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. 2021 Sep;12(9):1663-1670.
doi: 10.1111/jdi.13515. Epub 2021 Feb 20.

Quantitative vibration perception threshold in assessing diabetic polyneuropathy: Should the cut-off value be adjusted for Chinese individuals with type 2 diabetes?

Min Liu  1 , Yun Gao  1 , Da-Wei Chen  1 , Shuang Lin  1 , Chun Wang  1 , Li-Hong Chen  1 , Xing-Wu Ran  1
Affiliations

Quantitative vibration perception threshold in assessing diabetic polyneuropathy: Should the cut-off value be adjusted for Chinese individuals with type 2 diabetes?

Min Liu et al. J Diabetes Investig. 2021 Sep.

Abstract

Aims/introduction: To examine the performance and identify the optimal threshold of vibration perception threshold (VPT) for diagnosing diabetic polyneuropathy (DPN) in a Chinese population according to multiple definitions of DPN as gold standards.

Materials and methods: VPT was determined in 421 Chinese individuals with type 2 diabetes, who simultaneously completed a questionnaire of neuropathic symptoms, and underwent the assessment of signs of peripheral neuropathy and electromyography tests. Three definitions of DPN (i.e., clinician-diagnosed DPN, abnormal nerve conduction and confirmed DPN) were taken as reference gold standards.

Results: Vibration perception threshold was a specific measure for all three groups of DPN outcomes, with the highest specificity noted for clinician-diagnosed DPN (85.1%). The specificity for abnormal nerve conduction and confirmed DPN was 77.0 and 76.6%, respectively. The sensitivity of VPT was 67.0% for clinician-diagnosed DPN, 66.5% for abnormal nerve conduction and 67.2% for confirmed DPN. The optimal cut-off threshold for abnormal nerve conduction, as well as confirmed DPN, was VPT >14.9 V. The specificity and sensitivity of VPT >14.9 V as the cut-off value for clinician-diagnosed DPN were 85.6 and 66.2%, respectively. When taking clinician-diagnosed DPN as the gold standard, the performance of VPT for diagnosing DPN was best with an area under the curve value of 0.804.

Conclusions: VPT measured using the neurothesiometer had relatively high specificity and best performance for diagnosing DPN when clinician-diagnosed DPN rather than abnormal nerve conduction was taken as the gold standard in a Chinese population. A VPT value of ≥15 V might be equally applicable for diagnosing DPN in a Chinese population.

Keywords: Diabetic polyneuropathy; Type 2 diabetes mellitus; Vibration perception threshold.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Vibration perception threshold levels by clinician‐diagnosed diabetic polyneuropathy (DPN), abnormal nerve conduction and confirmed diabetic polyneuropathy status.
Figure 2
Figure 2
Receiver operating characteristic curve for the accuracy of vibration perception threshold testing at the great toe for (a) clinician‐diagnosed diabetic polyneuropathy, (b) abnormal nerve conduction and (c) confirmed diabetic polyneuropathy.
See this image and copyright information in PMC

References

    1. Dyck PJ, Kratz KM, Karnes JL, et al. The prevalence by staged severity of various types of diabetic neuropathy, retinopathy, and nephropathy in a population‐based cohort: the Rochester Diabetic Neuropathy Study. Neurology 1993; 43: 817–824. - PubMed
    1. Løseth S, Stålberg EV, Lindal S, et al. Small and large fiber neuropathy in those with type 1 and type 2 diabetes: a 5‐year follow‐up study. J Peripher Nerv Syst 2016; 21: 15–21. - PubMed
    1. Boulton AJ, Vinik AI, Arezzo JC, et al. Diabetic neuropathies: a statement by the American Diabetes Association. Diabetes Care 2005; 28: 956–962. - PubMed
    1. Boulton AJ, Kirsner RS, Vileikyte L. Clinical practice. Neuropathic diabetic foot ulcers. N Engl J Med 2004; 351: 48–55. - PubMed
    1. Xu Z, Ran X. Diabetic foot care in China: challenges and strategy. Lancet Diabetes Endocrinol 2016; 4: 297–298. - PubMed