Study on Changes of EMG Parameters and Their Correlation with Metabolic Indexes in DPN Patients

ZHANG Cong; XUE Ling; LIU Xuying; SONG Yuan

doi:10.3969/j.issn.2096-305X.2025.02.015

Abstract：Objective To explore the changes of neuro-electromyogram parameters in patients with diabetic peripheral neuropathy(DPN)and their correlation with metabolic indicators.Methods A total of 90 patients with type 2 diabetes mellitus complicated with DPN(DPN group)and 50 patients only with type 2 diabetes mellitus(control group)were selected between January 2019 and December 2019.Neuro-electromyogram parameters,glucolipid metabolism indicators[serum C peptide,glycosylated hemoglobin(HbA1c),triglyceride(TG),total cholesterol(TC),low-density lipoprotein cholesterol(LDL-C),high-density lipoprotein cholesterol(HDL-C)]and renal function metabolism indicators[urinary microalbumin,urinary creatinine,urinary albumin creatinine ratio(UACR)]were compared between the two groups;Pearson correlation method was used to explore the correlation between neuro-electromyogram parameters and metabolic indicators in patients with DPN;multivariate Logistic regression analysis was used to explore the influencing factors for DPN;ROC curve was drawn to explore the predictive value of metabolic indicators on the onset of DPN.Results The motor nerve conduction velocities of median nerve,ulnar nerve,common peroneal nerve and tibial nerve in DPN group were all lower than those in control group(P＜0.05);the motor nerve wave amplitudes of median nerve,ulnar nerve and common peroneal nerve were all lower than those in control group(P＜0.05);the motor nerve latency of median nerve and ulnar nerve were longer than those in control group(P＜0.05);the sensory nerve conduction velocity of superficial peroneal nerve was decreased compared with that in control group(P＜0.05);the sensory nerve wave amplitudes of median nerve and ulnar nerve were reduced compared to control group(P＜0.05).The levels of C peptide and HDL-C of DPN group were lower than those of control group(P＜0.05)while the levels of HbA1c,LDL-C,urinary microalbumin,urinary creatinine,and UACR were all higher than those of control group(P＜0.05).Pearson correlation analysis showed that median nerve motor nerve conduction velocity in patients with DPN was negatively correlated with LDL-C,urinary microalbumin and UACR(P＜0.05);latency was positively correlated with UACR(P＜0.05);tibial nerve motor nerve conduction velocity was negatively correlated with urinary microalbumin and UACR(P＜0.05);amplitude was negatively correlated with C peptide(P＜0.05);ulnar nerve motor nerve latency was positively correlated with HbA1c,urinary microalbumin and UACR(P＜0.05);common peroneal nerve motor nerve latency was positively correlated with urinary microalbumin and UACR(P＜0.05);median nerve sensory nerve conduction velocity was negatively correlated with HbA1c and LDL-C(P＜0.05),and the amplitude was negatively correlated with LDL-C(P＜0.05).Multivariate Logistic regression analysis showed that diabetes course,HbA1c,LDL-C,urinary microalbumin and UACR were independent risk factors for DPN(P＜0.05);C peptide and HDL-C were protective factors for DPN(P＜0.05).The areas under the ROC curves of HbA1c,LDL-C,urinary microalbumin and UACR in predicting the occurrence of DPN were 0.706,0.674,0.696 and 0.648 respectively.Conclusion Some neuro-electromyogram parameters have more obvious changes in patients with DPN than patients with simple type 2 diabetes mellitus,and they are related to glucolipid metabolism indicators and renal function metabolism indicators.Early monitoring of metabolic indicators has a certain predictive value on the occurrence of DPN.