Characteristics of Sural Nerve Conduction in Diabetic Distal Symmetric Polyneuropathy and Risk Factor Analysis

LIU Yuhong; JANG Yubao

doi:10.3969/j.issn.1002-3429.2025.15.017

Abstract：Objective To explore the characteristics of sural nerve conduction in diabetic distal symmetrical polyneuropathy(DSPN),and to analyze the influencing factors of sural nerve conduction injury(SNCI).Methods A total of 137 patients with type 2 diabetes mellitus(T2DM)admitted from May to October 2024 were collected and divided into the non-DSPN group(n=70)and the DSPN group(n=67)based on the presence or absence of DSPN.The sensory nerve action potential(SNAP),sensory conduction velocity(SCV),and the SNAP ratio of the sural nerve to the superficial radial nerve(SN/SRN)of the two groups were compared,and the receiver operating characteristic(ROC)curve was drawn to analyze the predictive value of sural nerve SNAP,SCV,and SN/SRN for DSPN.According to the presence or absence of SNCI,they were divided into the non-SNCI group(n=88)and the SNCI group(n=49).Multivariate logistic regression was used to analyze the risk factors for the occurrence of SNCI.Results The SNAP,SCV and SN/SRN of the sural nerve in the DSPN group were significantly lower than those in the non-DSPN group(P<0.01).The areas under the ROC curve(AUCs)of SNAP,SCV,SN/SRN detected alone and in combination for predicting the occurrence of DSPN were 0.851,0.762,0.884 and 0.922,respectively,and the optimal cut-off values were 10.8 μV,44.6 m/s and 0.42 respectively.Among them,SN/SRN had the highest sensitivity(86.8%)in diagnosing DSPN,and the combination of the three indicators had the highest specificity(98.4%)in diagnosing DSPN.Multivariate logistic regression analysis showed that the duration of diabetes and uric acid level were risk factors for the occurrence of SNCI.Conclusion The sensitivity and specificity of sural nerve SNAP,SCV,SN/SRN detected alone and in combination for predicting DSPN are relatively high.They can be used as routine screening methods for DSPN,which is helpful for the early diagnosis of DSPN,and the treatment of hyperuricemia is of great significance for delaying the progression of the disease.