypertension. PN has also previously been reported to be associated with elevated arterial stiffening [14][15][16][17][18]. In a previous work, we looked at total arterial compliance -the opposite of stiffness -in type 2 diabetic patients over 50 years of age [17].…”

“…While PWV is an independent risk factor, it is also strongly related to age and hypertension [4]. Elevated arterial stiffness has also been specifically related to diabetic retinopathy [11,12], diabetic nephropathy [13], peripheral neuropathy [14][15][16][17][18] and cardiac autonomic neuropathy [19,20]. However the cause and effect relationship between macro and micro-circulation changes is difficult to untangle especially as they share common link with hypertension.…”

“…It highlights that increased aortic stiffness could potentially lead to hypertension. In normotensive diabetic patients, PN might contribute to alter arterial stiffness and peripheral resistance by promoting medial arterial calcification, altering vessel tone and vasomotion [18,51] and might lead later to hypertension. A longitudinal follow-up of these patients is required to evaluate the pathophysiological progression of the damage to macro and microvasculature.…”

Nerve conduction velocity is negatively associated with intima-media thickness and brachial-ankle pulse wave velocity in men with type 2 diabetes mellitus

“…Nerve conduction velocity (NCV) is usually performed to detect neuron function in clinical settings, and it is a useful quantitative method for assessing severity of DPN [19,20]. However, thus far, there are few studies using NCV examination on the association between DPN and arterial stiffness [21,22]. Therefore, to investigate the relationship between NCV and parameters of atherosclerosis, we conducted a cross-sectional study in patients with T2DM.…”