Correlation Of Neuropathy Symptom Score/Neuropathy Disability Score And Ncv In The Diagnosis Of Diabetic Peripheral Neuropathy

Objective: Diabetic peripheral neuropathy is one of the most frequentcomplications of the diabetes mellitus. It is a significant independent riskfactor of foot ulcers, infection and lower extremity amputations in patientswith DM. Currently, there are lots of methods for the diagnose of DPN.Nerve conduction studies, including nerve conduction velocity, wereconsidered as objective, sensitive, quantitative and noninvasive tests, whichwere frequently used to diagnose DPN. We used NCV as the golden criteriaof DPN to assess the efficacy and clinical value of neuropathy symptomscore/neuropathy disability score.Methods: NSS/NDS, NCV and clinical biochemical parameters weremeasured in679type2diabetes patients of endocrinology department inThe First Affiliated Hospital of Chongqing Medical University from April2010to August2012.(1)Using the result of NCV as the golden criteria of DPN, thesensitivity, specificity, positive and negative predictive values, Youdenindex, kappa value and correlation with NSS/NDS were studied. (2) To analyze the percentage prevalence of different neuropathicdisabilities in679T2DM patients after characterized their level ofneuropathic symptoms.(3) To analyze the abnormal rate of NCV in different NSS and NDS.(4) The relativity between NCV of each measured nerve and NSSwere discussed, and we also observed the relationship between NCV andNDS.(5) The correlation between the above two methods and risk factors ofDPN were also discussed by logistic regression analyzes.Result:(1)While NSS/NDS was considered as the diagnosis criteriaof DPN, the sensitivity, specificity, positive predictive value, negativepredictive value, accuracy, Youden index, kappa value, correlation were68.0%,77.2%,86.5%,53.5%,71%,45.2%,0.405,0.424, respectively.(2)With the gradual increase of NSS, the proportion of NDS≥6scoreswas gradually increased. The more severe neuropathic symptoms when themore severe neuropathic signs.(3) In difference score of NSS and NDS, when NSS<5scores orNDS<6scores, the lower rate of NCV abnormalities were occurred(42%-49.5%); and when NSS≥5scores or NDS≥6scores, the higher rate ofNCV abnormalities were occurred (77.8%-100%).(4) NSS and NDS were negatively correlated with NCV of eachmeasured nerve in the lower limbs. (5) The logistic regression analysis showed the risk factors of DPNinclude age, urinary albumin-to-creatinine ratio and disease duration whenNSS/NSS was considered as the diagnostic criteria. It had similar resultwith NCV.Conclusion:(1) There were correlation between NSS/NDS and NCV,especially when neurological symptoms and neurological signs becamemore serious.(2) NSS/NDS was a simple and rapid test for screening DPN.If theresult of NSS/NDS was normal, the comprehensive judgment by NCS wereneeded.