https://scholars.lib.ntu.edu.tw/handle/123456789/519257
標題: | Effect of glycemic control on sudomotor denervation in type 2 diabetes | 作者: | Luo K.-R. CHI-CHAO CHAO PAUL-CHEN HSIEH JUNE-HORNG LUE SUNG-TSANG HSIEH |
公開日期: | 2012 | 卷: | 35 | 期: | 3 | 起(迄)頁: | 612-616 | 來源出版物: | Diabetes Care | 摘要: | OBJECTIVE - Sudomotor symptoms are a common component of diabetic autonomic neuropathy, but the pathology of sudomotor innervation and its relationship with glycemic control have remained obscured. RESEARCH DESIGN AND METHODS - We enrolled 42 patients (26 males and 16 females aged 56.64 ± 12.67 years) with diabetic neuropathy defined by symmetric distally predominant sensory symptoms, abnormal nerve conduction studies, and reduced intraepidermal nerve fiber density in the leg. Skin biopsies of the distal leg were immunostained with antiprotein gene product 9.5 for nerve fibers and counterstained with Congo red for sweat glands. Sweat gland innervation index (SGII) was quantified with a new computerized area-based morphometric system. RESULTS - Protein gene product 9.5(+) nerve terminals surrounded secretory coils of the sweat glands in the skin of control subjects. Sudomotor denervation was present in diabetic patients, manifesting as depletion of periglandular nerve fibers with lower SGII compared with 42 age- and sex-matched control subjects (2.54 ± 1.87 vs. 4.68 ± 1.51%, P < 0.001). The SGII was correlated with HbA 1c (P = 0.011) and was lower in patients with anhidrosis of the feet compared with those with normal sweating of the feet (0.82 ± 0.69 vs. 3.00 ± 1.81%, P = 0.001). Sudomotor denervation was concordant with cardiac autonomic dysfunction as assessed with reduced heart rate variability (P = 0.003). CONCLUSIONS - Sudomotor denervation is a significant presentation of diabetic neuropathy, and the SGII was associated with HbA 1c. A skin biopsy offers a structural assessment of sudomotor innervation. ? 2012 by the American Diabetes Association. |
URI: | https://www.scopus.com/inward/record.uri?eid=2-s2.0-84859098620&doi=10.2337%2fdc11-1607&partnerID=40&md5=aa5294056878f7d642317203a4c6cf55 https://scholars.lib.ntu.edu.tw/handle/123456789/519257 |
ISSN: | 0149-5992 | DOI: | 10.2337/dc11-1607 | SDG/關鍵字: | congo red; glucose; hemoglobin A1c; adult; anhidrosis; area under the curve; article; autonomic dysfunction; autonomic innervation; autonomic neuropathy; cardiovascular disease; clinical article; controlled study; denervation; diabetic neuropathy; disease duration; dysautonomia; female; gastrointestinal disease; glucose blood level; glycemic control; heart rate variability; human; human tissue; immunohistochemistry; leg; male; nerve conduction disorder; nerve ending; nerve fiber; non insulin dependent diabetes mellitus; receiver operating characteristic; sensitivity and specificity; sensory dysfunction; skin biopsy; sweat gland; sweating; sympathetic tone; Adult; Aged; Blood Glucose; Diabetes Mellitus, Type 2; Female; Humans; Male; Middle Aged; Nerve Fibers; Prospective Studies; Skin; Sweat Glands |
顯示於: | 醫學系 |
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