Lower Limb Arterial Ischemia: An Independent Risk Factor of Sudomotor Dysfunction in Type 2 Diabetes

作者全名："Lv, Yuhuan; Yang, Zheng; Xiang, Linyu; Yu, Meng; Zhao, Subei; Zhang, Xiaoru; Li, Rong"

作者地址："[Lv, Yuhuan; Yang, Zheng; Xiang, Linyu; Yu, Meng; Zhao, Subei; Zhang, Xiaoru; Li, Rong] Chongqing Med Univ, Affiliated Hosp 1, Dept Endocrinol, Chongqing 400016, Peoples R China; [Li, Rong] Chongqing Med Univ, Affiliated Hosp 1, Dept Endocrinol, YouYi Rd 1, Chongqing, Peoples R China"

通信作者："Li, R (通讯作者)，Chongqing Med Univ, Affiliated Hosp 1, Dept Endocrinol, YouYi Rd 1, Chongqing, Peoples R China."

来源：DIABETES METABOLIC SYNDROME AND OBESITY

ESI学科分类：CLINICAL MEDICINE

WOS号：WOS:000959130900001

JCR分区：　

影响因子：　

年份：2023

卷号：16

期号：　

开始页：883

结束页：891

文献类型：Article

关键词：sudomotor function; lower limb arterial ischemia; ankle brachial index; toe brachial index; transcutaneous oxygen tension

摘要："Background: As an early manifestation of diabetic peripheral neuropathy (DPN), sudomotor dysfunction significantly increases the risk of diabetic foot ulcer. The pathogenesis of sudomotor dysfunction is still unclear. Lower limb ischemia may be related to sudomotor dysfunction, but few studies have explored it. The purpose of this study is to explore the relationship between sudomotor function and comprehensive lower limb arterial ischemia including large arteries, small arteries and microvascular in type 2 diabetes mellitus (T2DM). Patients and Methods: 511 T2DM patients were enrolled in this cross-sectional study. Sudomotor function was assessed qualitatively and quantitatively by Neuropad. Lower limb arterial ischemia was defined as any abnormality of the ankle brachial index (ABI), toe brachial index (TBI) or transcutaneous oxygen tension (TcPO2). Results: In this study, 75.1% of patients had sudomotor dysfunction. Compared with normal sudomotor function, patients with sudomotor dysfunction had a higher incidence of lower limb arterial ischemia (51.2% vs 36.2%, p = 0.004). Similarly, compared with the non-arterial ischemia group, the proportion of sudomotor disorders was higher in the arterial ischemia group (p = 0.004). Low TBI and low TcPO2 groups also had a higher proportion of sudomotor disorders (allp < 0.05).Compare with normal groups, low ABI, low TBI, and low TcPO2 groups had lower Slop4 which quantitatively reflecting Neuropad discoloration. Arterial ischemia was an independent risk factor for sudomotor dysfunction [OR = 1.754, p = 0.024]. Low TcPO2 also independently increased the risk of sudomotor disorders [OR = 2.231, p = 0.026]. Conclusion: Lower limb arterial ischemia is an independent risk factor of sudomotor dysfunction. Especially below the ankle (BTA) small arteries and microvascular ischemia may also be involved in the occurrence of sudomotor disorders."

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