Araştırma Makalesi
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Retinopati düzeyine göre tip 2 diyabetli hastalarda santral ve periferik sinir iletiminin elektrofizyolojik değerlendirilmesi

Yıl 2025, Cilt: 6 Sayı: 5, 476 - 480, 24.10.2025

Öz

Amaç: Tip 2 diyabetes mellitus (T2DM) hastalarında görsel uyarılmış potansiyel (VEP) ve sinir iletim çalışmaları kullanılarak santral ve periferik sinir iletimini değerlendirmek ve bu parametrelerin diyabet süresi ile diyabetik retinopati şiddetiyle ilişkisini araştırmak.

Yöntem: Bu retrospektif kesitsel çalışmaya, 100 T2DM hastası ve yaş-cinsiyet uyumlu 100 sağlıklı kontrol dahil edilmiştir. Santral iletim için P100 latansı ölçülmüş, periferik iletim için tibial, ulnar ve sural sinirlerin distal latans, amplitüd ve ileti hızı parametreleri değerlendirilmiştir. İstatistiksel analizlerde t-testi, Mann–Whitney U testi, Ki-kare testi, ANOVA, Kruskal–Wallis testi ve Spearman korelasyon analizleri kullanılmıştır.

Bulgular: P100 latansı, diyabet grubunda kontrol grubuna göre anlamlı derecede uzundu (113,07 ± 4,66 ms vs. 104,10 ± 3,25 ms; p<0,001). Tüm motor ve duysal sinirlerde distal latans uzaması, amplitüd azalması ve ileti hızında yavaşlama saptandı (tümü için p<0,001). Diyabet süresi ile P100 latansı veya sinir iletim parametreleri arasında anlamlı korelasyon bulunmadı (p>0,05). Retinopati şiddeti grupları arasında P100 latansı açısından anlamlı fark yoktu (p=0,094).

Sonuç: Tip 2 diyabetli hastalarda, diyabet süresi veya retinopati şiddetinden bağımsız olarak hem santral hem de periferik sinir iletim bozuklukları görülebilir. VEP ve sinir iletim çalışmalarının birlikte uygulanması, diyabetik nöropatilerin erken tanısında daha kapsamlı bir yaklaşım sağlayabilir.

Kaynakça

  • American Diabetes Association. Diagnosis and classification of diabetes mellitus. Diabetes Care. 2014;37 Suppl 1(Suppl 1):S81-S90. doi:10.2337/dc14-S081
  • Tesfaye S, Selvarajah D. Diabetic peripheral neuropathy: explanatory factors and clinical relevance. Diabetes Res Clin Pract. 2012;96(3):214-223. doi:10.1016/j.diabres.2012.10.015
  • Cheung N, Mitchell P, Wong TY. Diabetic retinopathy. Lancet. 2010; 376(9735):124-136. doi:10.1016/S0140-6736(09)62124-3
  • Wilkinson CP, Ferris FL, Klein RE, et al. Proposed international clinical diabetic retinopathy and diabetic macular edema disease severity scales. Ophthalmology. 2003;110(9):1677-1682. doi:10.1016/S0161-6420(03)00475-5
  • Miura G. Visual evoked potentials for the detection of diabetic retinal neuropathy. Int J Mol Sci. 2023;24(8):7361. doi:10.3390/ijms24087361
  • England JD, Gronseth GS, Franklin G, et al. Distal symmetric polyneuropathy: a definition for clinical research. Muscle Nerve. 2005; 31(1):113-123. doi:10.1002/mus.20259
  • Pirart J. Diabetes mellitus and its degenerative complications: a prospective study of 4,400 patients observed between 1947 and 1973. Diabetes Care. 1978;1(3):168-188. doi:10.2337/diacare.1.3.168
  • Lövestam-Adrian M, Gränse L, Andersson G, Andreasson S. Multifocal visual evoked potentials (mfVEP) in diabetic patients with and without polyneuropathy. Open Ophthalmol J. 2012;6:98-103. doi:10.2174/ 1874364101206010098
  • Stratton IM, Adler AI, Neil HA, et al. Association of glycaemia with macrovascular and microvascular complications of type 2 diabetes: prospective observational study. BMJ. 2000;321(7258):405-412. doi:10. 1136/bmj.321.7258.405
  • Tesfaye S, Boulton AJ, Dyck PJ, et al. Diabetic neuropathies: update on definitions, diagnostic criteria, estimation of severity, and treatments. Diabetes Care. 2010;33(10):2285-2293. doi:10.2337/dc10-1303
  • Callaghan BC, Cheng HT, Stables CL, Smith AL, Feldman EL. Diabetic neuropathy: clinical manifestations and current treatments. Lancet Neurol. 2012;11(6):521-534. doi:10.1016/S1474-4422(12)70065-0
  • 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(4):817-824. doi:10.1212/WNL.43.4.817
  • Al-Geffari M. Correlation between diabetic neuropathy, retinopathy and nephropathy, and serum levels of vitamin D, HbA1c and lipids in Saudi Arabia. Int J Diabetes Dev Ctries. 2012;32(2):77-82. doi:10.1007/s13410-012-0075-9
  • Malik RA, Tesfaye S, Newrick PG, et al. Sural nerve pathology in diabetic patients with minimal but progressive neuropathy. Diabetologia. 2005; 48(3):578-585. doi:10.1007/s00125-005-1663-5

Electrophysiological evaluation of central and peripheral nerve conduction according to retinopathy level in type II diabetic patients

Yıl 2025, Cilt: 6 Sayı: 5, 476 - 480, 24.10.2025

Öz

Aims: To evaluate central and peripheral nerve conduction in patients with type 2 diabetes mellitus (T2DM) using visual evoked potentials (VEP) and nerve conduction studies, and to investigate their relationship with diabetes duration and diabetic retinopathy severity.
Methods: This retrospective cross-sectional study included 100 T2DM patients and 100 age- and sex-matched healthy controls. P100 latency was measured for central conduction, while distal latency, amplitude, and conduction velocity of the tibial, ulnar, and sural nerves were assessed for peripheral conduction. Statistical analyses included t-tests, Mann–Whitney U tests, Chi-square tests, ANOVA, Kruskal–Wallis tests, and Spearman’s correlations.
Results: P100 latency was significantly prolonged in the diabetic group compared with controls (113.07±4.66 ms vs. 104.10±3.25 ms; p<0.001). All motor and sensory nerves exhibited prolonged distal latencies, reduced amplitudes, and slower conduction velocities (p<0.001 for all). No significant correlation was found between diabetes duration and either P100 latency or nerve conduction parameters (p>0.05). P100 latency did not significantly differ between retinopathy severity groups (p=0.094).
Conclusion: Both central and peripheral nerve conduction abnormalities are present in T2DM patients, independent of diabetes duration or retinopathy severity. Combined VEP and nerve conduction studies may provide a more comprehensive approach for the early detection of diabetic neuropathies.

Etik Beyan

The study was approved by the Clinical Research Ethics Committee of Gaziantep City Hospital on September 18, 2024, with decision number 54/2024.

Destekleyen Kurum

Gaziantep City Hospital, Kocaeli University

Kaynakça

  • American Diabetes Association. Diagnosis and classification of diabetes mellitus. Diabetes Care. 2014;37 Suppl 1(Suppl 1):S81-S90. doi:10.2337/dc14-S081
  • Tesfaye S, Selvarajah D. Diabetic peripheral neuropathy: explanatory factors and clinical relevance. Diabetes Res Clin Pract. 2012;96(3):214-223. doi:10.1016/j.diabres.2012.10.015
  • Cheung N, Mitchell P, Wong TY. Diabetic retinopathy. Lancet. 2010; 376(9735):124-136. doi:10.1016/S0140-6736(09)62124-3
  • Wilkinson CP, Ferris FL, Klein RE, et al. Proposed international clinical diabetic retinopathy and diabetic macular edema disease severity scales. Ophthalmology. 2003;110(9):1677-1682. doi:10.1016/S0161-6420(03)00475-5
  • Miura G. Visual evoked potentials for the detection of diabetic retinal neuropathy. Int J Mol Sci. 2023;24(8):7361. doi:10.3390/ijms24087361
  • England JD, Gronseth GS, Franklin G, et al. Distal symmetric polyneuropathy: a definition for clinical research. Muscle Nerve. 2005; 31(1):113-123. doi:10.1002/mus.20259
  • Pirart J. Diabetes mellitus and its degenerative complications: a prospective study of 4,400 patients observed between 1947 and 1973. Diabetes Care. 1978;1(3):168-188. doi:10.2337/diacare.1.3.168
  • Lövestam-Adrian M, Gränse L, Andersson G, Andreasson S. Multifocal visual evoked potentials (mfVEP) in diabetic patients with and without polyneuropathy. Open Ophthalmol J. 2012;6:98-103. doi:10.2174/ 1874364101206010098
  • Stratton IM, Adler AI, Neil HA, et al. Association of glycaemia with macrovascular and microvascular complications of type 2 diabetes: prospective observational study. BMJ. 2000;321(7258):405-412. doi:10. 1136/bmj.321.7258.405
  • Tesfaye S, Boulton AJ, Dyck PJ, et al. Diabetic neuropathies: update on definitions, diagnostic criteria, estimation of severity, and treatments. Diabetes Care. 2010;33(10):2285-2293. doi:10.2337/dc10-1303
  • Callaghan BC, Cheng HT, Stables CL, Smith AL, Feldman EL. Diabetic neuropathy: clinical manifestations and current treatments. Lancet Neurol. 2012;11(6):521-534. doi:10.1016/S1474-4422(12)70065-0
  • 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(4):817-824. doi:10.1212/WNL.43.4.817
  • Al-Geffari M. Correlation between diabetic neuropathy, retinopathy and nephropathy, and serum levels of vitamin D, HbA1c and lipids in Saudi Arabia. Int J Diabetes Dev Ctries. 2012;32(2):77-82. doi:10.1007/s13410-012-0075-9
  • Malik RA, Tesfaye S, Newrick PG, et al. Sural nerve pathology in diabetic patients with minimal but progressive neuropathy. Diabetologia. 2005; 48(3):578-585. doi:10.1007/s00125-005-1663-5
Toplam 14 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Periferik Sinir Sistemi
Bölüm Research Articles [en] Araştırma Makaleleri [tr]
Yazarlar

Buket Yılmaz 0000-0002-1033-7737

Betül Özenç 0000-0003-3674-7643

Derya Bayrak 0009-0007-2501-3982

Pelin Yenilmez Yeşildaş 0009-0001-7454-9309

Gizem Gürbostan Soysal 0000-0002-6314-9246

Yayımlanma Tarihi 24 Ekim 2025
Gönderilme Tarihi 14 Ağustos 2025
Kabul Tarihi 6 Eylül 2025
Yayımlandığı Sayı Yıl 2025 Cilt: 6 Sayı: 5

Kaynak Göster

AMA Yılmaz B, Özenç B, Bayrak D, Yenilmez Yeşildaş P, Gürbostan Soysal G. Electrophysiological evaluation of central and peripheral nerve conduction according to retinopathy level in type II diabetic patients. J Med Palliat Care / JOMPAC / Jompac. Ekim 2025;6(5):476-480.

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