评估 1 型糖尿病的神经病变亚型。

IF 3.7 2区 医学 Q2 ENDOCRINOLOGY & METABOLISM
Pall Karlsson, Marie Balle Sjogaard, Karoline Schousboe, Hatice Isik Mizrak, Huda Kufaishi, Troels Staehelin Jensen, Jens Randel Nyengaard, Christian Stevns Hansen, Knud Bonnet Yderstræde, Christian Selmer Buhl
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引用次数: 0

摘要

简介糖尿病多发性神经病变(DPN)是糖尿病的一种常见并发症,可表现为小纤维神经病变、大纤维神经病变或混合纤维神经病变(分别为 SFN、LFN 和 MFN),具体取决于受累纤维的类型。尽管有证据表明,在 1 型糖尿病(T1DM)相关的 DPN 中,小纤维受累先于大纤维受累,但还没有证据表明哪种亚型更普遍。我们旨在确定在 T1DM 相关 DPN 中更常见的神经纤维损伤类型--SFN、LFN 和 MFN,包括有疼痛和无疼痛:在这项横断面研究中,参与者(n=216)被分为对照组、T1DM、T1DM伴非疼痛性DPN(NP-DPN)和T1DM伴疼痛性DPN(P-DPN)。根据神经病变的严重程度对 DPN 进一步分组。通过小纤维和大纤维特异性测试以及三种诊断模型:模型 1(≥1 次异常测试)、模型 2(≥2 次异常测试)和模型 3(≥3 次异常测试),确定了更普遍的纤维损伤类型:MFN在T1DM相关DPN中发病率最高。神经病变亚型在 NP-DPN 和 P-DPN 之间无差异。在模型 2 和模型 3 之间,DPN 和 SFN 的患病率处于高位。所有模型均显示,MFN的患病率随DPN严重程度的增加而增加。模型 3 显示,在早期神经病变中,DPN 的 LFN 患病率增加。DPN与普遍的SFN表现出相似的模式,但并不显著:结论:DPN 在 T1DM 中主要表现为 MFN,在 NP-DPN 和 P-DPN 之间没有区别。此外,我们建议将模型 2 作为诊断 T1DM 中较常见的 SFN 亚型 DPN 的初步标准。最后,研究表明,在轻度 DPN 阶段,一种类型的神经纤维(小或大)更容易受到损伤。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Assessment of neuropathy subtypes in type 1 diabetes.

Introduction: Diabetic polyneuropathy (DPN), a common complication of diabetes, can manifest as small, large, or mixed fiber neuropathy (SFN, LFN, and MFN, respectively), depending on the type of fibers involved. Despite evidence indicating small fiber involvement prior to large fiber involvement in type 1 diabetes mellitus (T1DM)-associated DPN, no evidence has been produced to determine the more prevalent subtype. We aim to determine the more prevalent type of nerve fiber damage-SFN, LFN, and MFN-in T1DM-associated DPN, both with and without pain.

Research design and methods: In this cross-sectional study, participants (n=216) were divided into controls; T1DM; T1DM with non-painful DPN (NP-DPN); and T1DM with painful DPN (P-DPN). DPN was further subgrouped based on neuropathy severity. The more prevalent type of fiber damage was determined applying small and large fiber-specific tests and three diagnostic models: model 1 (≥1 abnormal test); model 2 (≥2 abnormal tests); and model 3 (≥3 abnormal tests).

Results: MFN showed the highest prevalence in T1DM-associated DPN. No differences in neuropathy subtype were found between NP-DPN and P-DPN. DPN, with prevalent SFN plateaus between models 2 and 3. All models showed increased prevalence of MFN according to DPN severity. Model 3 showed increased DPN with prevalent LFN in early neuropathy. DPN with prevalent SFN demonstrated a similar, but non-significant pattern.

Conclusions: DPN primarily manifests as MFN in T1DM, with no differentiation between NP-DPN and P-DPN. Additionally, we propose model 2 as an initial criterion for diagnosing DPN with a more prevalent SFN subtype in T1DM. Lastly, the study suggests that in mild stages of DPN, one type of nerve fiber (either small or large) is more susceptible to damage.

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来源期刊
BMJ Open Diabetes Research & Care
BMJ Open Diabetes Research & Care Medicine-Endocrinology, Diabetes and Metabolism
CiteScore
9.30
自引率
2.40%
发文量
123
审稿时长
18 weeks
期刊介绍: BMJ Open Diabetes Research & Care is an open access journal committed to publishing high-quality, basic and clinical research articles regarding type 1 and type 2 diabetes, and associated complications. Only original content will be accepted, and submissions are subject to rigorous peer review to ensure the publication of high-quality — and evidence-based — original research articles.
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