The Study Of The Detection Of Skin Sympathetic Response In Peripheral Neuropathy Of Type 2 Diabetes Mellitus

Objective Diabetes Mellitus is one of the most common metabolic disorder diseases in the world.Type 2 diabetes mellitus(T2DM)is the primary type of diabetes.Recently,T2 DM is increasing in incidence and become a serious threat to human health.Diabetic Peripheral Neuropathy(DPN)is one of the most common complication of diabetes.Because of the high proportion of asymptomatic early diabetic neuropathy,it is difficult to timely diagnose in clinical practice,leading to the failure of timely treatment for DPN patients and aggravating the occurrence and development of the disease.Therefore,the early diagnosis of DPN in T2 DM patients is very important.Sympathetic Skin Response(SSR)is a potential associated with changes in epidermal voltage caused by sweat gland activity.SSR can reflect one of the indicators of unmyelinated fibrotic neuropathy,and has the advantages of portability,reliability,and reproducibility.Through the SSR detection of T2 DM patients and related laboratory indicators analysis,this article mainly to explore the impact of relevant factors on SSR detection in T2 DM patients,in order to evaluate the value of SSR in the early diagnosis of DPN in patients with T2 DM.Method 112 patients with type 2 diabetes from March,2017 to October 2018 in the Endocrinology Department of Anhui Provincial Hospital and 63 age-matched from healthy subjects were selected for SSR testing.The amplitude and latency of the upper and lower limbs of the healthy control group were determined.The SSR of patients with different T2 DM patients and the SSR of patients with different ages were compared to predict the impact of disease duration and age on SSR.SSR abnormalities in T2 DM patients were dependent variables,including: gender,age,disease duration,SBP,DBP,BMI,TC,TG,Hb A1 c,GLU,25-(OH)D3,NCV abnormalities,multivariate dichotomy logistic regression analysis was performed to further investigate whether there was any correlation between independent variables and SSR abnormalities.Result1.In the same period,63 healthy people in the physical examination center served as the control group,and the SSR waveform detection was cited as the reference value of the SSR result.2.Compared with the healthy control group,the T2 DM group had longer limb latency and decreased amplitude,and the difference was statistically significant.3.According to the course of diabetes,the T2 DM components were divided into two groups: disease duration ≤5 years and disease duration>5 years.The SSR latency and amplitude were compared between the two groups.The results showed that there was no significant difference in limb latency and amplitude between the two groups.4.According to the age,the T2 DM components were two groups of age ≤60 years old and age>60 years old.The SSR latency and amplitude were compared between the two groups.The results showed that compared with the age of ≤60 years,the latency of SSR in the left and right upper limbs of patients aged >60 years was prolonged,and the difference was statistically significant.5.Of the 112 patients with T2 DM in this study,33.0%(37/112)of patients with complete SSR and 67%(75/112)of patients with SSR abnormalities.The results showed that the difference of 25-(OH)D3 concentration(20.67±7.76 vs 15.49±5.61)was statistically significant in the SSR normal group.In the normal SSR group,the NCV abnormal rate was 18.9%.(7/37),the incidence of NCV abnormalities in the SSR abnormal group was 45.3%(34/75),and the difference between the two groups was statistically significant.Compared with the normal SSR group,the SSR abnormal group was in gender.There were no significant differences in age,duration of disease,SBP,DBP,BMI,TC,TG,Hb A1 c,and GLU.6.In 112 patients with T2 DM in this study,SSR results were used as dependent variables,with gender,age,duration,SBP,DBP,BMI,TC,TG,Hb A1 c,GLU,25-(OH)D3,NCV results and other indicators.Independent variables were analyzed by multivariate binary logistic regression.The results showed that with the increase of serum 25-(OH)D3 concentration,the incidence of SSR abnormalities decreased.With the abnormal increase of NCV,the incidence of SSR abnormalities increased,and the correlation was statistically significant.Conclusion The abnormal rate of SSR in patients with type 2 diabetes was higher than that in healthy people,and the abnormal rate of SSR in lower limbs was significantly higher than that in upper limbs.With the prolongation of the disease and the increase of age in patients with type 2 diabetes,the incidence of SSR abnormalities did not increase significantly.Elevated serum 25-(OH)D3 concentration is an independent protective factor for SSR abnormalities,and NCV abnormalities may be independent predictors of SSR abnormalities.In clinical work,doctors need to pay attention to SSR screening of diabetic patients and early improvement of serum25-(OH)D3 concentration,which provides a basis for early prevention and treatment of diabetic neuropathy.