SENSORY NEUROPATHY IN NON-INSULIN-DEPENDENT DIABETES-MELLITUS - THE SAN-LUIS VALLEY DIABETES STUDY
SENSORY NEUROPATHY IN NON-INSULIN-DEPENDENT DIABETES-MELLITUS - THE SAN-LUIS VALLEY DIABETES STUDY
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DOI：
10.1093/oxfordjournals.aje.a115547
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发表时间：
1990-04-01
影响因子：
5
通讯作者：
HAMMAN, RF
中科院分区：
文献类型：
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作者：
FRANKLIN, GM;KAHN, LB;HAMMAN, RF
描述和验证了1984-1986年间在科罗拉多州圣路易斯谷进行的一项大规模人群非胰岛素依赖型糖尿病研究中的筛查神经学检查，该检查能够发现远端对称性(感觉性)神经病变。这项检查在279名糖尿病患者和577名对照中完成，与对38名患者进行的标准神经学检查有90%的符合率。神经病变状态的独立验证通过Optakon触觉(振动)刺激器获得。平均年龄调整后的振动阈值在有神经病变的人中显著高于没有神经病变的人。在检测神经病变方面，最敏感的是神经病变症状阳性史和两个脚踝深肌腱反射减少或缺失的联合检查。对照组、糖耐量低减患者和糖尿病患者的年龄调整神经病患病率分别为3.9%、11.2%和25.8%。与糖耐量正常者相比，糖耐量受损和糖尿病患者出现神经病变的患病率优势比分别为3.5和10.6。神经病变与年龄、糖尿病病程、男性和血糖控制显著相关，但与盎格鲁/西班牙裔状态无关。
A screening neurologic examination capable of detecting distal symmetric (sensory) neuropathy in a large population-based study of non-insulin-dependent diabetes mellitus in San Luis Valley, Colorado, in 1984-1986 is described and validated. The examination, completed in 279 diabetics and 577 controls, had 90% agreement with a standard neruologic examination completed on a subsample of 38 patients. Independent validation of neuropathy status was obtained with the Optacon tactile (vibration) stimulator. Mean, age-adjusted vibration threshold was significantly greater in those with neuropathy than in those without. The subtests of the examination most sensitive in detecting neuropathy were a combination of a positive history of neuropathy symptoms and decreased or absent deep tendon reflexes in both ankles. Age-adjusted prevalence of neuropathy in controls, those with impaired glucose tolerance, and diabetics was 3.9%, 11.2%, and 25.8%, respectively. Prevalence odds ratios were 3.5 and 10.6 for the presence of neuropathy in persons with impaired glucose tolerance and diabetes, respectively, compared with personss with normal glucose tolerance. Neuropathy was significantly associated with age, duration of diabetes, male sex, and glycemic control, but not with Anglo/Hispanic status.