1型糖尿病青少年的神经病变:确认性诊断测试,床边测试和危险因素
Vinni Faber Rasmussen1, Mathilde Thrysøe2, Jens Randel Nyengaard3
1Danish Pain Research Center, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark; Steno Diabetes Center Aarhus, Aarhus University Hospital, Denmark; Department of Pediatrics and Adolescent Medicine, Randers Regional Hospital, Randers, Denmark.
Diabetes research and clinical practice
|June 5, 2023
概括
糖尿病神经病变,包括大纤维 (LFN) 和小纤维 (SFN) 类型,存在于患有1型糖尿病的青少年中. 早期查和风险因素管理对于预防至关重要.
科学领域:
- 神经学 神经学
- 内分泌学 在内分泌学.
- 糖尿病学 糖尿病学
背景情况:
- 1型糖尿病 (T1D) 影响青少年,可能导致神经病变等长期并发症.
- 糖尿病青少年的神经病变需要准确的流行率估计和风险因素识别.
研究的目的:
- 确定大纤维神经病变 (LFN),小纤维神经病变 (SFN) 和T1D青少年自主神经病变的流行率.
- 为了确定与这种人群中神经病变发展相关的风险因素.
- 评估床边诊断方法用于神经病变检测的疗效.
主要方法:
- 60名患有T1D (糖尿病持续时间>5年) 的青少年和23名对照人接受了神经学检查.
- 确认性测试包括神经传导研究,皮肤活检 (皮肤内神经纤维密度),定量动轴突反射测试 (QSART) 和心血管反射测试 (CART).
- 床边测试 (生物血压计,DPNCheck®,Sudoscan,Vagus®) 通过ROC分析与确认结果进行比较.
主要成果:
- 神经病发病率:14%确诊/26%亚临床LFN,2%确诊/25%亚临床SFN,20%异常QSART,8%异常CART,14%正静性低血压.
- 神经病变的危险因素包括较高的年龄,增加的胰岛素剂量,以前的吸烟,以及升高的甘油三.
- 临床测试显示,与确认诊断方法 (AUC ≤ 0.75) 的一致性差到可接受.
结论:
- 确认性诊断测试证实了1型糖尿病青少年的神经病变.
- 这些发现强调了积极预防策略和在这个人口群体中定期进行神经病变查的必要性.
- 进一步的研究可能将重点放在改善床边诊断工具的早期检测上.
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