The Association Of Nerve Conduction Velocity With Sympathetic Skin Response And Orthostatic Hypotension In Diabetic Patients

Objective:Diabetic peripheral neuropathy(DPN) patients are prone to orthostatic hypotension(OH). Nerve conduction velocity(NCV) testing and sympathetic skin response(SSR) are important cornerstones for diagnosis of DPN. We aim to explore the relationship between SSR/NCV and OH in DPN patients.Methods:According to the inclusion and exclusion criteria, we selected 298 diabetic patients on the basis of "China Type 2 Diabetes Prevention Guide" version of the2013 diagnostic criteria for the diagnosis of diabetes(DM) in the Second Affiliated Hospital of Nanchang University Endocrinology clinic from August 2014 to August2015. The patients were divided into OH group included 45 persons and non-OH group included 253 persons in accordance with the measurement results of blood pressure, Effect of baseline characteristics were compared to the OH. We analysed the impact of total abnormal SSR/NCV ratio on OH incidence and further analysis involved the relationship between the number of affected limbs by abnormal SSR/NCV and OH incidence.Results:There was no statistical significance of difference in OH incidence between oral anti-hypertensive drugs group and no taking anti-hypertensive drugs group(P> 0.05).High supine systolic blood pressure can significantly increase the incidence of OH[odds ratio(OR), 1.026; 95% confidential interval(CI), 1.007-1.046; P<0.05]; the OH incidence of normal NCV group has no difference to that of abnormal NCV group(P> 0.05); the OH incidence in abnormal SSR group was significantly higher than that of normal SSR group(OR, 1.026; 95%CI, 1.007-1.046; P<0.05); OH incidence in group with four-limb impaired SSR was significantly higher than that of normalSSR limbs group and two-limb impaired SSR group, respectively(P <0.05); there was no difference in OH incidence among groups with normal four-limb SSR,abnormal one-limb SSR, abnomal two-limb SSR and abnormal three- limb SSR(P>0.05).Conclusion:First, high supine systolic blood pressure is a risk predictor of OH; second,abnormal NCV may prompt peripheral sensory and motor nerve damage, which has no influence on OH incidence; third, the OH incidence in all SSR impaired group was significantly higher than that of normal SSR group, and abnormal SSR was a risk predictor of OH; fourth, there was a significant correlation between total abnormal SSR ratio and the OH incidence. Damage of SSR is limited to two- or less limb does not increase the OH incidence. Furthermore, incidence of OH is significantly higher among patients with three- or more limb SSR damaged.