The Abnormal Rate And Related Risk Factors Analysis Of Sympathetic Skin Response In Inpatients With Type2Diabetes Mellitus

Objective: Investigate the abnorma1rate and its risk factors of Sympathetic skinresponse (SSR) in the inpatients with type2diabetes mel1itus (T2DM).Methods:354hospitalized patients with type2diabetes mellitus were selectedduring the time from March20l3to June20l3in Endocrinology Department in theSecond Affiliated Hospital of Dalian Medical University, a1l in accordance with theWHO diagnostic criteria for diabetes in l999.65healthy subjects for a check-up inclinic of our hospital were selected as control group. A1l the subjects were performedSSR and nerve conduction velocity (NCV) tests.1. The SSR reference value was established in healthy control group. Theabnormal rate of SSR in patients with T2DM was calculated. Various parameters of SSRwere compared between T2DM group and healthy controls.2. T2DM group was divided into two groups (SSR normal group and abnormalgroup) according to the SSR results. Factors including age, gender, smoking history,diabetes duration, body mass index (BMI), total cholesterol (TC), triglyceride (TG),HDL-C, LDL-C, fasting plasma glucose (FPG), lhPG,2hPG, glycosy1ated hemoglobin(HbAlc), fasting insu1in (FINS), lhINS,2hINS, fasting C peptide (FC-P),1hC-P,2hC-P,uric acid (UA), carotid artery atherosclerosis, diabetic retinopathy (DR), ketosis,diabetic nephropathy (DN) and NCV abnormality were taken in single factor analysisbetween the two groups respectively, and further to get the results: if there was statisticsignificant difference between the two groups.3. SSR normal and abnormal results as dependent variables, factors which havestatistic significant difference from the results of single factor analysis as independentvariables, both of them were brought into Logistic regression analysis model of the binary classification, to study the independent risk factors of SSR abnormality inpatients with T2DM.Results：1. Healthy controls SSR reference and comparison of that with T2DM group:In upper limbs: The initial latencies of SSR:(1.27±0.14)s; The Amplitudes ofSSR:(1.75±1.11)mV. In lower limbs: The initial latencies of SSR:(1.82±0.23)s; Theamplitudes of SSR:(0.66±0.45)mV. The abnormal rate of SSR was32.77%in T2DMgroup,16.95%in upper limbs,27.68%in lower limbs. The abnormal rate of SSR inlower limbs was significantly higher than in upper limbs in T2DM group (P<0.01). Theinitial latencies of SSR in upper limbs and lower limbs were prolonged significantly inT2DM group as compared to the control group [upper limbs: T2DM group:(1.36±0.15)s, control group:(1.27±0.14)s, P<0.01; lower limbs: T2DM group:(1.93±0.25)s,control group:(1.82±0.23)s, P<0.01]. The amp1itudes of SSR in upper1imbs werereduced significantly in T2DM group as compared to the control group [T2DM group:(1.47±1.01)mV, control group:(1.75±1.11)s, P<0.05]. There were no significantdifferences in amp1itudes of SSR in lower limbs between the two groups (P>0.05).2. Single factor analysis:There were no significant differences between the SSR normal group and SSRabnormal group in general conditions including age, gender, smoking history and BMI(P>0.05). The duration of diabetes were prolonged significantly in SSR abnorma1groupas compared to the SSR normal group (P<0.01). In b1ood biochemical indicators,including TC, TG, HDL-C, LDL-C, FPG,1hPG,2hPG, HbA1c, FINS,1hINS,2hINS,FC-P,1hC-P,2hC-P and UA, there were no significant differences between the twogroups (P>0.05). In incidence of diabetes complications, including carotid arteryatherosc1erosis, ketosis and DN, there were no significant different between the twogroups (P>0.05). The incidence of DR and NCV abnormality in SSR abnormal groupwas significantly higher than SSR normal group (P<0.01).3. Logistic regression ana1ysis:DR (OR=1.588,95%CI:0.991-2.545, P=0.045), and NCV abnormality (OR=3.052,95%CI:1.847-5.042, P=0.000), were the independent risk factors of SSRabnormality in patients with T2DM.Conclusion:1. The abnormal rate of SSR in the inpatients with T2DM was32.77%. Theabnormal rate in1ower limbs was significantly higher than in upper1imbs. 2. The longer duration of diabetes, the easier SSR abnormal to be occurred; DRand NCV abnormality were the independent risk factors of SSR abnormality in patientswith T2DM.