Objective: This study investigates nerve fiber dysfunction in type 1 diabetes (T1D) patients and identifies risk factors for diabetic peripheral neuropathy (DPN). It evaluates the relationship between current perception threshold (CPT) tests and nerve conduction velocity (NCV), and assesses CPT's diagnostic accuracy for early DPN detection.

Research design and methods: This study enrolled 110 patients with T1D and 26 healthy controls between January 2020 and December 2021, in accordance with predefined inclusion/exclusion criteria. CPT testing at 2000 Hz, 250 Hz, and 5 Hz assessed Aβ, Aδ, and C fiber function, while NCV was measured in 47 patients. Subgroups were stratified by disease duration (>5 years vs ≤5 years). Multivariate logistic regression identified DPN risk factors, and CPT-NCV correlation was analyzed using Chi-square and Kappa tests. Receiver operating characteristic (ROC) curves evaluated CPT diagnostic efficacy.

Results: The incidence of DPN in 110 T1D patients was 78%, with no significant difference between disease duration subgroups (78.3% vs. 78.0%). Neurological abnormalities were significantly more common in the lower extremities compared to the upper extremities (67.27% vs. 49.09%, P < 0.05). Multivariate logistic regression analysis revealed that a waist-to-hip ratio (WHR) greater than 0.85 was an independent risk factor for DPN (OR = 3.01, 95% CI: 1.03-8.80, P < 0.05). Patients with a disease duration >5 years demonstrated significantly higher 2000Hz abnormality rates (68.09% vs. 46.15%, P < 0.05) and more severe neurological lesions (57.45% vs. 35.90%, P < 0.05). In contrast, those with disease duration ≤5 years exhibited elevated 5Hz abnormality rates (30.77% vs. 10.64%, P < 0.05) with predominantly milder lesions (56.41% vs. 31.91%, P < 0.05). Statistical analyses demonstrated a significant association between CPT and NCV (P<0.001), with moderate diagnostic consistency further supported by Cohen's Kappa Test (κ=0.515, P<0.001). ROC curve analysis demonstrated that CPT exhibited moderate diagnostic accuracy in detecting DPN at the 5Hz, with an area under the curve (AUC) of 0.723.

Conclusions: CPT showed moderate diagnostic accuracy for early unmyelinated (C) fibers detection, routine CPT screening in high-risk groups (central obesity/short disease duration) enables timely intervention to prevent irreversible damage.

Keywords: current perception threshold; diabetic peripheral neuropathy; nerve conduction velocity; risk factors; type 1 diabetes.

Copyright © 2025 Zhao, Wang, Liu, Jiang and Ma.

目标: 本研究调查了1型糖尿病（T1D）患者神经纤维功能障碍，并识别导致糖尿病周围神经病变（DPN）的风险因素。它评估了当前感知阈值（CPT）测试与神经传导速度（NCV）之间的关系，并评估了CPT在早期DPN检测中的诊断准确性。

研究设计和方法: 本研究于2020年1月至2021年12月期间，根据预设的纳入/排除标准招募了110名T1D患者和26名健康对照。CPT测试在2000 Hz、250 Hz和5 Hz下分别评估Aβ、Aδ和C纤维功能，而在47名患者中测量了NCV。根据病程（>5年 vs ≤5年）将研究对象分层为不同亚组。多元逻辑回归分析确定DPN的风险因素，并使用卡方检验和Kappa检验分析CPT与NCV的相关性。受试者工作特征曲线（ROC曲线）评估了CPT的诊断效能。

结果: 110名T1D患者中DPN的发生率为78%，不同病程亚组间无显著差异（78.3% vs 78.0%）。与上肢相比，下肢出现神经学异常的情况更为常见（67.27% vs 49.09%，P 5年的患者2000 Hz异常率显著升高（68.09% vs 46.15%，P

结论: CPT在早期检测未髓鞘化的（C）纤维方面显示出中等程度的诊断准确性。对高危群体进行常规CPT筛查（中心性肥胖/病程较短），能够及时干预，防止不可逆损伤。

关键词: 电流感知阈值；糖尿病周围神经病变；神经传导速度；风险因素；1型糖尿病。

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