在1型糖尿病中评估神经病变亚型
Pall Karlsson1,2,3, Marie Balle Sjogaard4,5, Karoline Schousboe6
1Danish Pain Research Center, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark pall@clin.au.dk.
BMJ open diabetes research & care
|July 18, 2024
概括
在1型糖尿病 (T1DM) 中,糖尿病多神经病变 (DPN) 最常见的是涉及混合神经纤维. 疼痛或非疼痛的DPN在亚型上没有差异,但严重程度会影响纤维类型的流行.
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:
- 糖尿病多神经病 (DPN) 是一种常见的糖尿病并发症,影响小,大或混合的神经纤维.
- 与1型糖尿病 (T1DM) 相关的DPN显示了大纤维损伤之前的小纤维参与的证据.
- 在T1DM中特定的DPN亚型的患病率仍然未确定.
研究的目的:
- 确定T1DM相关的DPN中最常见的神经纤维损伤亚型 (小纤维神经病变[SFN],大纤维神经病变[LFN]或混合纤维神经病变[MFN])
- 为了比较疼痛性DPN (P-DPN) 与非疼痛性DPN (NP-DPN) 的神经病变亚型.
主要方法:
- 一项涉及216名参与者的横截面研究:对照组,T1DM,NP-DPN和P-DPN组.
- 通过小型和大型纤维特异性测试评估的神经病变亚型.
- 应用了三个诊断模型 (≥1,≥2,或≥3个异常测试) 来确定普遍的纤维损伤.
主要成果:
- 混合纤维神经病变 (MFN) 在T1DM相关的DPN中表现出最高的患病率.
- 在NP-DPN和P-DPN组之间没有观察到神经病变亚型的显著差异.
- 随着DPN的严重程度,MFN的患病率增加;早期的神经病变在Model 3中显示出LFN的流行,在Model 2和3中显示出SFN的流行.
结论:
- 在T1DM中,DPN主要表现为MFN,而不考虑疼痛.
- 模型2被提议作为T1DM DPN与普遍的SFN的初始诊断标准.
- 轻微的DPN阶段表明,小或大神经纤维对损伤的敏感性更高.
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