Exp Clin Endocrinol Diabetes 2021; 129(09): 689-694
DOI: 10.1055/a-1025-3724
Article

Self-Reported Depressive Symptoms Might be Associated with Sudomotor Dysfunction in Chinese T2DM Patients

Lijin Ji
1   Department of Endocrinology and Metabolism, Huashan Hospital, Shanghai Medical College, Fudan University
,
Yuanpin Zhang
1   Department of Endocrinology and Metabolism, Huashan Hospital, Shanghai Medical College, Fudan University
,
Qi Zhang
1   Department of Endocrinology and Metabolism, Huashan Hospital, Shanghai Medical College, Fudan University
,
Hangping Zheng
1   Department of Endocrinology and Metabolism, Huashan Hospital, Shanghai Medical College, Fudan University
,
Wanwan Sun
1   Department of Endocrinology and Metabolism, Huashan Hospital, Shanghai Medical College, Fudan University
,
Xiaoming Zhu
1   Department of Endocrinology and Metabolism, Huashan Hospital, Shanghai Medical College, Fudan University
,
Shuo Zhang
1   Department of Endocrinology and Metabolism, Huashan Hospital, Shanghai Medical College, Fudan University
,
Bin Lu
1   Department of Endocrinology and Metabolism, Huashan Hospital, Shanghai Medical College, Fudan University
,
Liang Su
2   Department of Psychiatry, Huashan Hospital, Shanghai Medical College, Fudan University, China
,
Hongli Shi
1   Department of Endocrinology and Metabolism, Huashan Hospital, Shanghai Medical College, Fudan University
,
Yiming Li
1   Department of Endocrinology and Metabolism, Huashan Hospital, Shanghai Medical College, Fudan University
,
Xiaoxia Liu
1   Department of Endocrinology and Metabolism, Huashan Hospital, Shanghai Medical College, Fudan University
› Author Affiliations
Funding: The present study was supported by grants from the National Natural Science Foundation of China (81770807 to Bin Lu and 81800692 to Lijin Ji), Shanghai Science and Technology Committee Program (17411961500, to Shuo Zhang), Shanghai Clinical Collaboration Program of Chinese traditional and Western medicine (ZY(2018–2020)-FWTX-1002, to Yiming Li), Shanghai Shenkang Hospital Developing Center Clinical Scientific and Technological Innovation Program (SHDC12016210, to Bin Lu), Shanghai training programme for young special practitioners (2017–01, to Xiaoxia Liu), Ministry of Science and Technology Program (2017ZX09304005, to Shuo Zhang) and Shanghai Municipal Commission of Health and Family Planning Clinical Research Project (20184Y0318, to Lijin Ji).

Abstract

Aims To determine the relationships of sudomotor functions, nerve conductions and self-reported depressive symptoms in Chinese type 2 diabetes (T2DM) patients.

Methods T2DM patients in a single community health center were included in this study. Demographic, medical and laboratory data were collected. Michigan Neuropathy Screening Instrument (MNSI) examination was conducted in all patients. SUDOSCAN test and Point-of-care Nerve Conduction Device (DPN-check) were conducted and all the patients finished the Patient Health Questionnaire-9 (PHQ-9).

Results A total of 162 T2DM patients (74 males and 88 females) were included. The mean age was 69.0±7.2 years and the mean course of diabetes was 10.5±8.0 years with a mean HbA1c level of 7.3±1.4%. Thirty of them (18.5%) had self-reported depressive symptoms (PHQ-9 scores≥5). Diabetic peripheral neuropathy (DPN) was diagnosed according to the MSNI examination in 74 patients. Electrochemical skin conductance (ESC) values of both hands and feet were significantly lower in patients with depressive symptoms (Hands ESC: 60.63±18.92 vs. 67.64±16.02 μS, p<0.05; Feet ESC: 59.60 ± 15.19 vs. 66.19±14.99 μS, p<0.05). The proportion of patients with moderate to severe depressive symptoms were significantly higher in those with ESC values<60 μS (13.33% vs. 3.846%, p<0.05). Hands ESC values were negatively related to PHQ-9 scores (r =− 0.168, p<0.05). After adjusting for variables, hands and feet ESC values remained negatively related with depressive symptoms (β =− 0.036 and−0.038, p<0.05). Female were positively related to depressive symptoms with odds ratio 3.4 (95%CI 1.1–10.5, p<0.05).

Conclusion Self-reported depressive symptoms might be associated with sudomotor dysfunction in Chinese T2DM patients.



Publication History

Received: 17 July 2019
Received: 24 September 2019

Accepted: 10 October 2019

Article published online:
13 November 2019

© 2019. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 
  • References

  • 1 Pop-Busui R, Boulton AJ, Feldman EL. et al. Diabetic neuropathy: A position statement by the American Diabetes Association. Diabetes Care 2017; 40: 136-154
  • 2 Lin EH, Rutter CM, Katon W. et al. Depression and advanced complications of diabetes: a prospective cohort study. Diabetes Care 2010; 33: 264-269
  • 3 Dziemidok P, Dąbrowski M, Makara-Studzińska M. Relationship between diabetic neuropathy and occurrence of depression among diabetic patients. Psychiatr Pol 2016; 50: 407-415
  • 4 Dziemidok P, Dąbrowski M, Makara-Studzińska M. Relationship between diabetic neuropathy and occurrence of depression among diabetic patients. Psychiatr Pol 2016; 50: 407-415
  • 5 Vinik AI, Nevoret ML, Casellini C. The new age of sudomotor function testing: a sensitive and specific biomarker for diagnosis, estimation of severity, monitoring progression, and regression in response to intervention. Front Endocrinol (Lausanne) 2015; 11 6: 94
  • 6 Mao F, Liu S, Qiao X. et al. Sudoscan is an effective screening method for asymptomatic diabetic neuropathy in Chinese type 2 diabetes mellitus patients. J Diabetes Investig 2017; 8: 363-368
  • 7 Perkins BA, Grewal J, Ng E. et al. Validation of a novel point-of-care nerve conduction device for the detection of diabetic sensorimotor polyneuropathy. Diabetes Care 2006; 29: 2023-2027
  • 8 Kroenke K, Spitzer RL, Williams JB. The PHQ-9: validity of a brief depression severity measure. J Gen Intern Med 2001; 16: 606-613
  • 9 Smith AG, Lessard M, Reyna S. et al. The diagnostic utility of Sudoscan for distal symmetric peripheral neuropathy. J Diabetes Complications 2014; 28: 511-516
  • 10 Zhu X, Mao F, Liu S. et al. Association of SUDOSCAN values with vibration perception threshold in chinese patients with type 2 diabetes mellitus. Int J Endocrinol 2017; 2017: 8435252
  • 11 Lee JA, Halpern EM, Lovblom LE. et al. Reliability and validity of a point-of-care sural nerve conduction device for identification of diabetic neuropathy. PLoS One 2014; 9: e86515
  • 12 Binns-Hall O, Selvarajah D, Sanger D. et al. One-stop microvascular screening service: an effective model for the early detection of diabetic peripheral neuropathy and the high-risk foot. Diabet Med 2018; 35: 887-894
  • 13 Chatzikosma G, Pafili K, Demetriou M. et al. Evaluation of sural nerve automated nerve conduction study in the diagnosis of peripheral neuropathy in patients with type 2 diabetes mellitus. Arch Med Sci 2016; 12: 390-393
  • 14 Feldman EL, Stevens MJ, Thomas PK. et al. A practical two-step quantitative clinical and electrophysiological assessment for the diagnosis and staging of diabetic neuropathy. Diabetes Care 1994; 17: 1281-1289
  • 15 Vinik A, Casellini C, Nevoret ML. Diabetic Neuropathies. Book. 2018; PMID: 25905398
  • 16 Krieger SM, Reimann M, Haase R. et al. Sudomotor testing of diabetes polyneuropathy. Front Neurol 2018; 26 9 803
  • 17 Calvet JH, Dupin J, Winiecki H. et al. Assessment of small fiber neuropathy through a quick, simple and non invasive method in a German diabetes outpatient clinic. Exp Clin Endocrinol Diabetes 2013; 121: 80-83
  • 18 Vinik AI, Nevoret ML, Casellini C. The new age of sudomotor function testing: a sensitive and specific biomarker for diagnosis, estimation of severity, monitoring progression, and regression in response to intervention. Front Endocrinol (Lausanne) 2015; 6: 94
  • 19 Eranki VG, Santosh R, Rajitha K. et al. Sudomotor function assessment as a screening tool for microvascular complications in type 2 diabetes. Diabetes Res Clin Pract 2013; 101: e11-e13
  • 20 Vileikyte L, Leventhal H, Gonzalez JS. et al. Diabetic peripheral neuropathy and depressive symptoms: the association revisited. Diabetes Care 2005; 28: 2378-2383
  • 21 Zafeiri M, Tsioutis C, Kleinaki Z. et al. Clinical characteristics of patients with co-existent diabetic peripheral neuropathy and depression: a systematic review. Exp Clin Endocrinol Diabetes 2018; 26 DOI: 10.1055/a-0741-6937.
  • 22 Ishizawa K, Babazono T, Horiba Y. et al. The relationship between depressive symptoms and diabetic complications in elderly patients with diabetes: Analysis using the Diabetes Study from the Center of Tokyo Women's Medical University (DIACET). J Diabetes Complications 2016; 30: 597-602
  • 23 Moulton CD, Pickup JC, Ismail K. et al. The link between depression and diabetes: the search for shared mechanisms. Lancet Diabetes Endocrinol 2015; 3: 461-471
  • 24 Laake JP, Stahl D, Amiel SA. et al. The association between depressive symptoms and systemic inflammation in people with type 2 diabetes: findings from the South London Diabetes Study. Diabetes Care 2014; 37: 2186-2192
  • 25 Uçeyler N, Kafke W, Riediger N. et al. Elevated proinflammatory cytokine expression in affected skin in small fiber neuropathy. Neurology 2010; 74: 1806-1813