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Table 2

Neurophysiological function

Healthy controlDiabetes with no neuropathyDiabetes with neuropathyROC thresholdSensitivitySpecificity
Autonomic testing       
    Phase 2 Valsalva maneuver blood pressure (mmHg) 1.80 ± 0.40 1.33 ± 0.71* 0.73 ± 0.67* <2 89 57 
    Valsalva ratio 1.54 ± 0.23 1.50 ± 0.29 1.26 ± 0.21* <1.3 73 78 
    Heart rate variability (bpm) 16.3 ± 6.7 12.5 ± 5.9 8.2 ± 5.0* <9.6 73 74 
    Valsalva phase 4 blood pressure overshoot 1.92 ± 0.28 1.41 ± 0.75* 0.86 ± 0.87* <2 70 67 
    Fall in systolic blood pressure during tilt (mmHg) 15.9 ± 13.9 14.9 ± 12.0 19.6 ± 16.4 >16 52 53 
    Change in heart rate during tilt (bpm) 16.0 ± 8.5 14.6 ± 8.5 7.7 ± 13.7* <12 35 39 
Nerve conduction studies       
    Peroneal amplitude (mV) 6.7 ± 2.6 5.5 ± 2.6 3.5 ± 2.4* <4.5 73 78 
    Sural amplitude (μV) 10.7 ± 8.0 7.5 ± 6.5* 3.4 ± 4.1* <4 68 70 
    Peroneal velocity (m/s) 47.7 ± 4.4 45.0 ± 4.9 42.0 ± 5.4* <44 64 72 
    Peroneal distal latency (ms) 4.7 ± 0.8 4.7 ± 0.6 5.0 ± 0.7* >4.5 61 53 
    Sural velocity (m/s) 47.4 ± 5.8 45.7 ± 6.3 42.6 ± 6.5* <43 59 70 
Sensory testing       
    Cold-pain foot (°C) 6.4 ± 10.1 7.3 ± 9.3 2.1 ± 4.7* <10 89 29 
    Heat-pain hand (°C) 46.0 ± 4.5 45.5 ± 4.5 46.8 ± 3.2 >45.1 80 41 
    Cold detection foot (°C) 25.7 ± 7.0 25.3 ± 6.4 17.2 ± 10.5* <25.5 77 70 
    Monofilament threshold right (g) 3.76 ± 0.4 3.8 ± 0.5 4.7 ± 1.3* >4.1 76 75 
    Vibratory detection toe 4.8 ± 7.4 5.2 ± 7.6 20.6 ± 26.0* >4.3 76 72 
    Heat-pain foot (°C) 47.4 ± 3.5 47.7 ± 2.5 49.0 ± 1.7* >48.3 69 62 
    Heat detection hand (°C) 34.3 ± 2.9 35.1 ± 1.9 36.7 ± 3.8* >34.5 69 49 
    Heat detection foot (°C) 39.1 ± 5.9 40.3 ± 4.2 44.4 ± 4.2* >43 67 72 
    Vibratory detection thumb 1.0 ± 0.5 2.0 ± 2.5* 3.8 ± 6.3* >1.5 67 70 
    Cold detection hand (°C) 30.2 ± 2.0 31.1 ± 4.9 28.9 ± 3.7 <30.2 61 72 
    Cold-pain hand (°C) 6.2 ± 6.5 7.7 ± 8.9 4.2 ± 6.9* <3 61 54 
Cutaneous blood flow       
    Direct leg % change 248 ± 285 202 ± 205 114 ± 159* <125% 77 60 
    Direct forearm % change 490 ± 435 372 ± 366 344 ± 314 <315% 55 50 
    Axon reflex leg % change 146 ± 212 150 ± 257 63 ± 74* <75% 69 49 
    Axon reflex arm % change 291 ± 354 412 ± 920 720 ± 3,370 <220% 71 43 
Healthy controlDiabetes with no neuropathyDiabetes with neuropathyROC thresholdSensitivitySpecificity
Autonomic testing       
    Phase 2 Valsalva maneuver blood pressure (mmHg) 1.80 ± 0.40 1.33 ± 0.71* 0.73 ± 0.67* <2 89 57 
    Valsalva ratio 1.54 ± 0.23 1.50 ± 0.29 1.26 ± 0.21* <1.3 73 78 
    Heart rate variability (bpm) 16.3 ± 6.7 12.5 ± 5.9 8.2 ± 5.0* <9.6 73 74 
    Valsalva phase 4 blood pressure overshoot 1.92 ± 0.28 1.41 ± 0.75* 0.86 ± 0.87* <2 70 67 
    Fall in systolic blood pressure during tilt (mmHg) 15.9 ± 13.9 14.9 ± 12.0 19.6 ± 16.4 >16 52 53 
    Change in heart rate during tilt (bpm) 16.0 ± 8.5 14.6 ± 8.5 7.7 ± 13.7* <12 35 39 
Nerve conduction studies       
    Peroneal amplitude (mV) 6.7 ± 2.6 5.5 ± 2.6 3.5 ± 2.4* <4.5 73 78 
    Sural amplitude (μV) 10.7 ± 8.0 7.5 ± 6.5* 3.4 ± 4.1* <4 68 70 
    Peroneal velocity (m/s) 47.7 ± 4.4 45.0 ± 4.9 42.0 ± 5.4* <44 64 72 
    Peroneal distal latency (ms) 4.7 ± 0.8 4.7 ± 0.6 5.0 ± 0.7* >4.5 61 53 
    Sural velocity (m/s) 47.4 ± 5.8 45.7 ± 6.3 42.6 ± 6.5* <43 59 70 
Sensory testing       
    Cold-pain foot (°C) 6.4 ± 10.1 7.3 ± 9.3 2.1 ± 4.7* <10 89 29 
    Heat-pain hand (°C) 46.0 ± 4.5 45.5 ± 4.5 46.8 ± 3.2 >45.1 80 41 
    Cold detection foot (°C) 25.7 ± 7.0 25.3 ± 6.4 17.2 ± 10.5* <25.5 77 70 
    Monofilament threshold right (g) 3.76 ± 0.4 3.8 ± 0.5 4.7 ± 1.3* >4.1 76 75 
    Vibratory detection toe 4.8 ± 7.4 5.2 ± 7.6 20.6 ± 26.0* >4.3 76 72 
    Heat-pain foot (°C) 47.4 ± 3.5 47.7 ± 2.5 49.0 ± 1.7* >48.3 69 62 
    Heat detection hand (°C) 34.3 ± 2.9 35.1 ± 1.9 36.7 ± 3.8* >34.5 69 49 
    Heat detection foot (°C) 39.1 ± 5.9 40.3 ± 4.2 44.4 ± 4.2* >43 67 72 
    Vibratory detection thumb 1.0 ± 0.5 2.0 ± 2.5* 3.8 ± 6.3* >1.5 67 70 
    Cold detection hand (°C) 30.2 ± 2.0 31.1 ± 4.9 28.9 ± 3.7 <30.2 61 72 
    Cold-pain hand (°C) 6.2 ± 6.5 7.7 ± 8.9 4.2 ± 6.9* <3 61 54 
Cutaneous blood flow       
    Direct leg % change 248 ± 285 202 ± 205 114 ± 159* <125% 77 60 
    Direct forearm % change 490 ± 435 372 ± 366 344 ± 314 <315% 55 50 
    Axon reflex leg % change 146 ± 212 150 ± 257 63 ± 74* <75% 69 49 
    Axon reflex arm % change 291 ± 354 412 ± 920 720 ± 3,370 <220% 71 43 

Data are means ± SD or % for sensitivity and specificity. Characteristics of the study groups were compared by one-way ANOVA with Tamhane T2 post hoc tests. ROC curves were generated with the selected maximal sensitivity and specificity for each test shown, and test values for the selection are reported as the ROC threshold.

*P < 0.01 vs. healthy control subjects;

P < 0.01 vs. diabetes without neuropathy.

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