Analysis Of The Specificity And Sensitivity Of Sural Nerve Conduction Device (DPNcheck) In The Diagnosis Of Diebetic Peripheral Neuropathy In Patients With Type 2 Diabetes Mellitus

Objective:At present,relevant studies at home and abroad have shown that the incidence of diabetic peripheral neuropathy(DPN)is getting higher and higher,which seriously affects the prognosis of diabetic patients.However,there are many methods for diagnosing DPN,and there is a lack of unified diagnostic criteria and diagnostic methods,so the detection rate of DPN is low.The sural nerve detection device DPNCheck is increasingly used as a diagnostic tool for DPN in patients with diabetes(Diabetes Mellitus,DM).Therefore,this study is mainly to explore the specificity and sensitivity of the sural nerve detection device DPNCheck in diagnosing peripheral neuropathy in patients with type 2 diabetes,in order to find a reliable and convenient early diagnosis method.Method:1.This study selected 240 patients with type 2 diabetes(Tpye 2 diabetes mellitus,T2DM)who were hospitalized in the Department of Endocrinology and Metabolic Diseases of the Second Affiliated Hospital of Nanchang University from May 2020 to December 2020(using the 1999 WHO diabetes diagnostic criteria)According to standard neuroelectrophysiological testing results,240 patients with type 2 diabetes were divided into diabetic peripheral neuropathy group(DPN group),114 cases and non-diabetic peripheral neuropathy group(non-DPN group),126 cases.2.The 240 research subjects enrolled in the group were all examined by a professional physician in the neuroelectrophysiology room of our hospital for Nerve conduction velocity(NCV).According to the test results,they were divided into DPN group and non-DPN group(Non-DPN group).)To get the sural nerve conduction velocity(SNCV)and amplitude(SNAP)data.240 study subjects received the sural nerve detection device DPNCheck at the same time,and the sural nerve conduction velocity(SNCV)and amplitude(SNAP)data were obtained.Simultaneously collect medical history and biochemical data of all patients,including gender,age,diabetes course,and time of taking metformin;measure weight and height,calculate body mass index(BMI)=weight(Kg)/height(m)~2,systolic blood pressure(SBP),Diastolic blood pressure(DBP),fasting serum glucose(FPG),2 hours postprandial serum glucose(2h PG),glycosylated hemoglobin(Hb A1c),blood creatinine(Scr),total cholesterol(TC),triglycerides(TG),high Density lipoprotein(HDL-C),low density lipoprotein(LDL-C),25-hydroxyvitamin D3,vitamin B12,and urine albumin-creatinine ratio(ACR).3.All test data were analyzed using SPSS software,and the Kolmogorov-Smirnov test was used to test the normal distribution of the data.Normally distributed data is represented by(S),non-normally distributed data is represented by quartiles[M(P25,P75)],independent sample t-test is used for comparison of two samples,and single-factor analysis of variance is used for comparison of multi-sample means.P<0.05 was considered as statistically significant.Results:1.DPNCheck was used to detect the sural nerve.Compared with the non-DPN group,the DPN group had SNAP(7.31±5.91 vs.14.56±8.80 mv,P<0.001)and SNCV(44.80±7.79 vs.52.50±5.20 m/s,P<0.001)were lower than the non-DPN group(all P<0.05),and the differences were statistically significant.2.Calculate the area under the curve(AUC)analysis by ROC curve.SNCV=47.5m/s is the cut-off point for diagnosing DPN,and the AUC area under the curve is 0.823.At this time,the sensitivity of diagnosing DPN is 0.867 and the specificity is 0.708.,Youden index 0.575;SNAP=7.5 mv is the cutoff point for diagnosing DPN,the AUC area under the curve is 0.801,the sensitivity of diagnosing DPN is 0.793,the specificity is 0.69,and the Youden index is 0.483.3.Compared with the non-DPN group,the duration of type 2 diabetes in the DPN group was longer(7.63±8.90 vs.11.00±7.91 years,P<0.05),and the DPN group took metformin hydrochloride for a longer time(13.33±9.58 vs.32.29)±7.82 months,P<0.05).4.Compared with the non-DPN group,the Hb A1c,FPG,LDL-C and blood Scr in the DPN group were all increased,and the P<0.001,<0.001,0.02,0.003,and the difference was statistically significant.Conclusions:1.The sural nerve detection device DPNCheck is an effective,sensitive and reliable simple tool for diagnosing DPN in patients with type 2 diabetes.2.Patients with type 2 diabetes have a long course of disease,long-term use of metformin,poor blood sugar control and impaired renal function,and are more likely to have DPN.Diabetic patients should actively control blood sugar and conduct DPN screening in the early stage of diabetes.