Diabetes, Metabolic Syndrome and Obesity (Jan 2022)

Median Nerve Affection in Hypertensive Patients with and without Diabetes High-Resolution Ultrasound Assessment

  • Esmat A,
  • Elshamy MI,
  • Mohamed Zakaria D,
  • Shady Z,
  • Roshdy Mohamed E,
  • El-Khouly N,
  • Hassan MM,
  • El-Senosy FM

Journal volume & issue
Vol. Volume 15
pp. 183 – 188

Abstract

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Ahmed Esmat,1 Mahmoud I Elshamy,2 Doaa Mohamed Zakaria,3 Zakarya Shady,4 Eman Roshdy Mohamed,3 Nashwa El-Khouly,3 Marwa M Hassan,3 Fatma M El-Senosy3 1Department of Neurology, Al-Azhar University, Faculty of Medicine, Cairo, Egypt; 2Department of Radiology, Al-Azhar University, Faculty of Medicine, Cairo, Egypt; 3Department of Internal Medicine, Faculty of Medicine (Girls), Al-Azhar University, Cairo, Egypt; 4Department of Internal Medicine, Faculty of Medicine, Al-Azhar University, Cairo, EgyptCorrespondence: Zakarya Shady Tel +201001281304Email [email protected]: Diabetes is a documented risk factor for peripheral neuropathy. It was reported that associated hypertension could increase this risk. The present study aimed to assess the effect of hypertension and diabetes on median nerve using high-resolution ultrasound.Methods: The study includes 50 hypertensive patients (HTN group), 50 diabetic patients (DM group), 50 patients with coexisting diabetes and hypertension (HTN + DM group) and 50 healthy controls. Median nerve affection in the studied groups was studied by vibration perception thresholds (VPT). The median nerve cross-sectional area was determined at the nerve cross-sectional area of the median nerve at the carpal tunnel by high-resolution ultrasound. Clinical symptoms were assessed using Toronto Clinical Severity Score (TCSS).Results: There was significantly higher median nerve CSA in all patient groups in comparison to controls. HTN + DM group had significantly higher median nerve CSA when compared with DM group. Patients with peripheral neuropathy in HTN + DM and DM groups had significantly higher median nerve CSA than patients without. Using ROC curve analysis, it was shown that median CSA could successfully distinguish patients with peripheral neuropathy from patients without in HTN + DM group [AUC (95% CI): 0.71 (0.54– 0.89)] and in DM group [AUC (95% CI): 0.86 (0.72– 0.99)].Conclusion: Hypertensive patients with and without diabetes have significantly higher median nerve CSA when compared with controls.Keywords: hypertension, peripheral neuropathy, high-resolution ultrasound, diabetes mellitus, median nerve

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