Comparison of conventional and non-invasive techniques for the early identification of diabetic neuropathy in children and adolescents with type 1 diabetes
Comparison of conventional and non-invasive techniques for the early identification of diabetic neuropathy in children and adolescents with type 1 diabetes
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DOI：
10.1111/j.1399-5448.2006.00208.x
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发表时间：
2006-12-01
影响因子：
3.4
通讯作者：
Pacaud, Daniele
中科院分区：
文献类型：
--
作者：
Nelson, Danielle;Mah, Jean K.;Pacaud, Daniele
背景：神经病变是一种重要的并发症，导致糖尿病的发病率增加。用于筛查糖尿病儿童早期糖尿病神经病变（DN）的简单和非侵入性测试的可用性可能会防止这种并发症的进一步发展。本研究的目的是比较传统神经传导研究 (NCS) 与非侵入性技术，包括振动知觉阈值 (VPT) 和触觉知觉阈值 (TPT)，用于检测患有 1 型糖尿病的儿童和青少年的 DN。方法：对阿尔伯塔省儿童医院糖尿病诊所患有至少 5 年 1 型糖尿病病程的儿童进行详细评估，包括神经系统检查、NCS、VPT 和 TPT 测试。还收集了有关糖尿病病程、身高和平均糖化血红蛋白 (A1C) 的信息。使用描述性统计数据（包括学生 t 检验和卡方检验）进行分析。结果：73 名儿童（平均年龄 13.7 +/- 2.6 岁）完成了研究。糖尿病平均病程为 8.1 +/- 2.6 年，平均 A1C 为 9.0 +/- 1.0%。根据 NCS，四十二名 (57%) 儿童患有 DN。以NCS为金标准，VPT的敏感性和特异性分别为62%和65%，而TPT的敏感性和特异性分别为19%和64%。结论：亚临床DN在1型糖尿病儿童和青少年中常见，该人群需要更好的代谢控制。 VPT 和 TPT 可能不足以作为儿童 DN 检测的筛查工具。
Background: Neuropathy is an important complication and contributes to the morbidity of diabetes mellitus. The availability of simple and non-invasive tests for screening of early diabetic neuropathy (DN) in children with diabetes may prevent further progression of this complication. The purpose of this study was to compare conventional nerve conduction studies (NCS) with non-invasive techniques, including vibration perception thresholds (VPT) and tactile perception thresholds (TPT) for the detection of DN in children and adolescents with type 1 diabetes.Methods: Children from the Alberta Children's Hospital Diabetes Clinic with at least 5 yr duration of type 1 diabetes underwent detailed evaluations, including neurologic exam, NCS, VPT, and TPT testing. Information on duration of diabetes, height, and mean glycosylated hemoglobin (A1C) were also collected. Descriptive statistics, including Student's t-test and chi-squared test, were used for analysis.Results: Seventy-three children (mean age of 13.7 +/- 2.6 yr) completed the study. The mean duration of diabetes was 8.1 +/- 2.6 yr, and the mean A1C was 9.0 +/- 1.0%. Forty-two (57%) children had DN based on NCS. Using NCS as a gold standard, the sensitivity and specificity of VPT were 62 and 65%, while the sensitivity and specificity of TPT were 19 and 64%, respectively.Conclusions: Subclinical DN is common among children and adolescents with type 1 diabetes, and there is a need for better metabolic control in this population. VPT and TPT may not be adequate screening tools for the detection of DN in children.