The prevalence of clinical diabetic polyneuropathy in Spain: a study in primary care and hospital clinic groups
The prevalence of clinical diabetic polyneuropathy in Spain: a study in primary care and hospital clinic groups
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DOI：
10.1007/s001250051063
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发表时间：
1998-11-01
期刊：
影响因子：
8.2
通讯作者：
Cabezas-Cerrato, J
中科院分区：
文献类型：
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作者：
Cabezas-Cerrato, J
临床糖尿病多发神经病变（DPN）的多区域横断面研究在西班牙糖尿病患者中进行，使用标准系统评分多发神经病变的症状和体征。主要患者样本包括2644例患者（54.7%为女性），年龄15-74岁（平均57.2 +/- 0.3岁），其中86.9%患有II型（非胰岛素依赖型）糖尿病，29.4%在医院就诊。自诊断以来糖尿病的平均病程为10.2 +/- 0.2年。整个样本中DPN患病率为22.7%(95%置信区间为21.2-24.3%)，I型（胰岛素依赖）糖尿病患者患病率为12.9% (9.3-16.5%)，II型糖尿病患者患病率为24.1% (22.4-25.9%)；男性和女性的患病率没有显著差异。患病率随年龄（15- 19岁年龄组< 5%，70- 74岁组29.5%）和诊断后糖尿病病程（病程< 5年者14.2%，病程> 30年者44.2%）而增加。在补充样本中，年龄在75 - 79岁之间的161例糖尿病患者（为了防止混淆糖尿病引起的和衰老引起的神经病变，从主要样本中排除）患病率为37.8%。93例患者（3.3%）患有或曾经患有足部溃疡，其中21例（0.7%）截肢；90.8%的溃疡患者患有II型糖尿病，54%的患者患有DPN（在大多数情况下失去振动感知），而在没有溃疡的患者中DPN的患病率为19.9%。我们得出的结论是，近四分之一的西班牙糖尿病患者患有DPN；超过90.8%的DPN患者患有II型糖尿病；DPN的患病率随着年龄的增长和病程的延长而增加，DPN患者足部溃疡的风险大约是无DPN的糖尿病患者的三倍。因此，我们强调初级保健医生有责任通过早期诊断DPN来预防糖尿病足病变。
A multiregional cross-sectional study of clinical diabetic polyneuropathy (DPN) was carried out among Spanish diabetes patients using a standard system for scoring symptoms and signs of polyneuropathy. The main patient sample comprised 2644 patients (54.7% women) aged 15-74 years (mean 57.2 +/- 0.3 years), 86.9% of whom had Type II (noninsulin-dependent) diabetes mellitus and 29.4% were attending hospital clinics. Mean duration of diabetes since diagnosis was 10.2 +/- 0.2 years. The prevalence of DPN was 22.7% (95% confidence interval 21.2-24.3%) in the whole sample, 12.9% (9.3-16.5%) among patients with Type I (insulin-dependent) diabetes mellitus and 24.1% (22.4-25.9%) among patients with Type II diabetes; there was no significant difference in prevalence between men and women. Prevalence increased with age (from < 5% in the 15- to 19-year-old age group to 29.5% in the 70- to 74-year-old group) and with duration of diabetes since diagnosis (from 14.2% among those with duration < 5 years to 44.2% among those with duration > 30 years). In a supplementary sample of 161 diabetic patients aged 75 to 79 years (excluded from the main sample to prevent confusion between diabetes-induced and ageing-induced neuropathies), prevalence was 37.8%. Ninety-three patients (3.3%) had or had had foot ulcers and 21 of these 93 (0.7%) had undergone amputation; 90.8% of ulcerated patients had Type II diabetes, and 54% had DPN (in most cases with loss of perception of vibration), as against a prevalence of DPN of 19.9% among patients without ulcers. We conclude that nearly a quarter of Spanish diabetic patients have DPN; that over 90.8% of DPN patients have Type II diabetes; that the prevalence of DPN increases with age and with the duration of the disease, and that the risk of foot ulcers among DPN patients is about three times the risk among diabetic patients without DPN. We accordingly emphasize the responsibility of primary care physicians to try to prevent diabetic foot lesions by early diagnosis of DPN.