A MULTICENTER STUDY OF THE PREVALENCE OF DIABETIC PERIPHERAL NEUROPATHY IN THE UNITED-KINGDOM HOSPITAL CLINIC POPULATION
A MULTICENTER STUDY OF THE PREVALENCE OF DIABETIC PERIPHERAL NEUROPATHY IN THE UNITED-KINGDOM HOSPITAL CLINIC POPULATION
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DOI：
10.1007/bf00400697
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发表时间：
1993-02-01
期刊：
影响因子：
8.2
通讯作者：
SONKSEN, PH
中科院分区：
文献类型：
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作者：
YOUNG, MJ;BOULTON, AJM;SONKSEN, PH
使用标准化问卷和检查对随机选择的糖尿病患者进行了一项横断面多中心研究，以确定在英国118家医院糖尿病诊所就诊的患者周围神经病变的患病率。在两个中心进行振动感知阈值测试，并与临床评分系统进行比较。共研究了6487例糖尿病患者，53.9%为男性，中位年龄59岁（范围18 - 90岁），37.4%为1型（胰岛素依赖型）糖尿病，糖尿病中位病程8年（0 - 62年）。该人群神经病变的总体患病率为28.5%（27.4 - 29.6%）（95%置信区间）。1型糖尿病患者的患病率为22.7%（21.0 - 24.4%），2型（非胰岛素依赖型）糖尿病患者的患病率为32.1%（30.6 - 33.6%）。糖尿病周围神经病变的患病率随着年龄的增长而增加，从20 - 29岁年龄组的5%（3.1 - 6.9%）增加到70 - 79岁年龄组的44.2%（41.1 - 47.3%）。神经病变与糖尿病病程相关，糖尿病病程小于5年的患者中有20.8%（19.1 - 22.5%），糖尿病病程大于10年的患者中有36.8%（34.9 - 38.7%）。在大脚趾处测量的平均振动感知阈值为21.1 +/-13.5 SD伏，并且与神经病残疾评分相关，r = 0.8 p <0.001。总之，糖尿病周围神经病变是一种常见的并发症与糖尿病。它随着年龄和糖尿病持续时间的增加而增加，直到超过50%的60岁以上的2型糖尿病患者中存在。提高对周围神经病变高患病率的认识，特别是在老年患者中，应改善筛查方案，以降低神经性糖尿病足溃疡的高发病率。
A cross-sectional multicentre study of randomly selected diabetic patients was performed using a standardised questionnaire and examination, to establish the prevalence of peripheral neuropathy in patients attending 118 hospital diabetes clinics in the UK. Vibration perception threshold was performed in two centres to compare with the clinical scoring systems. A total of 6487 diabetic patients were studied, 53.9 % male, median age 59 years (range 18-90 years), 37.4 % Type 1 (insulin-dependent) diabetes mellitus, with a median duration of diabetes 8 years (0-62 years). The overall prevalence of neuropathy was 28.5 % (27.4-29.6 %) (95 % confidence interval) in this population. The prevalence in Type 1 diabetic patients was 22.7 % (21.0-24.4 %) and in Type 2 (non-insulin-dependent) diabetic patients it was 32.1 % (30.6-33.6 %). The prevalence of diabetic peripheral neuropathy increased with age, from 5 % (3.1-6.9 %) in the 20-29 year age group to 44.2 % (41.1-47.3 %) in the 70-79 year age group. Neuropathy was associated with duration of diabetes, and was present in 20.8 % (19.1-22.5 %) of patients with diabetes duration less than 5 years and in 36.8 % (34.9-38.7 %) of those with diabetes duration greater than 10 years. Mean vibration perception threshold measured at the great toe was 21.1 +/- 13.5 SD volts and correlated with the neuropathy disability score, r = 0.8 p < 0.001. In conclusion, diabetic peripheral neuropathy is a common complication associated with diabetes. It increases with both age and duration of diabetes, until it is present in more than 50 % of Type 2 diabetic patients aged over 60 years. An increased awareness of the high prevalence of peripheral neuropathy, especially in older patients, should result in improved screening programmes in order to reduce the high incidence of neuropathic diabetic foot ulceration.