Corneal confocal microscopy identifies small fibre damage and progression of diabetic neuropathy
| Autor: | Jan Hoong Ho, Ioannis N. Petropoulos, Shaishav Dhage, Andrew Atkinson, Uazman Alam, Maryam Ferdousi, Safwaan Adam, Georgios Ponirakis, Handrean Soran, Shazli Azmi, Alise Kalteniece, Maria Jeziorska, Andrew Marshall, Rayaz A. Malik |
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| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
Diabetic neuropathy
Urinary albumin Nerve Fibers/pathology Body Mass Index Cornea chemistry.chemical_compound 0302 clinical medicine Nerve Fibers Diabetic Neuropathies Diabetes complications Diabetic Neuropathies/blood Multidisciplinary Microscopy Confocal/methods Microscopy Confocal Quantitative sensory testing Diabetes Middle Aged Cornea/pathology Cholesterol LDL/blood Disease Progression Medicine Diabetes Mellitus Type 2/blood Adult medicine.medical_specialty Glycated Hemoglobin A/metabolism Science 030209 endocrinology & metabolism Article 03 medical and health sciences Vibration perception Diabetes mellitus Ophthalmology medicine Humans Aged Glycated Hemoglobin Creatinine Analysis of Variance Autonomic nerve business.industry Diabetes Mellitus Type 1/blood Cholesterol LDL medicine.disease Peripheral neuropathy Diabetes Mellitus Type 1 chemistry Diabetes Mellitus Type 2 business 030217 neurology & neurosurgery |
| Zdroj: | SCIENTIFIC REPORTS Scientific Reports Dhage, S, Ferdousi, M, Adam, S, Ho, J H, Kalteniece, A, Azmi, S, Alam, U, Ponirakis, G, Petropoulos, I, Atkinson, A J, Marshall, A, Jeziorska, M, Soran, H & Malik, R A 2021, ' Corneal confocal microscopy identifies small fibre damage and progression of diabetic neuropathy ', Scientific Reports, vol. 11, no. 1, 1859 . https://doi.org/10.1038/s41598-021-81302-8 Scientific Reports, Vol 11, Iss 1, Pp 1-9 (2021) |
| DOI: | 10.1038/s41598-021-81302-8 |
| Popis: | Accurately quantifying the progression of diabetic peripheral neuropathy is key to identify individuals who will progress to foot ulceration and to power clinical intervention trials. We have undertaken detailed neuropathy phenotyping to assess the longitudinal utility of different measures of neuropathy in patients with diabetes. Nineteen patients with diabetes (age 52.5 ± 14.7 years, duration of diabetes 26.0 ± 13.8 years) and 19 healthy controls underwent assessment of symptoms and signs of neuropathy, quantitative sensory testing, autonomic nerve function, neurophysiology, intra-epidermal nerve fibre density (IENFD) and corneal confocal microscopy (CCM) to quantify corneal nerve fibre density (CNFD), branch density (CNBD) and fibre length (CNFL). Mean follow-up was 6.5 years. Glycated haemoglobin (p = 0.04), low-density lipoprotein-cholesterol (LDL-C) (p = 0.0009) and urinary albumin creatinine ratio (p p = 0.03), neuropathy disability score (p = 0.04), vibration perception threshold (p = 0.02), cold perception threshold (p = 0.006), CNFD (p = 0.03), CNBD (p p p = 0.04), sural (p = 0.02) and peroneal motor nerve conduction velocity (p = 0.03) deteriorated significantly. Change (∆) in CNFL correlated with ∆CPT (p = 0.006) and ∆Expiration/Inspiration ratio (p = 0.002) and ∆IENFD correlated with ∆CNFD (p = 0.005), ∆CNBD (p = 0.02) and ∆CNFL (p = 0.01). This study shows worsening of diabetic neuropathy across a range of neuropathy measures, especially CCM, despite an improvement in HbA1c and LDL-C. It further supports the utility of CCM as a rapid, non-invasive surrogate measure of diabetic neuropathy. |
| Databáze: | OpenAIRE |
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