Difficulties in screening for peripheral neuropathies in children with diabetes
Difficulties in screening for peripheral neuropathies in children with diabetes
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DOI：
10.1111/dme.12684
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发表时间：
2015-06-01
影响因子：
3.5
通讯作者：
Zernikow, B.
中科院分区：
文献类型：
--
作者：
Hirschfeld, G.;von Glischinski, M.;Zernikow, B.
目的评估一种新型的缩短单丝试验与音叉试验在检测儿童糖尿病周围神经病变中的诊断价值。方法采用单丝试验和音叉法对88例1型糖尿病患儿进行糖尿病周围神经病变筛查。神经传导研究按照神经病变的金标准进行。我们评估了两种筛查方法的诊断效用和内部一致性。结果6 ~ 18岁儿童43例（49%）至少有一次神经传导异常。两种筛查方法的诊断效用和评价一致性都很低。单丝试验的敏感性为18%，特异性为80%。音叉的灵敏度为0%，特异性为98%。结论简略单丝试验对早期糖尿病周围神经病变的诊断价值较低，可靠性较低。为了改善儿童和青少年糖尿病管理的筛查程序，需要更彻底地解决可靠性问题。
AimsTo assess the diagnostic utility of a novel abbreviated monofilament test in comparison with the tuning fork test to detect diabetic peripheral neuropathy in children.MethodsA total of 88 children with Type 1 diabetes mellitus were screened for diabetic peripheral neuropathy using the monofilament test and the tuning fork. Nerve conduction studies were performed according to the gold standard' for neuropathy. We assessed the diagnostic utility and inter-rater agreement of the two screening methods.ResultsA total of 43 (49%) children (aged 6-18years) had at least one abnormal nerve conduction study result. Diagnostic utility and inter-rater agreement were very low for both screening methods. The monofilament test yielded a sensitivity of 18% and a specificity of 80%. The tuning fork yielded a sensitivity of 0% and a specificity of 98%.ConclusionThe present study found that an abbreviated monofilament test has low diagnostic utility for the detection of early diabetic peripheral neuropathy because of its low reliability. The problem of reliability needs to be more thoroughly addressed in order to improve the screening procedures in diabetes management in childhood and adolescence.