Abstract：
We investigated associations between gastrointestinal symptoms - evaluated as a combined weighted symptom score (CWSS) - Diabetic autonomic neuropathy (DAN), and distal symmetrical polyneuropathy (DSPN) in type 1 and type 2 diabetes.
Cross-sectional study in a tertiary outpatient clinic. CWSS was calculated based on questionnaires: gastroparesis composite symptom index (GCSI) and gastrointestinal symptom rating score (GSRS). DAN and DSPN were addressed using the composite autonomic symptom score 31 (COMPASS-31) questionnaire, cardiac autonomic reflex tests (CARTs), electrochemical skin conductance (ESC), vibration perception threshold (VPT), Michigan Neuropathy Screening Instrument (MNSI), pain- and thermal sensation. Analyses were adjusted for age, sex, diabetes duration, smoking, LDL-cholesterol, HbA1C and systolic blood pressure. Type 1 and type 2 diabetes were evaluated separately.
We included 566 with type 1 diabetes and 377 with type 2 diabetes. Mean ± SD age was 58 ± 15 years and 565 (59.9 %) were women. A high CWSS was present in 143 (25 %) with type 1 and 142 (38 %) with type 2 diabetes. The odds of DAN by COMPASS-31 (p < 0.001) were higher in the high score group. For type 1 diabetes, odds of cardiac autonomic neuropathy were higher in the high CWSS group. The odds of DSPN by VPT and MNSI in type 1 diabetes, and by ESC, VPT and pain sensation in type 2 diabetes were higher in the high CWSS group.
A high symptom score was associated with neuropathy by COMPASS-31 and vibration perception. Gastrointestinal symptom burden associated inconsistently with other neuropathy tests between diabetes types.
Cross-sectional study in a tertiary outpatient clinic. CWSS was calculated based on questionnaires: gastroparesis composite symptom index (GCSI) and gastrointestinal symptom rating score (GSRS). DAN and DSPN were addressed using the composite autonomic symptom score 31 (COMPASS-31) questionnaire, cardiac autonomic reflex tests (CARTs), electrochemical skin conductance (ESC), vibration perception threshold (VPT), Michigan Neuropathy Screening Instrument (MNSI), pain- and thermal sensation. Analyses were adjusted for age, sex, diabetes duration, smoking, LDL-cholesterol, HbA1C and systolic blood pressure. Type 1 and type 2 diabetes were evaluated separately.
We included 566 with type 1 diabetes and 377 with type 2 diabetes. Mean ± SD age was 58 ± 15 years and 565 (59.9 %) were women. A high CWSS was present in 143 (25 %) with type 1 and 142 (38 %) with type 2 diabetes. The odds of DAN by COMPASS-31 (p < 0.001) were higher in the high score group. For type 1 diabetes, odds of cardiac autonomic neuropathy were higher in the high CWSS group. The odds of DSPN by VPT and MNSI in type 1 diabetes, and by ESC, VPT and pain sensation in type 2 diabetes were higher in the high CWSS group.
A high symptom score was associated with neuropathy by COMPASS-31 and vibration perception. Gastrointestinal symptom burden associated inconsistently with other neuropathy tests between diabetes types.
摘要：
目的：我们调查了胃肠道症状-以联合加权症状评分（CWSS）评估-糖尿病自主神经病变（DAN）之间的关联，1型和2型糖尿病的远端对称性多发性神经病（DSPN）。
方法：在三级门诊进行的横断面研究。CWSS基于问卷计算：胃轻瘫综合症状指数（GCSI）和胃肠道症状评分（GSRS）。DAN和DSPN使用复合自主神经症状评分31（COMPASS-31）问卷进行了处理，心脏自主神经反射试验(CART),电化学皮肤电导（ESC），振动感知阈值（VPT），密歇根神经病筛查仪（MNSI），疼痛和热感觉。分析根据年龄进行了调整，性别,糖尿病持续时间，吸烟,LDL-胆固醇,HbA1C和收缩压。1型和2型糖尿病分别进行评估。
结果：我们纳入了566例1型糖尿病患者和377例2型糖尿病患者。平均±SD年龄为58±15岁，女性为565（59.9％）。1型糖尿病患者143例（25％）和2型糖尿病患者142例（38％）存在高CWSS。在高分组中，通过COMPASS-31（p<0.001）DAN的几率更高。对于1型糖尿病，高CWSS组发生心脏自主神经病变的几率较高.1型糖尿病患者VPT和MNSI的DSPN几率，通过ESC，高CWSS组2型糖尿病患者的VPT和疼痛感觉较高。
结论：通过COMPASS-31和振动感知，高症状评分与神经病变相关。胃肠道症状负担与糖尿病类型之间的其他神经病变测试不一致。
方法：在三级门诊进行的横断面研究。CWSS基于问卷计算：胃轻瘫综合症状指数（GCSI）和胃肠道症状评分（GSRS）。DAN和DSPN使用复合自主神经症状评分31（COMPASS-31）问卷进行了处理，心脏自主神经反射试验(CART),电化学皮肤电导（ESC），振动感知阈值（VPT），密歇根神经病筛查仪（MNSI），疼痛和热感觉。分析根据年龄进行了调整，性别,糖尿病持续时间，吸烟,LDL-胆固醇,HbA1C和收缩压。1型和2型糖尿病分别进行评估。
结果：我们纳入了566例1型糖尿病患者和377例2型糖尿病患者。平均±SD年龄为58±15岁，女性为565（59.9％）。1型糖尿病患者143例（25％）和2型糖尿病患者142例（38％）存在高CWSS。在高分组中，通过COMPASS-31（p<0.001）DAN的几率更高。对于1型糖尿病，高CWSS组发生心脏自主神经病变的几率较高.1型糖尿病患者VPT和MNSI的DSPN几率，通过ESC，高CWSS组2型糖尿病患者的VPT和疼痛感觉较高。
结论：通过COMPASS-31和振动感知，高症状评分与神经病变相关。胃肠道症状负担与糖尿病类型之间的其他神经病变测试不一致。
