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Early Electrophysiological Abnormalities and Clinical Neuropathy: A prospective study in patients with type 1 diabetes

OBJECTIVE: The aim of this study was to elucidate whether subclinical nerve dysfunction as reflected by neurophysiological testing predicts the development of clinical neuropathy in patients with type 1 diabetes. RESEARCH DESIGN AND METHODS: Fifty-nine patients were studied twice with neurophysiolog...

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Autores principales: Hyllienmark, Lars, Alstrand, Nils, Jonsson, Björn, Ludvigsson, Johnny, Cooray, Gerald, Wahlberg-Topp, Jeanette
Formato: Online Artículo Texto
Lenguaje:English
Publicado: American Diabetes Association 2013
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3781488/
https://www.ncbi.nlm.nih.gov/pubmed/23723354
http://dx.doi.org/10.2337/dc12-2226
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author Hyllienmark, Lars
Alstrand, Nils
Jonsson, Björn
Ludvigsson, Johnny
Cooray, Gerald
Wahlberg-Topp, Jeanette
author_facet Hyllienmark, Lars
Alstrand, Nils
Jonsson, Björn
Ludvigsson, Johnny
Cooray, Gerald
Wahlberg-Topp, Jeanette
author_sort Hyllienmark, Lars
collection PubMed
description OBJECTIVE: The aim of this study was to elucidate whether subclinical nerve dysfunction as reflected by neurophysiological testing predicts the development of clinical neuropathy in patients with type 1 diabetes. RESEARCH DESIGN AND METHODS: Fifty-nine patients were studied twice with neurophysiological measurements at baseline and at follow-up. At baseline, patients were 15.5 ± 3.22 years (range 7–22 years) of age, and duration of diabetes was 6.8 ± 3.3 years. At follow-up, patients were 20–35 years of age, and disease duration was 20 ± 5.3 years (range 10–31 years). RESULTS: At baseline, patients showed modestly reduced nerve conduction velocities and amplitudes compared with healthy subjects, but all were free of clinical neuropathy. At follow-up, clinical neuropathy was present in nine (15%) patients. These patients had a more pronounced reduction in peroneal motor nerve conduction velocity (MCV), median MCV, and sural sensory nerve action potential at baseline (P < 0.010–0.003). In simple logistic regression analyses, the predictor with the strongest association with clinical neuropathy was baseline HbA(1c) (R(2) = 48%, odds ratio 7.9, P < 0.002) followed by peroneal MCV at baseline (R(2) = 38%, odds ratio 0.6, P < 0.006). With the use of a stepwise forward analysis that included all predictors, first baseline HbA(1c) and then only peroneal MCV at baseline entered significantly (R(2) = 61%). Neuropathy impairment assessment showed a stronger correlation with baseline HbA(1c) (ρ = 0.40, P < 0.002) than with follow-up HbA(1c) (ρ = 0.034, P < 0.007). CONCLUSIONS: Early defects in nerve conduction velocity predict the development of diabetic neuropathy. However, the strongest predictor was HbA(1c) during the first years of the disease.
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spelling pubmed-37814882014-10-01 Early Electrophysiological Abnormalities and Clinical Neuropathy: A prospective study in patients with type 1 diabetes Hyllienmark, Lars Alstrand, Nils Jonsson, Björn Ludvigsson, Johnny Cooray, Gerald Wahlberg-Topp, Jeanette Diabetes Care Original Research OBJECTIVE: The aim of this study was to elucidate whether subclinical nerve dysfunction as reflected by neurophysiological testing predicts the development of clinical neuropathy in patients with type 1 diabetes. RESEARCH DESIGN AND METHODS: Fifty-nine patients were studied twice with neurophysiological measurements at baseline and at follow-up. At baseline, patients were 15.5 ± 3.22 years (range 7–22 years) of age, and duration of diabetes was 6.8 ± 3.3 years. At follow-up, patients were 20–35 years of age, and disease duration was 20 ± 5.3 years (range 10–31 years). RESULTS: At baseline, patients showed modestly reduced nerve conduction velocities and amplitudes compared with healthy subjects, but all were free of clinical neuropathy. At follow-up, clinical neuropathy was present in nine (15%) patients. These patients had a more pronounced reduction in peroneal motor nerve conduction velocity (MCV), median MCV, and sural sensory nerve action potential at baseline (P < 0.010–0.003). In simple logistic regression analyses, the predictor with the strongest association with clinical neuropathy was baseline HbA(1c) (R(2) = 48%, odds ratio 7.9, P < 0.002) followed by peroneal MCV at baseline (R(2) = 38%, odds ratio 0.6, P < 0.006). With the use of a stepwise forward analysis that included all predictors, first baseline HbA(1c) and then only peroneal MCV at baseline entered significantly (R(2) = 61%). Neuropathy impairment assessment showed a stronger correlation with baseline HbA(1c) (ρ = 0.40, P < 0.002) than with follow-up HbA(1c) (ρ = 0.034, P < 0.007). CONCLUSIONS: Early defects in nerve conduction velocity predict the development of diabetic neuropathy. However, the strongest predictor was HbA(1c) during the first years of the disease. American Diabetes Association 2013-10 2013-09-14 /pmc/articles/PMC3781488/ /pubmed/23723354 http://dx.doi.org/10.2337/dc12-2226 Text en © 2013 by the American Diabetes Association. Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered. See http://creativecommons.org/licenses/by-nc-nd/3.0/ for details.
spellingShingle Original Research
Hyllienmark, Lars
Alstrand, Nils
Jonsson, Björn
Ludvigsson, Johnny
Cooray, Gerald
Wahlberg-Topp, Jeanette
Early Electrophysiological Abnormalities and Clinical Neuropathy: A prospective study in patients with type 1 diabetes
title Early Electrophysiological Abnormalities and Clinical Neuropathy: A prospective study in patients with type 1 diabetes
title_full Early Electrophysiological Abnormalities and Clinical Neuropathy: A prospective study in patients with type 1 diabetes
title_fullStr Early Electrophysiological Abnormalities and Clinical Neuropathy: A prospective study in patients with type 1 diabetes
title_full_unstemmed Early Electrophysiological Abnormalities and Clinical Neuropathy: A prospective study in patients with type 1 diabetes
title_short Early Electrophysiological Abnormalities and Clinical Neuropathy: A prospective study in patients with type 1 diabetes
title_sort early electrophysiological abnormalities and clinical neuropathy: a prospective study in patients with type 1 diabetes
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3781488/
https://www.ncbi.nlm.nih.gov/pubmed/23723354
http://dx.doi.org/10.2337/dc12-2226
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