Effect of Anemia on Sensory Nerve Conduction in Diabetic Peripheral Neuropathy: A Cross Sectional study

Nirangjhana, S (2020) Effect of Anemia on Sensory Nerve Conduction in Diabetic Peripheral Neuropathy: A Cross Sectional study. Masters thesis, PSG Institute of Medical Sciences and Research, Coimbatore.


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BACKGROUND: Diabetic Peripheral Neuropathy (DPN) contributes to significant morbidity. Though multi-factorial pathogenesis has been claimed for its occurrence, the exact mechanism is unclear. Prevalence of anemia is 2-3 times higher in diabetic patients even with preserved renal function. AIM OF THE STUDY: To compare the sensory nerve conduction study variables such as latency (ms), amplitude (μV) and (NCV) nerve conduction velocity (m/s) of median, ulnar and sural nerves in diabetic peripheral neuropathy (DPN) patients with anemia to those without anemia. METHODOLOGY: In this cross sectional study, 80 DPN subjects were enrolled. Diagnosis of DPN was made using the criteria proposed in the 19th annual NEURODIAB. These subjects were grouped into those without anemia (n=40) and those with anemia (n=40) based on WHO criteria. Sensory nerve conduction studies were done using Recorders Medicare System (RMS) EMG EPM 2K version 1. Data collected was analyzed using SPSS IBM software version 25 and p value < 0.05 was considered to be statistically significant. Independent t test was used to compare sensory nerve conduction characteristics between the two groups. Karl Pearsons correlation was used to correlate BMI, HbA1c, hemoglobin with sensory nerve conduction characteristics.The type of anemia was delineated using hemoglobin concentration, MCV and MCH obtained by fully automated machines. RESULTS: NCV of right median nerve (46.48 ± 3.42 vs 49.29 ± 1.20 m/s, p value 0.000), right ulnar nerve (35.96 ± 6.92 vs 45.99 ± 10.11 m/s, p value 0.035), right sural nerve (29.67 ± 6.23 vs 51.76 ± 11.11 m/s, p value 0.023) and left sural nerve (29.06 ± 7.26 vs 57.90 ± 13.51m/s, p value 0.000) were significantly reduced in DPN with anemia when compared to DPN without anemia. Amplitude of left ulnar nerve (16.46 ± 3.46 vs 17.21 ± 3.99 μV, p value 0.017), left sural nerve ( 3.53 ± 1.02 vs 6.64 ± 1.74 μV, p value 0.002) and right sural nerve (3.24 ± 0.90 vs 9.60 ± 1.92 μV, p value 0.010) were significantly reduced in DPN with anemia compared to DPN without anemia. Latency of sensory nerves was positively correlated with BMI, HbA1c and negatively correlated with hemoglobin levels. Amplitude, NCV of sensory nerves was negatively correlated with BMI, HbA1c and hemoglobin levels. Out of 40 DPN subjects with anemia, 57.50% had mild anemia and 42.50% had moderate anemia. In the present study, normocytic normochromic anemia was the predominant form of anemia. CONCLUSION: In the present study, diabetic peripheral neuropathy patients with anemia had lower NCV and amplitude of sensory nerves when compared to those without anemia. NCV of sural nerve which is a lower limb nerve was reduced when compared to upper limb nerves. Hence anemia is a risk factor that could predict the outcome in diabetic peripheral neuropathy patients.

Item Type: Thesis (Masters)
Additional Information: 201715401
Uncontrolled Keywords: Diabetic peripheral neuropathy (DPN), Distal symmetric polyneuropathy (DSPN), anemia, latency, amplitude, nerve conduction velocity (NCV), MCV (Mean Corpuscular Volume), MCH (Mean Corpuscular Hemoglobin), BMI (Body Mass Index), HbA1c (Glycosylated hemoglobin).
Subjects: MEDICAL > Physiology
Depositing User: Subramani R
Date Deposited: 30 Jan 2021 17:21
Last Modified: 01 Mar 2021 02:26
URI: http://repository-tnmgrmu.ac.in/id/eprint/13505

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