AUTHOR=Lin Xiaopu , Chen Chuna , Liu Yingshan , Peng Yu , Chen Zhenguo , Huang Haishan , Xu Lingling
TITLE=Peripheral Nerve Conduction And Sympathetic Skin Response Are Reliable Methods to Detect Diabetic Cardiac Autonomic Neuropathy
JOURNAL=Frontiers in Endocrinology
VOLUME=12
YEAR=2021
URL=https://www.frontiersin.org/journals/endocrinology/articles/10.3389/fendo.2021.709114
DOI=10.3389/fendo.2021.709114
ISSN=1664-2392
ABSTRACT=AimThis study aimed to investigate the role of nerve conduction studies (NCS) and sympathetic skin response (SSR) in evaluating diabetic cardiac autonomic neuropathy (DCAN).
MethodsDCAN was diagnosed using the Ewing test combined with heart rate variability analysis. NCS and SSR were assessed by electrophysiological methods. The association between NCS/SSR and DCAN was assessed via multivariate regression and receiver-operating characteristic analyses.
ResultsThe amplitude and conduction velocity of the motor/sensory nerve were found to be significantly lower in the DCAN+ group (all P < 0.05). A lower amplitude of peroneal nerve motor fiber was found to be associated with increased odds for DCAN (OR 2.77, P < 0.05). The SSR amplitude was lower while the SSR latency was longer in the DCAN+ group than in the DCAN– group. The receiver-operating characteristic analysis revealed that the optimal cutoff points of upper/lower limb amplitude of SSR to indicate DCAN were 1.40 mV (sensitivity, 61.9%; specificity, 66.3%, P < 0.001) and 0.85 mV (sensitivity, 66.7%; specificity, 68.5%, P < 0.001), respectively. The optimal cutoff points of upper/lower limb latency to indicate DCAN were 1.40 s (sensitivity, 61.9%; specificity, 62%, P < 0.05) and 1.81 s (sensitivity, 69.0%; specificity, 52.2%, P < 0.05), respectively.
ConclusionsNCS and SSR are reliable methods to detect DCAN. Abnormality in the peroneal nerve (motor nerve) is crucial in predicting DCAN. SSR may help predict DCAN.