■在糖尿病前期和明显的糖尿病中均观察到自主神经和感觉神经病变。然而,缺乏关于患者是否处于中度或高度发展糖尿病风险的可用数据,然而,目前没有糖尿病前期或糖尿病的诊断,表现出神经病变的患病率增加。
■FINDRISC(芬兰糖尿病风险评分)用于对有风险的个体进行分类(≥12分,n=44;控制<12点,n=28)。HbA1c水平>5.6%作为排除标准,同时排除了已知有神经病变倾向的患者.通过标准化方案评估心脏自主神经功能(尤因试验)和周围感觉神经病变(Neurometer和Q-sense)。并使用回归模型分析了它们与增加的FINDRISC点的潜在关联。
■对照组的平均年龄为46.7±14.3岁,危险增加组的平均年龄为55.7±14.1岁。男性/女性比例没有差异。患糖尿病风险增加的个体更肥胖(BMI:29.9±12.5kg/m2vs.25.9±8.9kg/m2)。此外,其中高血压更常见(68.2%vs.17.9%),他们的脂质参数也不太有利。两组均存在副交感神经病变(56.8%vs.32.1%,分别)。未发现交感神经病变。感觉神经功能障碍在高危人群中患病率较低,在健康对照组中未发生。在多元逻辑回归分析中,HbA1c与副交感神经病变独立相关(OR:5.9;95%CI:1.08-32.68;p<0.041)。
发展为前驱糖尿病/糖尿病的风险增加似乎与发展为自主神经或感觉神经病变的可能性增加没有很强的相关性。然而,健康个体发生副交感神经自主神经病变的病因尚不清楚.
Autonomic and sensory neuropathy have been observed in both prediabetes and manifest diabetes mellitus. However, there is a lack of available data regarding whether patients at a moderate or high risk of developing diabetes, yet without a current diagnosis of prediabetes or diabetes, exhibit an increased prevalence of neuropathy.
FINDRISC (Finnish Diabetes Risk Score) was used to classify individuals at risk (≥12 points, n = 44; control <12 points, n = 28). HbA1c levels >5.6% served as exclusion criteria, and patients with known medical conditions predisposing to neuropathy were also excluded. Cardiac autonomic function (Ewing tests) and peripheral sensory neuropathy (Neurometer and Q-sense) were assessed by standardized protocols, and their potential association with increased FINDRISC points was analyzed using a regression model.
Mean age was 46.7 ± 14.3 years in the control and 55.7 ± 14.1 years in the increased risk group. Male/female ratio did not differ. Individuals with increased risk of diabetes were more obese (BMI: 29.9 ± 12.5 kg/m2 vs. 25.9 ± 8.9 kg/m2). Additionally, hypertension was more frequent among them (68.2% vs. 17.9%), and their lipid parameters were also less favorable. Parasympathetic neuropathy was present in both groups (56.8% vs. 32.1%, respectively). Sympathetic neuropathy was not found. Sensory nerve dysfunction was of low prevalence in the high-risk group and did not occur in healthy controls. In multiple logistic regression analysis, HbA1c exhibited an independent association with parasympathetic neuropathy (OR: 5.9; 95% CI: 1.08-32.68; p < 0.041).
An increased risk of developing prediabetes/diabetes does not appear to have a strong correlation with an increased likelihood of developing autonomic or sensory neuropathy. However, the etiology behind the occurrence of parasympathetic autonomic neuropathy in healthy individuals remains unknown.