The Effect of Peripheral Vascular Disease on Diabetic Neuropathy.

, Park, Geun Young; , Park, Joo Hyun; , Lee, So Eui; , Kang, Hyun Kyu; , Chung, Myung Eun; , Seong, Nam Seok

Original Article

Journal of the Korean Academy of Rehabilitation Medicine 2006;30(1):25-32.

Park, Geun Young , Park, Joo Hyun , Lee, So Eui , Kang, Hyun Kyu , Chung, Myung Eun , Seong, Nam Seok

¹Department of Rehabilitation Medicine, College of Medicine, The Catholic University of Korea. pmr@dreamwiz.com
²Department of Rehabilitation Medicine, School of Medicine, Eulgi University.

말초 혈관 질환이 당뇨병성 신경병증에 미치는 영향

박근영, 박주현, 이소의¹, 강현규, 정명은, 성남석

가톨릭대학교 의과대학 재활의학교실, ¹을지의과대학교 재활의학교실

Abstract

Objective
To evaluate the effect of peripheral vascular disease (PVD) on diabetic neuropathy with the use of Doppler ultrasound and electrodiagnostic study.
Method
One hundred fifty one patients with diabetes mellitus underwent nerve conduction studies. PVD was diagnosed when ankle-brachial index (ABI) was 0.9 and less and also toe-brachial index (TBI) was 0.7 and less. Electrophysiologically normal group was subdivided into non- PVD group (A1) and PVD group (A2). Diabetic neuropathy group was subdivided into non-PVD group (B1) and PVD group (B2). The frequency of diabetic neuropathy and the difference of amplitude, conduction velocity, and F wave latency within A groups and B groups were investigated.
Results
Diabetic neuropathy was significantly correlated with PVD (p＜0.05). There was no definite difference of electrophysiologic parameters between A1 and A2 groups. B1 group showed significantly reduced amplitude of sensory nerve action potential (SNAP) in sural nerve compared with B2 group (p＜0.05). In all patients, the amplitude of SNAP in sural nerve was related with duration of diabetes and TBI by multiple linear regression analysis.
Conclusion
This study supports the influence of PVD on diabetic neuropathy and suggests vascular abnormality in patients with diabetic neuropathy may result in predominantly axonal injury rather than demyelinating injury. (J Korean Acad Rehab Med 2006; 30: 25-32)

Key Words: Diabetic neuropathy, Ankle-brachial index, Toe-brachial index, Nerve conduction study, Peripheral vascular disease