Clinical Differences of Diabetic Polyneuropathy or Carpal Tunnel Syndrome in Patients with Diabetes
2
조회
0
다운로드
1
인용
0
참고문헌
키워드
초록
Objective: To investigate whether there are clinical differences in patients with diabetic peripheral polyneuropathy (DPN) or carpal tunnel syndrome (CTS). Method: 587 patients with diabetes mellitus who had an electrodiagnostic study to investigate whether they had DPN or CTS were enrolled. The patients were divided into DPN, CTS, DPN+CTS groups. General characteristics, diabetes-related factors, and associated complications were compared between these two groups. Results: Of the 587 diabetic patients, 111 patients had DPN, CTS or both. Among 111 patients, 47 had DPN (42.3%), 29 had CTS (26.1%) and 35 had both (31.5%). The results showed that the duration of diabetes was associated with DPN. Patients who had both DPN and CTS had higher levels of Hb1Ac, PP2, albumin/creatinine ratio, and longer duration of diabetes than the patients who had only DPN or CTS. Conclusion: These results suggest that patients with both DPN and CTS showed a higher level of Hb1Ac, PP2, a longer duration of diabetes or renal complications, more so than seen in patients who have only DPN or CTS. Therefore, nerve conduction studies are recommended for patients who have these risk factors to be screened out for both DPN and CTS.
Abstract
Objective: To investigate whether there are clinical differences in patients with diabetic peripheral polyneuropathy (DPN) or carpal tunnel syndrome (CTS). Method: 587 patients with diabetes mellitus who had an electrodiagnostic study to investigate whether they had DPN or CTS were enrolled. The patients were divided into DPN, CTS, DPN+CTS groups. General characteristics, diabetes-related factors, and associated complications were compared between these two groups. Results: Of the 587 diabetic patients, 111 patients had DPN, CTS or both. Among 111 patients, 47 had DPN (42.3%), 29 had CTS (26.1%) and 35 had both (31.5%). The results showed that the duration of diabetes was associated with DPN. Patients who had both DPN and CTS had higher levels of Hb1Ac, PP2, albumin/creatinine ratio, and longer duration of diabetes than the patients who had only DPN or CTS. Conclusion: These results suggest that patients with both DPN and CTS showed a higher level of Hb1Ac, PP2, a longer duration of diabetes or renal complications, more so than seen in patients who have only DPN or CTS. Therefore, nerve conduction studies are recommended for patients who have these risk factors to be screened out for both DPN and CTS.
참고문헌 (30)
- Tanaka S, "The US prevalence of self-reported carpal tunnel syndrome: 1988 National Health Interview Survey data", American journal of public health, 84, pp.1846~1848 (1994)
- Dyck PJ, "The prevalence by staged severity of various types of diabetic neuropathy, retinopathy, and nephropathy in a population-based cohort: the Rochester Diabetic Neuropathy Study", Neurology, 43, pp.817~824 (1993)
- Bruce A, "Carpal Tunnel Syndrome in Patients With Diabetic Polyneuropathy", Diabetes care, 25, pp.565~569 (2002)
- Tesfaye S, "Diabetic neuropathies: update on definitions, diagnostic criteria, estimation of severity, and treatments", Diabetes care, 33, pp.2285~2293 (2010)
- Dyck PJ, "Diabetic Polyneuropathies: Update on Research Definition, Diagnostic Criteria and Estimation of Severity", Diabetes, 2011, pp.27, 620~628
- Ozaki I, "Deleterious ef fect of the carpal tunnel on nerve conduction in diabetic polyneuropathy", Electromyography and clinical neurophysiology, 28, pp.301~306 (1988)
- Solomon DH, "Nonoccupational risk factors for carpal tunnel syndrome", Journal of general internal medicine, 14, pp.310~314 (1999)
- Gamstedt A, "Hand abnormalities are strongly associated with the duration of diabetes mellitus", Journal of internal medicine, 234, pp.189~193 (1993)
- 김대열, "무증상의 당뇨병성 신경병증을 배제에 필요한 최소한의 전기진단 검사의 적용", 대한근전도 전기진단의학회지, 15(2), pp.73~80 (2013), 대한근전도전기진단의학회
- Gazioglu S, "Electrodiagnosis of carpal tunnel syndrome in patients with diabetic polyneuropathy", Clinical neurophysiology : official journal of the International Federation of Clinical Neurophysiology, 122, pp.1463~1469 (2011)
- 권희규, "당뇨병성 신경병증 심도에 따른 수근관 증후군의 동반 빈도", Annals of Rehabilitation Medicine, 29(3), pp.272~275 (2005), 대한재활의학회
- carlos Pastore VI, "A comparison of electrophysiological tests for the early diagnosis of diabetic neuropathy", Muscle & nerve, 22, pp.1667~1673 (1999)
- Dyck PJ, "Modeling nerve conduction criteria for diagnosis of diabetic polyneuropathy", Muscle &nerve, 44, pp.340~345 (2011)
- Jeong SW, "Usefulness of Questinnaires, Physical Examination and Median Mixed Nerve Conduction Studies in Patients with Diabetes Mellitus", J Korean Acad Rehab Med, 23, pp.292~302 (1999)
- Kasznicki J, "Advances in the diagnosis and management of diabetic distal symmetric polyneuropathy", Archives of medical science : AMS, 10, pp.345~354 (2014)
- 권용욱, "당뇨병 환자의 수근관 증후군 유병률 및 위험인자", Annals of Rehabilitation Medicine, 26(6), pp.17~754 (2002), 대한재활의학회
- Stevens JC, "AAEM minimonograph #26: the electrodiagnosis of carpal tunnel syndrome. American Association of Electrodiagnostic Medicine", Muscle & nerve, 20, pp.1477~1486 (1997)
- Kaku M, "Pathways in the diagnosis and management of diabetic polyneuropathy", Current diabetes reports, 15, pp.609~ (2015)
- Cornblath DR, "Diabetic Neuropathy: Diagnostic Methods", Adv Stud Med, 4, pp.650~661 (2004)
- Stevens JC, "Carpal tunnel syndrome in Rochester, Minnesota, 1961 to 1980", Neurology, 38, pp.134~138 (1988)
- Adams ML, "Outcome of carpal tunnel surgery in Washington State workers' compensation", American journal of industrial medicine, 25, pp.527~536 (1994)
- Kimura J, "Distal slowing of motor nerve conduction velocity in diabetic polyneuropathy", Journal of the neurological sciences, 42, pp.291~302 (1979)
- Spallone V, "Validation of DN4 as a screening tool for neuropathic pain in painful diabetic polyneuropathy", Diabetic medicine: a journal of the British Diabetic Association, 29, pp.578~585 (2012)
- 이종민, "수근관 증후군 환자에서 전기진단 중증도와 증상, 기능, 임상 중증도의 관계", Annals of Rehabilitation Medicine, 27(6), pp.16~911 (2003), 대한재활의학회
- 김선영, "당뇨병 환자에게 동반된 손목굴증후군의 임상적 특징", 대한신경과학회지, 28(4), pp.277~282 (2010), 대한신경과학회
- Rendell MS, "Mapping diabetic sensory neuropathy by current perception threshold testing", Diabetes care, 12, pp.636~640 (1989)
- Pitei DL, "The value of the Neurometer in assessing diabetic neuropathy by measurement of the current perception threshold", Diabetic medicine : a journal of the British Diabetic Association, 11, pp.872~876 (1994)
- Martin CL, "Vibration perception threshold as a measure of distal symmetrical peripheral neuropathy in type 1 diabetes: results from the DCCT", EDIC study, 2010, pp.33, 2635~2641
- Albers JW, "Diabetic neuropathy: mechanisms, emerging treatments, and subtypes", Current neurology and neuroscience reports, 14, pp.473~ (2014)
- Rolim LC, "Diabetic cardiovascular autonomic neuropathy: risk factors, clinical impact and early diagnosis", Arquivos brasileiros de cardiologia, 90, pp.e24~e31 (2008)