Comparison Of Clinical Effectiveness For The Different Neuropathy Scoring Systems In Screening Of Asymptomatic Diabetic Peripheral Neuropathy

Objective:Assessment of clinical effectiveness for the Michigan Neuropathy Screening Instrument (MNSI) and the Toronto Clinical Scoring System(TCSS) in screening of asymptomatic diabetic peripheral neuropathy(ADPN)Methods:232 neurologically asymptomatic patients with type 2 diabetes underwent 3 simple tests:MNSI,TCSS and neural electrophysiological test(NET), Using the results of NET as the golden criteria for diagnosis of diabetic peripheral neuropathy, we evaluated the effectiveness of 2 different Scoring System by the receiver operator characteristic curve. The correlation between MNSI and the risk factors of diabetic peripheral neuropathy(DPN) were also analyzed.Result:The area under the ROC curve of MNSI and TCSS were 0.566, 0.370,respectively. The Youden indexes of MNSI over 2 and TCSS over 2 were 0.566, 0.370 and theκvalues were 0.588,0.345 respectively. MNSI is associated with most related risk factors of DPN which included age,glycosylated hemoglobin (HbA1c),HbA1c×disease duration,Islet function,high-density lipoprotein cholesterol.Conclusion:MNSI is better than TCSS in the effectiveness of diagnosing ADPN and consistence with the result of NET. MNSI is a fast and reliable screening method, and is well consistent with the related risk factors of DPN. It can be applied in clinical and epidemiological screening and evaluation for ADPN.