A New Quantitative Neuropad for Early Diagnosis of Diabetic Peripheral Neuropathy

IF 4.6 2区医学 Q1 ENDOCRINOLOGY & METABOLISM Diabetes/Metabolism Research and Reviews Pub Date : 2024-11-19 DOI:10.1002/dmrr.70010

Zheng Yang, Subei Zhao, Yuhuan Lv, Linyu Xiang, Xiaoru Zhang, Zhengping Feng, Zhiping Liu, Rong Li

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Abstract

Aims

Diabetic peripheral neuropathy (DPN) often coexists with sudomotor dysfunction, resulting in an increased risk of diabetic foot. This study aimed to explore an efficient method for early diagnosis of DPN by establishing a quantitative Neuropad.

Methods

We recruited 518 patients with type 2 diabetes. Neuropathy Symptoms Score (NSS) combined with Neuropathy Disability Score (NDS) was used to assess distal symmetrical peripheral neuropathy (DSPN). The area under the ROC curve (AUROC), sensitivity, and specificity were used to compare the diagnostic efficacy of quantitative Neuropad (the change rate of the chromatic aberration value per minute) and two types of visual Neuropad (visual Neuropad A: whether the time to complete colour change within 10 min, visual Neuropad B: the time to complete colour change) for DPN.

Results

We did not observe very good diagnostic efficacy of Neuropad (visual Neuropad A and B: 0.59 and 0.64, quantitative Neuropad AUROC: 0.62–0.64) when using standard DSPN diagnostic criteria (NDS 6–12 or NDS 3–5 combined with NSS 5–9). When DPN was assessed by NSS + NDS ≥ 4, visual Neuropad B improved the specificity (AUROC 0.72, 67.00%, specificity 71.70%) by extending the detection time compared with visual Neuropad A (AUROC 0.62, sensitivity 81.80%, specificity 41.70%). Quantitative Neuropad significantly improved the diagnostic effect (AUROC 0.81, sensitivity 80.0%, specificity 76.3%) and reduced the detection time (4 min).

Conclusions

This study provides a new quantitative Neuropad, which has great potential to be an extremely useful diagnostic tool for early screening of sudomotor dysfunction in the clinical practice.

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用于早期诊断糖尿病周围神经病变的新型定量神经垫

目的糖尿病周围神经病变（DPN）往往与运动功能障碍并存，导致糖尿病足风险增加。本研究旨在通过建立定量 Neuropad，探索早期诊断 DPN 的有效方法。方法我们招募了 518 名 2 型糖尿病患者。采用神经病变症状评分（NSS）和神经病变残疾评分（NDS）来评估远端对称性周围神经病变（DSPN）。采用 ROC 曲线下面积（AUROC）、灵敏度和特异性来比较定量 Neuropad（每分钟色差值的变化率）和两种视觉 Neuropad（视觉 Neuropad A：是否在 10 分钟内完成颜色变化；视觉 Neuropad B：完成颜色变化的时间）对 DSPN 的诊断效果。结果在使用标准 DSPN 诊断标准（NDS 6-12 或 NDS 3-5 结合 NSS 5-9）时，我们没有观察到 Neuropad 非常好的诊断效果（视觉 Neuropad A 和 B：0.59 和 0.64，定量 Neuropad AUROC：0.62-0.64）。当通过 NSS + NDS ≥ 4 评估 DPN 时，与视觉 Neuropad A（AUROC 0.62，灵敏度 81.80%，特异度 41.70%）相比，视觉 Neuropad B 通过延长检测时间提高了特异度（AUROC 0.72，67.00%，特异度 71.70%）。定量神经垫明显提高了诊断效果（AUROC 0.81，灵敏度 80.0%，特异性 76.3%），并缩短了检测时间（4 分钟）。结论本研究提供了一种新的定量 Neuropad，它极有可能成为临床实践中早期筛查肢体运动功能障碍的一种非常有用的诊断工具。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Diabetes/Metabolism Research and Reviews 医学-内分泌学与代谢

CiteScore

17.20

自引率

2.50%

发文量

审稿时长

4-8 weeks

期刊介绍： Diabetes/Metabolism Research and Reviews is a premier endocrinology and metabolism journal esteemed by clinicians and researchers alike. Encompassing a wide spectrum of topics including diabetes, endocrinology, metabolism, and obesity, the journal eagerly accepts submissions ranging from clinical studies to basic and translational research, as well as reviews exploring historical progress, controversial issues, and prominent opinions in the field. Join us in advancing knowledge and understanding in the realm of diabetes and metabolism.