Large fibre, small fibre and autonomic neuropathy in adolescents with type 1 diabetes: A systematic review,Journal of Diabetes and its Complications

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Large fibre, small fibre and autonomic neuropathy in adolescents with type 1 diabetes: A systematic review
Journal of Diabetes and its Complications ( IF 3 ) Pub Date : 2021-08-18 , DOI: 10.1016/j.jdiacomp.2021.108027
Vinni Faber Rasmussen ₁ , Troels Staehelin Jensen ₂ , Hatice Tankisi ₃ , Páll Karlsson ₄ , Esben Thyssen Vestergaard ₅ , Kurt Kristensen ₆ , Jens Randel Nyengaard ₇ , Astrid Juhl Terkelsen ₈

Affiliation

Danish Pain Research Center, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark; Department of Paediatrics, Randers Regional Hospital, Randers, Denmark.
Danish Pain Research Center, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark; International Diabetic Neuropathy Consortium, Aarhus University, Denmark.
Department of Neurophysiology, Department of Clinical Medicine, Aarhus University, Denmark.
Danish Pain Research Center, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark; Core Centre for Molecular Morphology, Section for Stereology and Microscopy, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark.
Department of Paediatrics, Randers Regional Hospital, Randers, Denmark; Steno Diabetes Center Aarhus, Aarhus University Hospital, Denmark.
Steno Diabetes Center Aarhus, Aarhus University Hospital, Denmark.
Core Centre for Molecular Morphology, Section for Stereology and Microscopy, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark; Department of Pathology, Aarhus University Hospital, Aarhus, Denmark.
Danish Pain Research Center, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark; Department of Neurology, Aarhus University Hospital, Aarhus, Denmark.

Aims

To estimate the prevalence of neuropathy in adolescents with type 1 diabetes.

Methods

Systematic collection of published studies exploring the prevalence of large fibre neuropathy (LFN), small fibre neuropathy (SFN), and autonomic neuropathy in adolescents with type 1 diabetes. Following prospective registration (Prospero CRD42020206093), PubMed, EMBASE, and Cochrane Library were searched for studies from 2000 to 2020. PICO framework was used in the selection process (Population: adolescents aged 10–19 years with type 1 diabetes; Intervention: diagnostic methods for neuropathy; Comparison: reference data; Outcome: data on prevalence or comparison). Data were extracted concerning study quality based on available data and established methods for determining and diagnosing various neuropathy types.

Results

From 2,017 initial citations, 27 studies (7589 participants) fulfilled eligibility criteria. The study population (47% males) had a diabetes duration between 4.0 and 10.6 years, and HbA1c level between 7.3 and 10.8%, 56–95 mmol/mol. The prevalence of LFN, based on nerve conduction studies, was 10–57%. Based on other tests for neuropathy, the prevalence of LFN and SFN was 12–62%, and that of cardiac autonomic neuropathy was 12–75%.

Conclusion

The described prevalence of neuropathy in adolescents with type 1 diabetes varied, which can be methodological due to different screening methods and classifications of neuropathy.

中文翻译：

青少年 1 型糖尿病的大纤维、小纤维和自主神经病变：系统评价

目标

估计青少年 1 型糖尿病患者神经病变的患病率。

方法

系统收集已发表的研究，探索 1 型糖尿病青少年中大纤维神经病变 (LFN)、小纤维神经病变 (SFN) 和自主神经病变的患病率。在前瞻性注册 (Prospero CRD42020206093) 后，PubMed、EMBASE 和 Cochrane Library 搜索了 2000 年至 2020 年的研究。选择过程中使用了 PICO 框架（人群：10-19 岁患有 1 型糖尿病的青少年；干预：诊断方法用于神经病变；比较：参考数据；结果：患病率或比较数据）。根据现有数据和确定和诊断各种神经病变类型的既定方法，提取有关研究质量的数据。

结果

从 2,017 份初始引文中，27 项研究（7589 名参与者）符合资格标准。研究人群（47% 男性）的糖尿病病程在 4.0 到 10.6 年之间，HbA1c 水平在 7.3 到 10.8% 之间，56-95 mmol/mol。根据神经传导研究，LFN 的患病率为 10-57%。根据其他神经病变检查，LFN 和 SFN 的患病率为 12-62%，心脏自主神经病变的患病率为 12-75%。