The relationship between sural nerve morphometric findings and measures of peripheral nerve function in mild diabetic neuropathy

• Published in: Diabetic medicine Vol. 8; no. 10; p. 917
• Main Authors: Veves, A, Malik, R A, Lye, R H, Masson, E A, Sharma, A K, Schady, W, Boulton, A J
• Format: Journal Article
• Language: English
• Published: England 01-12-1991
• Subjects: Biopsy; Diabetes Mellitus, Type 1 - pathology; Diabetes Mellitus, Type 1 - physiopathology; Diabetes Mellitus, Type 2 - pathology; Diabetes Mellitus, Type 2 - physiopathology; Diabetic Neuropathies - pathology; Diabetic Neuropathies - physiopathology; Female; Humans; Male; Middle Aged; Nerve Fibers, Myelinated - ultrastructure; Neural Conduction; Peripheral Nerves - physiopathology; Peroneal Nerve - physiopathology; Reference Values; Sensory Thresholds; Sural Nerve - pathology; Sural Nerve - physiopathology
• ISSN: 0742-3071
• DOI: 10.1111/j.1464-5491.1991.tb01530.x

The morphological findings in sural nerve biopsy specimens from 15 diabetic patients with mild neuropathy were compared with control biopsies from eight non-neuropathic, non-diabetic subjects, and correlations were sought with electrophysiological studies and quantitative sensory tests for vibration, thermal, and current perception thresholds. Myelinated fibre density was reduced compared with control biopsies (4042 +/- 2090 (+/- SD) vs 6800 +/- 1100 mm-2; p less than 0.01). A strong correlation existed between myelinated fibre density and sural sensory conduction velocity (r = 0.84, p less than 0.001), sural action potential amplitude (r = 0.74, p less than 0.001), peroneal motor conduction velocity (r = 0.58, p less than 0.02), and median sensory amplitude (r = 0.64, p less than 0.01) but there was no correlation between myelinated fibre density and any quantitative sensory test. We conclude that conventional electrophysiological tests in the lower limb are reliable surrogate measures for structural abnormalities in early diabetic neuropathy.