Relationship between sonographically measured median nerve cross-sectional area and presence of peripheral neuropathy in diabetic subjects

doi:10.4239/wjd.v10.i1.47

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World Journal of Diabetes

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1948-9358

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

Case Control Study

World J Diabetes. Jan 15, 2019; 10(1): 47-56
Published online Jan 15, 2019. doi: 10.4239/wjd.v10.i1.47

Table 1 Demographic, anthropometric and clinical characteristics of the study subjects n (%)

Variables	DM, n = 85	HC, n = 85	P-value
Age (yr)
mean ± SD¹	61.7 ± 11.1	60.9 ± 10.3	0.620
< 50 yr	11 (12.9)	11 (12.9)	0.965
50-59 yr	25 (29.4)	27 (31.8)
60-69 yr	22 (25.9)	23 (27.1)
≥ 70 yr	27 (31.8)	24 (28.2)
Gender
Male	44 (51.8)	44 (51.8)	1.000
Female	41 (48.2)	41 (48.2)	1.000
Height (m)¹	1.66 ± 0.08	1.65 ± 0.08	0.473
Weight (Kg)¹	71.3 ± 13.6	65.4 ± 11.5	0.003
BMI (Kg/m²)¹
mean ± SD¹	26.0 ± 5.3	24.1 ± 4.3	0.010
Underweight	3 (3.5)	4 (4.7)	0.072
Normal BMI	35 (41.2)	51 (60.0)
Overweight	31 (36.5)	21 (24.7)
Obese	16 (18.8)	9 (10.6)
Systolic BP (mmHg)¹	129.8 ± 20.7	131.9 ± 24.3	0.557
Diastolic BP (mmHg)¹	84.2 ± 11.5	82.8 ± 13.1	0.404
Total cholesterol (mmHg)¹	4.90	4.78	0.622
FBG (mmol/L)¹	7.00 ± 2.16	5.15 ± 0.06	0.001
HbA1C in % (mean ± SD)	8.69 ± 2.46	-	-
Duration of DM in months median (range)	48.0 (0.3-312)	-	-
Peripheral neuropathy	51 (60)	-	-

¹P values < 0.05 are significant. BMI: Body mass index; SBP: Systolic blood pressure; DBP: Diastolic blood pressure; DM: Diabetes mellitus; FBG: Fasting blood glucose; HbA1c: Glycated haemoglobin.

Table 2 Comparison of median nerve cross-sectional area between diabetics and healthy controls

Median nerve CSA (mm²)		DM, n = 85	HC, n = 85	P-value
Right	Carpal tunnel	12.5 ± 2.5	8.8 ± 1.7	< 0.01
Right	5 cm proximal	8.0 ± 2.0	5.3 ± 1.2	< 0.01
Left	Carpal tunnel	12.3 ± 2.5	8.6 ± 1.7	< 0.01
Left	5 cm proximal	7.9 ± 1.9	5.4 ± 1.4	< 0.001

CSA: Cross sectional area; DM: Diabetic subjects; HC: Healthy control subjects. P values < 0.05 are significant.

Table 3 Comparison of median nerve cross-sectional area between diabetics with and diabetics without diabetic peripheral neuropathy

Median nerve CSA (mm²)	Diabetic peripheral neuropathy		P-value
Median nerve CSA (mm²)	Absent n = 34	Present n = 51	P-value
Carpal tunnel	11.8 ± 2.4	12.9 ± 2.5	0.049
5cm Proximal	8.0 ± 2.2	8.0 ± 2.0	0.856

CSA: Cross sectional area. P values< 0.05 are significant.

Table 4 Comparison of median nerve cross-sectional area between diabetics without diabetic peripheral neuropathy, diabetics with mild diabetic peripheral neuropathy and diabetics with moderate/severe diabetic peripheral neuropathy

Median nerve CSA (mm²)	Peripheral neuropathy			*P-value*
Median nerve CSA (mm²)	Absent (n = 34)	Mild (n = 32)	Moderate/severe (n = 19)	*P-value*
Carpal tunnel	11.8 ± 2.4^a	13.2 ± 2.6^a	12.3 ± 2.1^a	0.062
5 cm Proximal	7.9 ± 2.2^b	8.3 ± 2.2^b	7.6 ± 1.4^b	0.145

CSA: Cross sectional area; DPN: Diabetic peripheral neuropathy; NB: The same alphabets in each row indicate insignificant differences using scheffe post hoc test to evaluate intergroup differences.

Table 5 Comparison of median nerve cross-sectional area between categories of age, gender, duration of diabetes mellitus, and glycemic control at carpal tunnel and 5 cm proximal to the carpal tunnel

		Median nerve CSA (mm²) at CATL
		DM_nonDPN	P-value	DM_DPN	P-value	HC	P-value
Duration of DM	≤ 5 yr	11.4 ± 1.8	0.65	12.9 ± 2.4	0.99	-	-
Duration of DM	> 5 yr	11.8 ± 3.3	0.65	12.9 ± 2.7	0.99	-	-
FBG	≤ 7 mmol/L	11.6 ± 2.3	0.79	13.2 ± 2.9	0.34	-	-
FBG	> 7 mmol/L	11.4 ± 2.0	0.79	12.5 ± 1.8	0.34	-	-
HBA1c	≤ 7%	11.0 ± 1.8	0.45	12.3 ± 2.4	0.20	-	-
HBA1c	> 7%	11.7 ± 2.3	0.45	13.2 ± 2.6	0.20	-	-
Age	≤ 60 yr	11.1 ± 1.9	0.25	12.9 ± 2.3	1.00	8.7 ± 1.5	0.37
Age	> 60 yr	12.0 ± 2.4	0.25	12.9 ± 2.7	1.00	8.4 ± 1.9	0.37
Sex	Female	11.3 ± 1.9	0.62	13.2 ± 2.6	0.42	8.1 ± 1.2	0.02
Sex	Male	11.7 ± 2.4	0.62	12.6 ± 2.4	0.42	9.0 ± 2.0	0.02
		Median nerve CSA (mm²) at 5cmCATL
		DM_nonDPN	P-value	DM_DPN	P-value	HC	P-value
Duration of DM	≤ 5 yr	7.6 ± 1.9	0.87	7.7 ± 1.7	0.13	-	-
Duration of DM	> 5 yr	7.5 ± 1.5	0.87	8.5 ± 2.2	0.13	-	-
FBG	≤ 7 mmol/L	7.5 ± 1.3	0.74	8.2 ± 1.9	0.57	-	-
FBG	> 7 mmol/L	7.7 ± 2.5	0.74	7.9 ± 2.0	0.57	-	-
HBA1c	≤ 7%	7.5 ± 1.4	0.86	7.7 ± 2.2	0.29	-	-
HBA1c	> 7%	7.6 ± 1.9	0.86	8.3 ± 1.8	0.29	-	-
Age	≤ 60 yr	7.3 ± 1.5	0.32	8.4 ± 2.1	0.25	5.5 ± 1.2	0.79
Age	> 60 yr	7.9 ± 2.2	0.32	7.8 ± 1.8	0.25	5.4 ± 1.5	0.79
Sex	Female	7.0 ± 1.4	0.10	7.8 ± 1.7	0.37	4.9 ± 0.7	0.00
Sex	Male	8.0 ± 2.0	0.10	8.3 ± 2.2	0.37	5.9 ± 1.6	0.00

CATL: Carpal tunnel; 5cmCATL: 5 cm proximal to the carpal tunnel; DM_nonDPN: Diabetics without diabetic peripheral neuropathy; DM_DPN: Diabetics without diabetic peripheral neuropathy; HC : Healthy controls. P values < 0.05 are significant.

Table 6 Relationship between median nerve cross-sectional area on ultrasound and clinical/laboratory parameters of the diabetic subjects

Variables	CATL		5cmCATL
Variables	r	P-value	r	P-value
Age	-0.041	0.898	-0.050	0.650
Sex	-0.058¹	0.601	-0.050¹	0.651
Weight	0.094	0.390	-0.041	0.708
Height	0.042	0.703	0.025	0.817
BMI	0.091	0.407	-0.056	0.611
SBP	-0.126	0.251	0.050	0.648
DBP	0.043	0.693	0.050	0.648
TC	0.092	0.402	0.092	0.056
Duration of DM	0.110²	0.318	0.151²	0.167
FBG	-0.059	0.591	0.026	0.811
HbA_1c	-0.012	0.916	0.034	0.758

¹Point-biserial correlation coefficient;

²Spearman correlation coefficient. CATL: Carpal tunnel; 5cmCATL: 5 cm proximal to the carpal tunnel; r: Pearson correlation coefficient;; CSA: Cross sectional area; BMI: Body mass index; SBP: Systolic blood pressure; DBP: Diastolic blood pressure; DM: Diabetes mellitus; FBG: Fasting blood glucose; HbA1c: Glycated haemoglobin P values < 0.05 are significant.

Citation: Attah FA, Asaleye CM, Omisore AD, Kolawole BA, Aderibigbe AS, Alo M. Relationship between sonographically measured median nerve cross-sectional area and presence of peripheral neuropathy in diabetic subjects. World J Diabetes 2019; 10(1): 47-56
URL: https://www.wjgnet.com/1948-9358/full/v10/i1/47.htm
DOI: https://dx.doi.org/10.4239/wjd.v10.i1.47