Diagnostic value of shear wave elastography combined with vascular endothelial growth factor B and hemoglobin A1c in early diabetic peripheral neuropathy_West China Medical Journal

Authors：

LI Juan ¹ , ZHENG Jiali ¹ , LI Yue ¹ ,  HUANG Jing ²

1. Department of Ultrasound Medicine, Mianyang Central Hospital, Mianyang, Sichuan 621000, P. R. China;
2. Endocrine Department, Mianyang Central Hospital, Mianyang, Sichuan 621000, P. R. China;

Corresponding?author：

HUANG Jing, Email: 32872173@qq.com

Keywords：

Shear wave elastography; vascular endothelial growth factor B; hemoglobin A1c; diabetic peripheral neuropathy

DOI：

10.7507/1002-0179.202410084

Video：

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Objective To analyze the diagnostic value of shear wave elastography (SWE) combined with vascular endothelial growth factor B (VEGF-B) and hemoglobin A1c (HbA1c) in early diabetic peripheral neuropathy (DPN). Methods A total of 100 patients with type 2 diabetes mellitus (T2DM) admitted to Mianyang Central Hospital between October 2020 and October 2023 were selected and divided into a T2DM with DPN group (n=31) and a T2DM without DPN group (n=69) based on the presence or absence of DPN. Additionally, 50 healthy individuals from the same hospital’s health examination center were included as a healthy control group. The basic clinical characteristics, mean elasticity (E_mean) values of the left and right median and tibial nerves, serum VEGF-B, and HbA1c levels were compared among the three groups. The diagnostic efficacy of SWE, VEGF-B, and HbA1c for DPN was evaluated using receiver operating characteristic (ROC) curves, and Pearson correlation analysis was performed to assess the relationships between median/tibial nerve E_mean and VEGF-B/HbA1c. Results The E_mean values of the left and right median nerves, E_mean values of the left and right tibial nerves, serum VEGF-B, and HbA1c levels in the T2DM with DPN group were significantly higher than those in the T2DM without DPN group and the healthy control group (P<0.05). The E_mean values of the left and right median and tibial nerves, E_mean values of the left and right tibial nerves, and HbA1c level in the T2DM without DPN group were significantly higher than those in the healthy control group (P<0.05), while no significant difference was observed in serum VEGF-B level between the T2DM without DPN group and the healthy control group (P>0.05). The area under the ROC curve for the combined diagnosis of DPN using SWE, VEGF-B, and HbA1c was 0.859 [95% confidence interval (0.828, 0.955)]. The sensitivity of the combined diagnosis (93.72%) was significantly higher than that of individual diagnoses (78.82%, 75.39%, and 71.05%, respectively; P<0.05), while the specificity (88.64%) showed no significant difference compared to individual diagnoses (80.18%, 78.96%, and 82.88%, respectively; P>0.05). Positive correlations were observed between median/tibial nerve E_mean and VEGF-B/HbA1c levels (r=0.428, 0.395, 0.416, and 0.416, respectively; P<0.05). Conclusions Elevated median/tibial nerve E_mean, serum VEGF-B, and HbA1c levels are closely associated with DPN. The combination of SWE, VEGF-B, and HbA1c improves diagnostic sensitivity for DPN, demonstrating significant clinical value.

Citation： LI Juan, ZHENG Jiali, LI Yue, HUANG Jing. Diagnostic value of shear wave elastography combined with vascular endothelial growth factor B and hemoglobin A1c in early diabetic peripheral neuropathy. West China Medical Journal, 2025, 40(5): 710-715. doi: 10.7507/1002-0179.202410084 Copy

1.	Didangelos T, Veves A. Treatment of diabetic cardiovascular autonomic, peripheral and painful neuropathy. Focus on the treatment of cardiovascular autonomic neuropathy with ACE inhibitors. Curr Vasc Pharmacol, 2020, 18(2): 158-171.
2.	穆晶晶, 田臻, 吳成蓉, 等. 高頻超聲及剪切波彈性成像技術對 2 型糖尿病下肢神經病變的定量評估. 中國臨床醫學影像雜志, 2023, 34(7): 512-516.
3.	侯愛蓮, 鄒好楠, 楊德, 等. 超聲剪切波彈性成像對 2 型糖尿病尺神經病變診斷價值的初步研究. 中華保健醫學雜志, 2020, 22(2): 180-183.
4.	唐曉蕾, 代艷, 丁倩, 等. LncRNA H19 和 VEGF-b 在糖尿病視網膜病變患者中的表達及臨床意義. 中國實驗診斷學, 2022, 26(5): 642-647.
5.	石敏, 鄒健, 李喬岳, 等. 2 型糖尿病患者糖化白蛋白和糖化血紅蛋白比值與周圍神經病變相關性研究. 陜西醫學雜志, 2020, 49(12): 1557-1560.
6.	中華醫學會糖尿病學分會. 中國 2 型糖尿病防治指南(2020 年版). 國際內分泌代謝雜志, 2021, 41(5): 482-548.
7.	中華醫學會糖尿病學分會神經并發癥學組. 糖尿病神經病變診治專家共識(2021 年版). 中華糖尿病雜志, 2021, 13(6): 540-557.
8.	Franceschi R, Mozzillo E, Di Candia F, et al. A systematic review of the prevalence, risk factors and screening tools for autonomic and diabetic peripheral neuropathy in children, adolescents and young adults with type 1 diabetes. Acta Diabetol, 2022, 59(3): 293-308.
9.	李雪花, 鄒汶兵, 陳一平. 2 型糖尿病合并糖尿病周圍神經病變患者血清神經膠質纖維酸性蛋白水平及其臨床意義. 廣西醫學, 2020, 42(5): 562-565.
10.	孫冉, 梁丹艷, 吳國柱, 等. 高頻超聲與剪切波彈性成像結合臨床指標評估糖尿病患者脛神經病變風險. 臨床超聲醫學雜志, 2020, 22(3): 189-193.
11.	Vas PRJ, Papanas N. Diabetic peripheral neuropathy and depression: dancing with wolves? - Mini-review and commentary on Alghafri et al. “Screening for depressive symptoms amongst patients with diabetic peripheral neuropathy”. Rev Diabet Stud, 2021, 17(1): 17-20.
12.	唐一植, 陳偉, 靳麗嘉, 等. 高頻超聲結合剪切波彈性成像在診斷糖尿病周圍神經病變中的應用價值. 四川醫學, 2020, 41(12): 1217-1222.
13.	鄧紅菊, 張宇虹, 張萍, 等. 常規超聲及二維超聲剪切波彈性成像技術評價 2 型糖尿病周圍神經病變患者股四頭肌異常改變. 中國臨床醫學影像雜志, 2023, 34(3): 199-203.
14.	李艷飛, 王晶, 陳定章, 等. 下肢神經剪切波彈性成像對不同程度糖尿病周圍神經病變的診斷效能分析. 陜西醫學雜志, 2022, 51(9): 1102-1105.
15.	陸倩, 吳意赟, 王麗娟, 等. 剪切波彈性成像技術對 2 型糖尿病周圍神經病變評價價值. 臨床軍醫雜志, 2022, 50(3): 305-307.
16.	靳麗嘉, 唐一植. 多模態超聲成像可診斷糖尿病患者的周圍神經病變. 分子影像學雜志, 2020, 43(3): 404-409.
17.	王菲, 馬麒, 鄭苗. 剪切波彈性成像聯合多倫多臨床評分系統對糖尿病周圍神經病變的診斷價值. 中國醫學影像學雜志, 2022, 30(2): 159-163, 166.
18.	靳麗嘉, 唐一植, 陳鵬, 等. 基于 Logistic 回歸模型篩選 CEUS 及 SWE 診斷 2 型糖尿病周圍神經病變的定量參數. 河北醫學, 2022, 28(9): 1550-1554.
19.	賴誠, 李明新. 血管內皮生長因子-B 對高糖環境下人視網膜色素上皮細胞凋亡的保護作用. 眼科新進展, 2020, 40(5): 430-434.
20.	童國玉, 李翠柳, 楊東輝, 等. 糖尿病前期和新診斷 2 型糖尿病患者血清血管內皮生長因子 B 水平與胰島素抵抗的相關性. 現代生物醫學進展, 2019, 19(21): 4049-4054.
21.	Hagberg CE, Falkevall A, Wang X, et al. Vascular endothelial growth factor B controls endothelial fatty acid uptake. Nature, 2010, 464(7290): 917-921.
22.	Sugimoto K, Yasujima M, Yagihashi S. Role of advanced glycation end products in diabetic neuropathy. Curr Pharm Des, 2008, 14(10): 953-961.

1. Didangelos T, Veves A. Treatment of diabetic cardiovascular autonomic, peripheral and painful neuropathy. Focus on the treatment of cardiovascular autonomic neuropathy with ACE inhibitors. Curr Vasc Pharmacol, 2020, 18(2): 158-171.
2. 穆晶晶, 田臻, 吳成蓉, 等. 高頻超聲及剪切波彈性成像技術對 2 型糖尿病下肢神經病變的定量評估. 中國臨床醫學影像雜志, 2023, 34(7): 512-516.
3. 侯愛蓮, 鄒好楠, 楊德, 等. 超聲剪切波彈性成像對 2 型糖尿病尺神經病變診斷價值的初步研究. 中華保健醫學雜志, 2020, 22(2): 180-183.
4. 唐曉蕾, 代艷, 丁倩, 等. LncRNA H19 和 VEGF-b 在糖尿病視網膜病變患者中的表達及臨床意義. 中國實驗診斷學, 2022, 26(5): 642-647.
5. 石敏, 鄒健, 李喬岳, 等. 2 型糖尿病患者糖化白蛋白和糖化血紅蛋白比值與周圍神經病變相關性研究. 陜西醫學雜志, 2020, 49(12): 1557-1560.
6. 中華醫學會糖尿病學分會. 中國 2 型糖尿病防治指南(2020 年版). 國際內分泌代謝雜志, 2021, 41(5): 482-548.
7. 中華醫學會糖尿病學分會神經并發癥學組. 糖尿病神經病變診治專家共識(2021 年版). 中華糖尿病雜志, 2021, 13(6): 540-557.
8. Franceschi R, Mozzillo E, Di Candia F, et al. A systematic review of the prevalence, risk factors and screening tools for autonomic and diabetic peripheral neuropathy in children, adolescents and young adults with type 1 diabetes. Acta Diabetol, 2022, 59(3): 293-308.
9. 李雪花, 鄒汶兵, 陳一平. 2 型糖尿病合并糖尿病周圍神經病變患者血清神經膠質纖維酸性蛋白水平及其臨床意義. 廣西醫學, 2020, 42(5): 562-565.
10. 孫冉, 梁丹艷, 吳國柱, 等. 高頻超聲與剪切波彈性成像結合臨床指標評估糖尿病患者脛神經病變風險. 臨床超聲醫學雜志, 2020, 22(3): 189-193.
11. Vas PRJ, Papanas N. Diabetic peripheral neuropathy and depression: dancing with wolves? - Mini-review and commentary on Alghafri et al. “Screening for depressive symptoms amongst patients with diabetic peripheral neuropathy”. Rev Diabet Stud, 2021, 17(1): 17-20.
12. 唐一植, 陳偉, 靳麗嘉, 等. 高頻超聲結合剪切波彈性成像在診斷糖尿病周圍神經病變中的應用價值. 四川醫學, 2020, 41(12): 1217-1222.
13. 鄧紅菊, 張宇虹, 張萍, 等. 常規超聲及二維超聲剪切波彈性成像技術評價 2 型糖尿病周圍神經病變患者股四頭肌異常改變. 中國臨床醫學影像雜志, 2023, 34(3): 199-203.
14. 李艷飛, 王晶, 陳定章, 等. 下肢神經剪切波彈性成像對不同程度糖尿病周圍神經病變的診斷效能分析. 陜西醫學雜志, 2022, 51(9): 1102-1105.
15. 陸倩, 吳意赟, 王麗娟, 等. 剪切波彈性成像技術對 2 型糖尿病周圍神經病變評價價值. 臨床軍醫雜志, 2022, 50(3): 305-307.
16. 靳麗嘉, 唐一植. 多模態超聲成像可診斷糖尿病患者的周圍神經病變. 分子影像學雜志, 2020, 43(3): 404-409.
17. 王菲, 馬麒, 鄭苗. 剪切波彈性成像聯合多倫多臨床評分系統對糖尿病周圍神經病變的診斷價值. 中國醫學影像學雜志, 2022, 30(2): 159-163, 166.
18. 靳麗嘉, 唐一植, 陳鵬, 等. 基于 Logistic 回歸模型篩選 CEUS 及 SWE 診斷 2 型糖尿病周圍神經病變的定量參數. 河北醫學, 2022, 28(9): 1550-1554.
19. 賴誠, 李明新. 血管內皮生長因子-B 對高糖環境下人視網膜色素上皮細胞凋亡的保護作用. 眼科新進展, 2020, 40(5): 430-434.
20. 童國玉, 李翠柳, 楊東輝, 等. 糖尿病前期和新診斷 2 型糖尿病患者血清血管內皮生長因子 B 水平與胰島素抵抗的相關性. 現代生物醫學進展, 2019, 19(21): 4049-4054.
21. Hagberg CE, Falkevall A, Wang X, et al. Vascular endothelial growth factor B controls endothelial fatty acid uptake. Nature, 2010, 464(7290): 917-921.
22. Sugimoto K, Yasujima M, Yagihashi S. Role of advanced glycation end products in diabetic neuropathy. Curr Pharm Des, 2008, 14(10): 953-961.

West China Medical Journal

Diagnostic value of shear wave elastography combined with vascular endothelial growth factor B and hemoglobin A1c in early diabetic peripheral neuropathy

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