Wuquan Deng1, Xiaoying Dong2, Yuping Zhang2, Youzhao Jiang2, Debin Lu2, Qinan Wu2, Ziwen Liang2, Gangyi Yang3, Bing Chen4. 1. Department of Endocrinology and Metabolism, Southwest Hospital, Third Military Medical University, Chongqing 400038, China; Department of Endocrinology, The Second Affiliated Hospital, Chongqing Medical University, Chongqing 400010, China. Electronic address: dwq_cq@126.com. 2. Department of Endocrinology and Metabolism, Southwest Hospital, Third Military Medical University, Chongqing 400038, China. 3. Department of Endocrinology, The Second Affiliated Hospital, Chongqing Medical University, Chongqing 400010, China. 4. Department of Endocrinology and Metabolism, Southwest Hospital, Third Military Medical University, Chongqing 400038, China. Electronic address: chenbing3@medmail.com.cn.
Abstract
AIMS: The assessment of transcutaneous oxygen pressure (TcPO2) may serve as a non-invasive and lower-cost alternative to nerve conduction studies (NCSs) for the diagnosis of diabetic peripheral neuropathy (DPN). The aim of this study was to determine whether the measurement of TcPO2 is useful for evaluating DPN. METHODS: We performed a cross-sectional study of 381 consecutive hospitalized diabetic patients classified by clinical examination and NCS as having DPN. Anthropometric and metabolic parameters were assessed. The TcPO2 examination was performed in both supine and sitting positions. RESULTS: Three hundred and one patients had DPN. The TcPO2 in both the supine and sitting positions was highest in the Non-DPN group and lower in the confirmed DPN group than the other three groups (p<0.001). The Non-DPN group had the lowest sitting-supine position difference in TcPO2 among the groups (p<0.001). The risk factors strongly associated with DPN included sitting-supine position difference in TcPO2 (OR=4.971, p<0.001), diabetic retinopathy (DR) (odds ratio [OR]=3.794, p=0.002), and HbA1c (OR=1.534, p=0.033). The area under the curve (AUC) of the sitting-supine position difference in TcPO2 was 0.722 and revealed an optimal cut-off point for the identification of DPN (19.5 mmHg) that had a sensitivity of 0.611 and a specificity of 0.738 based on AUC analysis. CONCLUSIONS: This large study of diabetic patients confirms that the sitting-supine position difference in TcPO2 is higher in DPN patients than control subjects, indicating that TcPO2 examination is a promising valuable diagnostic tool for DPN.
AIMS: The assessment of transcutaneous oxygen pressure (TcPO2) may serve as a non-invasive and lower-cost alternative to nerve conduction studies (NCSs) for the diagnosis of diabetic peripheral neuropathy (DPN). The aim of this study was to determine whether the measurement of TcPO2 is useful for evaluating DPN. METHODS: We performed a cross-sectional study of 381 consecutive hospitalized diabeticpatients classified by clinical examination and NCS as having DPN. Anthropometric and metabolic parameters were assessed. The TcPO2 examination was performed in both supine and sitting positions. RESULTS: Three hundred and one patients had DPN. The TcPO2 in both the supine and sitting positions was highest in the Non-DPN group and lower in the confirmed DPN group than the other three groups (p<0.001). The Non-DPN group had the lowest sitting-supine position difference in TcPO2 among the groups (p<0.001). The risk factors strongly associated with DPN included sitting-supine position difference in TcPO2 (OR=4.971, p<0.001), diabetic retinopathy (DR) (odds ratio [OR]=3.794, p=0.002), and HbA1c (OR=1.534, p=0.033). The area under the curve (AUC) of the sitting-supine position difference in TcPO2 was 0.722 and revealed an optimal cut-off point for the identification of DPN (19.5 mmHg) that had a sensitivity of 0.611 and a specificity of 0.738 based on AUC analysis. CONCLUSIONS: This large study of diabeticpatients confirms that the sitting-supine position difference in TcPO2 is higher in DPNpatients than control subjects, indicating that TcPO2 examination is a promising valuable diagnostic tool for DPN.