The Value Of Vibration Perception Threshold In Diagnosis Of Diabetic Peripheral Neuropathy

Objective:To evaluate the value of vibration perception threshold in diagnosis of diabetic peripheral neuropathy (DPN).Methods:283 patients with type 2 diabetes from outpatient and hospitalized were divided into two groups according to the ADA diagnosis criteria of DPN. The association among DPN and age, disease duration, BMI, FBS, PBS, HbA1c, serum lipids, BUN, BCr, FINS, PINS, hsCRP, FFA, family history, smoking history, Bp were analysis by correlation and Logistic regression. Receiver operation curve(ROC) was used to measure the value of vibration perception threshold (VPT) in diagnosis of DPN.Results:1.Disease duration, FBS, PBS, HbA1c, and hsCRP were higher in patients with DPN than those in patients without DPN. In contrast, concentration of serum insulin, level of diastolic blood pressure were lower than those in patients without DPN. Logistic regression analysis showed that levels of HbA1c and postprandial insulin were correlated with the incidence of DPN (OR were 1.213 and 4.830 respectively).2. There is no significant difference in NCV and VPT in both side of limbs, but the NCV in lower limbs were slower than that in arms. 3.ROC showed that area under curve(AUC) of VPT and NCV were 0.639 and 0.668 respectively. The cut-off point of VPT is 11.0, the sensitivity of that point is 74.6%, the specificity of that point is 76.0%.4. In our study, ratio of DPN diagnosed by combining impaired NCV and VPT was 62.9%, it is significantly higher than the ratio of DPN diagnosed only by impaired NCV(p=0.000). Conclusions:1. VPT examination had similar value in diagnosis DPN compare with NCV, that means it maybe a simply and useful tool in screening DPN.2. Combined using the methods of NCV and VPT was helpful in improving the diagnosis rate of DPN.