Assessment of sensory current threshold in the diagnosis of type 2 diabetic peripheral neuropathy clinical application of current perception threshold in the diagnosis of diabetic peripheral neuropathy / 中国糖尿病杂志

ABSTRACT

Objective To evaluate the diagnostic value of current perception threshold (CPT)diabetic peripheral neuropathy (DPN).Methods A total of 437 patients with type 2 diabetes (T2DM) were enrolled.The subjects were divided into DPN group and non-DPN group according to'the criteria of diagnosis and treatment of diabetic peripheral neuropathy in China'.The diagnostic value of CPT,10 g monofilament test,Toronto clinical scoring system (TCSS) and nerve conduction velocity (NCV) were evaluated.Results Compared with non-DPN group,the patients in DPN group were significantly older [(61.31±9.63) vs (58.09±10.38) year],with longer duration of diabetes [(8.81±6.04) vs (6.93±5.65) year],higher HbA1c [(8.60±2.05)％ vs (8.09±2.01) ％] and fasting plasma glucose (FPG) [(9.67± 3.92) vs (8.95 ± 3.45) mmol/L],more smokers (30.0％ vs 15.8％) and more likely complicated with retinopathy (36.4％ vs 22.2％).The proportion of hypoesthesia and hyperesthesia detected by CPT at all frequencies in DPN group were much higher than non-DPN group (P＜0.05).The correlation analysis showed that CPT values at each frequency were negatively correlated with NCV (r=-0.260,r=-0.155 and r=-0.168,respectively,P＜0.01).CPT 2000 Hz and 250 Hz were positively correlated with TCSS scores (r=0.105 and 0.142,respectively,P＜0.05).ROC analysis showed that CPT 2000 Hz had the largest areas under the curve (AUC=0.840),with the highest sensitivity (77.14％)and NCV test had the highest specificity (98.32％) in diagnosing DPN.Conclusion CPT can selectively and quantitatively determine different types of sensory nerve damage,which providing a useful method for early-screening of DPN.