Small-fibre neuropathy in men with type 1 diabetes and erectile dysfunction: a cross-sectional study

被引：22

作者：

Azmi, Shazli ^{[1
,2
]}

Ferdousi, Maryam ^{[1
,2
]}

Alam, Uazman ^{[1
,2
,3
]}

Petropoulos, Ioannis N. ^{[1
,2
]}

Ponirakis, Georgios ^{[1
,2
,4
]}

Marshall, Andrew ^{[5
]}

Asghar, Omar ^{[1
,2
]}

Fadavi, Hassan ^{[1
,2
]}

Jones, Wendy ^{[1
,2
]}

Tavakoli, Mitra ^{[1
,2
,6
]}

Boulton, Andrew J. M. ^{[1
,2
]}

Jeziorska, Maria ^{[1
,2
]}

Soran, Handrean ^{[1
,2
]}

Efron, Nathan ^{[7
]}

Malik, Rayaz A. ^{[1
,2
,4
]}

机构：

[1] Univ Manchester, Ctr Endocrinol & Diabet, Inst Human Dev, Core Technol Facil, 46 Grafton St, Manchester M13 9NT, Lancs, England

[2] Cent Manchester NHS Fdn Trust, Manchester Acad Hlth Sci Ctr, Core Technol Facil, 46 Grafton St, Manchester M13 9NT, Lancs, England

[3] Univ Liverpool, Inst Ageing & Chron Dis, Dept Eye & Vis Sci, Liverpool, Merseyside, England

[4] Weill Cornell Med Qatar, Dept Med, Doha, Qatar

[5] Cent Manchester NHS Fdn Trust, Dept Clin Neurophysiol, Manchester, Lancs, England

[6] Univ Exeter, Dept Med, Sch Med, Exeter, Devon, England

[7] Queensland Univ Technol, Inst Hlth & Biomed Innovat, Brisbane, Qld, Australia

来源：

DIABETOLOGIA | 2017年 / 60卷 / 06期

关键词：

Corneal confocal microscopy; Erectile dysfunction; Neuropathy; Small-fibre neuropathy; Type; 1; diabetes; CORNEAL CONFOCAL MICROSCOPY; PERIPHERAL NEUROPATHY; PREVALENCE; IMPOTENCE; DIAGNOSIS; STRATEGIES; THERAPY; DENSITY; DISEASE; HEALTH;

D O I：

10.1007/s00125-017-4245-z

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

The aim of this study was to identify the contribution of small- and large-fibre neuropathy to erectile dysfunction in men with type 1 diabetes mellitus. A total of 70 participants (29 without and 41 with erectile dysfunction) with type 1 diabetes and 34 age-matched control participants underwent a comprehensive assessment of large- and small-fibre neuropathy. The prevalence of erectile dysfunction in participants with type 1 diabetes was 58.6%. After adjusting for age, participants with type 1 diabetes and erectile dysfunction had a significantly higher score on the Neuropathy Symptom Profile (mean +/- SEM 5.3 +/- 0.9 vs 1.8 +/- 1.2, p = 0.03), a higher vibration perception threshold (18.3 +/- 1.9 vs 10.7 +/- 2.4 V, p = 0.02), and a lower sural nerve amplitude (5.0 +/- 1.1 vs 11.7 +/- 1.5 mV, p = 0.002), peroneal nerve amplitude (2.1 +/- 0.4 vs 4.7 +/- 0.5 mV, p < 0.001) and peroneal nerve conduction velocity (34.8 +/- 1.5 vs 41.9 +/- 2.0 m/s, p = 0.01) compared with those without erectile dysfunction. There was also evidence of a marked small-fibre neuropathy with an impaired cold threshold (19.7 +/- 1.4A degrees C vs 27.3 +/- 1.8A degrees C, p = 0.003), warm threshold (42.9 +/- 0.8A degrees C vs 39.0 +/- 0.9A degrees C, p = 0.005) and heart rate variability (21.5 +/- 3.1 vs 30.0 +/- 3.7 beats/min, p = 0.001) and reduced intraepidermal nerve fibre density (2.8 +/- 0.7 vs 5.9 +/- 0.7/mm, p = 0.008), corneal nerve fibre density (12.6 +/- 1.5 vs 23.9 +/- 2.0/mm(2), p < 0.001), corneal nerve branch density (12.7 +/- 2.5 vs 31.6 +/- 3.3/mm(2), p < 0.001) and corneal nerve fibre length (8.3 +/- 0.7 vs 14.5 +/- 1.0 mm/mm(2), p < 0.001) in participants with type 1 diabetes and erectile dysfunction. Erectile dysfunction correlated significantly with measures of both large- and small-fibre neuropathy. Small-fibre neuropathy is prominent in patients with type 1 diabetes, and is associated with erectile dysfunction and can be objectively quantified using corneal confocal microscopy. This may allow the identification of patients who are less likely to respond to conventional therapies such as phosphodiesterase type 5 inhibitors.

引用

页码：1094 / 1101

页数：8

共 34 条

[1] Erectile function in men with diabetes type 2: correlation with glycemic control [J].