Clinical Application Value Of Shear Wave Elastography In Type 2 Diabetic Peripheral Neuropathy

Purpose The aim of this study is using shear wave elastography(SWE)to analyze the effect of dabetic retinopathy and lower extremity arterial disease on young’s modulus of tibial nerve in patients with diabetic peripheral neuropathy(DPN)and to discuss the correlation between young’s modulus of tibial nerve and clinical indicators in patients with DPN,In order to discuss the clinical application of SWE technique in DPN,the correlation between the young’s modulus values of tibial nerve and the clinical indexes of DPN patients was determined.Methods From January 2022 to October 2022,100 patients with DPN are recruited in Endocrine ward 1 of our hospital as the DPN group,30 healthy patients who come to the physical examination department of the hospital during the same period are recruited as the healthy control group.The SWE technique is applied to measure the Young’s modulus of the tibial nerve at 5 cm above the inner ankle of all the selected patients.In the DPN group,clinical data including disease duration,glycosylated hemoglobin(Hb A1c),urinary albumin excretion rate(UAER),etc.should be collected;nerve conduction studies examination,fundus photography and bilateral lower limb arterial doppler ultrasonography are performed in the DPN group.The independent samples T-test is used to analyze the young’s modulus values between the two groups,and Pearson regression and multiple linear regression are used to analyze the correlates of young’s modulus values within the DPN group,and the difference is considered statistically significant at P < 0.05.Results 1.There was no significant difference in age,height,weight and BMI between the DPN group(n=100)and the control group(n=30)(P>0.05).there was no significant difference in the mean values of young’s modulus of the tibial nerve between the left and right sides of the DPN group and the control group(P>0.05),and there was no significant difference in the mean values of Young’s modulus of the tibial nerve between men and women in the group(P>0.05).2.The mean young’s modulus of tibial nerve in the DPN group(n=200)was higher than that in the control group(n=60),and the difference was statistically significant(P<0.05).3.The mean value of young’s modulus of tibial nerve in the DPN group with diabetic eye disease(n=136)was higher than that in patients without diabetic eye disease(n=64),and the difference was statistically significant(P<0.05);the mean value of young’s modulus of tibial nerve in patients with lower limb arteriopathy(n=172)was higher than that in patients without lower limb arteriopathy(n=28),and the difference was statistically significant(P< 0.05).The mean young’s modulus of the tibial nerve was12.42 kpa higher in patients with two comorbidities than in patients with DPN alone,P=0.025<005,a statistically significant difference,and the mean Young’s modulus of the tibial nerve was 15.75 kpa higher in patients with three comorbidities than in patients with DPN alone,P=0.002<0.01,a statistically significant difference,indicating that diabetes mellitus The difference was statistically significant,indicating that microangiopathy and lower extremity vasculopathy also affect Young’s modulus of the tibial nerve,leading to its further increase.4.The mean value of young’s modulus of tibial nerve in DPN patients was not significantly correlated with age,triglyceride and BMI,but positively correlated with disease duration and glycosylated hemoglobin,and the value of young’s modulus increased by 2.08 kpa for each 1-year increase in disease duration and 2.88 kpa for each1% increase in glycosylated hemoglobin in patients with other factors.Conclusion Young’s modulus of the tibial nerve is higher in DPN patients than in healthy control group;diabetic retinopathy and lower extremity arteriopathy further increase young’s modulus of the tibial nerve in DPN patients;disease duration and glycated hemoglobin are positively correlated with young’s modulus of the tibial nerve in DPN patients.The SWE technique can objectively reflect the changes of tibial nerve stiffness in DPN patients,so that can provide objective basis and reference for clinicians to diagnose and treat DPN.