Related Factors Of Diabetic Peripheral Neuropathy And Characteristics Of Nerve Damaged

Objective:Diabetic peripheral neuropathy (DNP) is one of important complications of diabetes, it is the major cause of all nontraumatic amputations, and diabetic neuropathy accounts for more hospitalizations than all other diabetic complications. The study utilized Neurometer CPT/C to detect peripheral nerves function in patients with type 2 diabetes, analyzed the results concerning the relationships between CPT/C abnormalities and age, sex, diabetes duration, symptoms, body mass index(BMI), blood pressure, resting tachycardia, fasting plasma glucose (FPG), glycosylated hemoglobin (HbA1C), lipids, residual urine volume; and the association between lipids and different diameters nerve fiber loss, the predilection sites of DNP and the characteristics of diabetic nerve damaged, in order to provide the theoretical basis of prevention, diagnosis and treatment.Methods:We recruited 113 subjects with type 2 diabetes mellitus hospitalized from October to December of 2010, A total of 113 T2DM patients including 66 men and 47 women were evaluated, who were characterized by normal liver and kidney functions, and excluded patients with long mass alcohol history, history of occupational exposure to neurotoxins, history of peripheral nerve injury, cervical spondylosis, lumber disc herniation, nerve root irritation, thyroid disease, those who need by narcotic analgesic pain and bladder dysfunction caused by organic diseases. Neuropathy was evaluated by history, clinical examination and devices including Neurometer CPT/C and Ultrasound. Data from 113 patients with T2DM were analyzed (47 women, 66 men; mean age; diabetes duration; glycosylated hemoglobin; BMI; blood pressure; resting tachycardia; FPG; lipids and residual urine volume). The differences among clinical findings, lipids and the results derived from Neurometer CPT/C and ultrasound were analyzed in diabetic patients with or without neuropathy. Data were analyzed by SAS 9.0 software.Results:1. The study showed that diabetic neuropathy was significantly higher with age, the duration of diabetes mellitus, but lower with level of HDL-C(P<0.05). Diabetic neuropathy seemed to be associated with TC, TG, LDL-C and abnormal residual urine volume, but without statistical significance(P>0.05). However, the likelihood of diabetic neuropathy was not significant with gender, blood pressure, FPG and HbA1C. The proportion of DNP symptoms was 32%. The resting tachycardia didn't show abnormal in the two groups. 2. Duration was the risk factor of DNP (P<0.05,OR=73.802), HDL-C was the protective factor of DNP (P<0.05,OR=73.802). Male (OR=2.385), systolic blood pressure (OR=1.484), FPG (OR=5.199), TG (OR=5.151), TC (OR=5.988), residual urine volume (OR=4.134) possibly had the positive correlations with DNP. 3. Compared with NDNP group, HDL-C level decreased obviously in patients with both thick and thin myelinated nerve fibers damage (P<0.05). The levels of TG, LDL-C in patients with thick and thin myelinated nerve fibers damaged groups and the level of TC in thin myelinated nerve fibers damaged group were higher than normal groups without statistical significant (P>0.05). The levels of TG, TC, LDL-C tend to be higher in patients with unmyelinated never fibers damage without statistical significant (P>0.05). 4. The predilection sites of DNP were thin myelinated nerve fibers of lower limbs(P<0.001).Conclusion:It should enhance the early screening of diabetic neuropathy complications, neurometer could be used to screen diabetic peripheral neuropathy. Duration of diabetes was the risk factor and HDL-C was the protective factor of DNP,and male, systolic blood pressure, FPG, TG, TC, residual urine volume had the positive correlations with DNP. Dyslipidemia was associated with myelinated never fibers damaged. The predilection sites of DNP were lower limbs, and the myelinated nerve fibers were mainly damaged.