Diabetic neuropathy as a heterogeneous syndrome: multivariate analysis of clinical and neurological findings

Sasaki, Hideyuki; Nanjo, Kishio; Yamada, Machi; Naka, Keigo; Bessho, H; Kikuoka, Hiroyoshi; Satogami, Eiichi; Matsumoto, Gensaku; Emoto, Masanao; Miyamura, Kei

doi:10.1016/s0168-8227(88)80021-4

Cited by 15 publications

(9 citation statements)

References 11 publications

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“…Some previous studies reported that MCV slowing in the upper limbs was similar to that in the lower limbs of diabetic patients. 25,26 In addition, the skin temperature and humidity easily affect the sensory nerve conduction velocity at the time of measurement, so it is often impossible to measure. Mizumoto et al 27 reported that they chose instead to look at the distal motor latency and MCV because the sensory nerve conduction velocity was not measurable in many hands and therefore appeared to be an unsuitable parameter.…”

Section: Discussionmentioning

confidence: 99%

Sonographic Evaluation of the Median Nerve in Diabetic Patients

Watanabe

Ito

Morita

et al. 2009

Journal of Ultrasound in Medicine

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Objective. Diabetes mellitus is becoming a major cause of premature disability in Japan, and peripheral neuropathy is a common complication of diabetes. The aim of this study was to evaluate the relationship between the results of nerve conduction studies (NCS) and the size of the nerve determined by sonography in diabetic patients. Methods. Twenty diabetic patients (mean age ± SD, 57.1 ± 13.6 years) and 20 healthy volunteers (mean, 61.1 ± 8.9 years) were enrolled in this study. Patients' wrists that had symptoms of carpal tunnel syndrome were not included in the study; those that were included had negative Phalen test results. We then divided the patients into 2 groups (patients with and without diabetic symmetric polyneuropathy [DPN]). The cross‐sectional area (CSA) was measured in the carpal tunnel 5 cm proximal to the wrist and elbow joint of the median nerve. Results. There was a significant increase in the CSA in patients with DPN in the carpal tunnel compared with the control participants (P < .01) and patients without DPN (P < .01). The CSA in the carpal tunnel showed a significant correlation with the motor nerve conduction velocity (r = −0.473). Conclusions. The CSA of the median nerve in the carpal tunnel of patients with DPN is greater than that in patients without DPN and healthy individuals and correlates with NCS.

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Section: Discussionmentioning

confidence: 99%

Sonographic Evaluation of the Median Nerve in Diabetic Patients

Watanabe

Ito

Morita

et al. 2009

Journal of Ultrasound in Medicine

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“…Because nerve conduction data (MCV, SCV, CMAP, and SNAP) and vibratory thresholds (QVT) were distributed normally, values exceeding the range of means ± 2 SD of the healthy subjects in our institute (4) were judged as impaired. CV-DB results that were converted into logarithms were distributed normally, and data that were more than the means −2 SD of logarithms of healthy subjects (5) was considered impaired.…”

Section: Methodsmentioning

confidence: 99%

Truncal Pruritus of Unknown Origin May Be a Symptom of Diabetic Polyneuropathy

et al. 2010

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OBJECTIVEOur goal was to ascertain the prevalence of pruritus in diabetic and nondiabetic subjects and the relevance of symptoms, signs, and nerve functions of diabetic polyneuropathy (DPN) of pruritus.RESEARCH DESIGN AND METHODSA large-scale survey of 2,656 diabetic outpatients and 499 nondiabetic subjects was performed. In diabetic subjects, the relationship between pruritus and age, sex, diabetic duration, A1C, Achilles tendon reflex (ATR), and abnormal sensation in legs was evaluated. In 105 diabetic subjects, nerve conduction studies, quantitative vibratory threshold (QVT), heart rate variability, and a fall of systolic blood pressure at a head-up tilt test (ΔBP) were performed, and the relationships between pruritus and nerve functions were evaluated.RESULTSAlthough the prevalence of truncal pruritus of unknown origin (TPUO) in diabetic subjects was significantly higher than that in age-matched nondiabetic subjects (11.3 vs. 2.9%, P = 0.0001), the prevalence of other pruritus was not different between the two groups. Multiple logistic regression analysis revealed that abnormal sensation and ATR areflexia were independent risk factors for TPUO in age, sex, duration of diabetes, and A1C. ΔBP in diabetic subjects with TPUO was significantly impaired compared with that in those without TPUO. Larger ΔBP was identified as a significant risk factor of TPUO independent of other nerve dysfunctions by multiple logistic regression analysis.CONCLUSIONSTPUO is significantly more frequent in diabetic than in nondiabetic individuals. TPUO is significantly associated with symptoms and signs of DPN, including impaired blood pressure response in a head-up tilt test. TPUO, therefore, might be a newly recognized symptom of DPN.

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“…Higher VPT values have been demonstrated to associate with DM retinopathy [13,14], proteinuria [14] and ischemic change of electrocardiogram [14]. It is also a predictor of foot ulceration in DM subjects [15].…”

Section: Introductionmentioning

confidence: 98%

Quantitative Vibration Perception Thresholds in Normal and Diabetic Chinese: Influence of Age, Height and Body Mass Index

Hwu

Chang²,

Chen

et al. 2002

Neuroepidemiology

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In this study, we established normality data of vibration perception thresholds (VPT) in a Chinese population. Over 1,400 healthy subjects were recruited to create age-related centile charts of VPT after pretesting for reliability. Another 273 diabetic (DM) patients were recruited to assess the impact of age, height and body mass index (BMI) on VPT values in DM and non-DM subjects. The present study is the first one which reports normality data of VPT from a large Chinese population. The VPT values were higher in male and female DM patients than in the non-DM counterparts. Age significantly contributed to the variance of VPT in both DM and non-DM subjects. Height was positively associated with VPT in men, so was BMI in non-DM subjects with much smaller magnitudes of effect than for age.

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Diabetic neuropathy as a heterogeneous syndrome: multivariate analysis of clinical and neurological findings

Cited by 15 publications

References 11 publications

Sonographic Evaluation of the Median Nerve in Diabetic Patients

Sonographic Evaluation of the Median Nerve in Diabetic Patients

Truncal Pruritus of Unknown Origin May Be a Symptom of Diabetic Polyneuropathy

Quantitative Vibration Perception Thresholds in Normal and Diabetic Chinese: Influence of Age, Height and Body Mass Index

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