Sweat gland nerve fiber density and association with sudomotor function, symptoms, and risk factors in adolescents with type 1 diabetes.
Sweat gland nerve fiber density and association with sudomotor function, symptoms, and risk factors in adolescents with type 1 diabetes.
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DOI：
10.1007/s10286-023-00973-7
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发表时间：
2023-12
影响因子：
5.8
通讯作者：
Singer, Wolfgang
中科院分区：
文献类型：
--
作者：
Rasmussen, Vinni Faber;Schmeichel, Ann;Thrysoe, Mathilde;Nyengaard, Jens Randel;Christensen, Ann-Margrethe Ronholt;Vestergaard, Esben Thyssen;Kristensen, Kurt;Terkelsen, Astrid Juhl;Karlsson, Pall;Singer, Wolfgang
关键词：
量化糖尿病青少年的汗腺神经纤维密度。此外，研究汗腺运动神经支配、出汗反应以及汗腺运动神经病变可能的危险因素之间的关联。
这是一项横断面研究，纳入了60名1型糖尿病病程>5年的青少年和23名对照受试者。获取了临床数据、定量汗腺轴突反射试验结果以及皮肤活检样本。对皮肤组织进行免疫染色，并通过共聚焦显微镜成像。使用无设计偏差的技术对汗腺体积进行量化以及对神经纤维进行三维重建。
与对照组相比，糖尿病青少年汗腺中神经纤维长度的最大值和平均值以及神经纤维密度均显著降低（p值<0.05）。未发现神经纤维密度与出汗反应之间存在关联（p = 0.21）。在汗腺神经纤维长度、神经纤维密度和体积降低的病例中，出汗反应减弱或缺失。身高、收缩压、低血糖时间以及每日总胰岛素剂量和基础/总胰岛素剂量与出汗反应呈正相关，而低密度脂蛋白和糖化血红蛋白与出汗反应呈负相关（p值<0.05）。其他微血管并发症和高胆固醇水平增加了汗腺神经纤维密度降低的相对风险。
我们对一组选定的青少年中汗腺神经支配减少的研究结果，为糖尿病导致的自主神经结构变化增添了新的知识。评估汗腺神经支配和汗腺体积对于理解与出汗反应的关联非常重要。需要进一步的研究来了解其临床相关性。
网络版包含补充材料，可在10.1007/s10286 - 023 - 00973 - 7获取。
To quantify sweat gland nerve fiber density in adolescents with diabetes. Additionally, to investigate associations between sudomotor innervation, sweat responses, and possible risk factors for sudomotor neuropathy. Cross-sectional study where 60 adolescents with type 1 diabetes (duration > 5 years) and 23 control subjects were included. Clinical data, quantitative sudomotor axon reflex test, and skin biopsies were obtained. Skin tissue was immunostained and imaged by confocal microscopy. Quantification of the sweat gland volume and three-dimensional reconstruction of the nerve fibers was performed using a design-unbiased technique. Adolescents with diabetes had a significant reduction of maximum and mean values of nerve fiber length and nerve fiber density in sweat glands compared to controls (p values < 0.05). No association between nerve fiber density and sweat responses was found (p = 0.21). In cases with reduced sweat gland nerve fiber length, nerve fiber density, and volume, the sweat response was reduced or absent. Height, systolic blood pressure, time in hypoglycemia, and total daily and basal/total insulin dose were positively correlated to sweat response, while low-density lipoprotein, and HbA1c were negatively correlated with sweat response (p values < 0.05). Other microvascular complications and high cholesterol levels increased the relative risk for reduced sweat gland nerve fiber density. Our findings of reduced sweat gland innervation in a selected group of adolescents add new knowledge about the structural changes that occur in autonomic nerves due to diabetes. Evaluating both the sweat gland innervation and sweat gland volume was important for understanding the association with sweat responses. Further research is needed to understand its clinical relevance. The online version contains supplementary material available at 10.1007/s10286-023-00973-7.
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