title: Reproducibility of vibration perception threshold values in children and adolescents with type 1 diabetes mellitus and associated factors.
abstract: OBJECTIVE
  To define the reproducibility of vibration perception thresholds (VPTs) and the possible associated factors, as an early index of peripheral diabetic neuropathy (PDN) in type 1 diabetes mellitus (T1DM) children and adolescents.
  
  
  METHODS
  A single examiner studied 118 T1DM subjects (aged 13.5±3.4 years) and 79 controls (aged 12.0±3.07 years). Glycaemic control was assessed with HbA1c levels. VPT was measured twice on upper and lower limbs, using a Biothesiometer. Concordance between the two VPT measurements was evaluated using the Cohen's Weighted Kappa statistic (Kappa=0.41-0.60→moderate concordance, Kappa=0.61-0.80→substantial concordance).
  
  
  RESULTS
  T1DM children had significantly higher VPTs than controls at all sites (p=0.001), but with lower Kappa values (0.64-0.70). VPT values increased in parallel with HbA1c (a.<8%, b. 8-9.5%, c.>9.5%) and T1DM duration (a.<5 years, b.5.1-10, c.>10 years). However, Kappa values were lower in the groups with the poorest control (HbA1c>9.5%) (Kappa=0.54-0.76) or the longest T1DM duration (>10 years) (Kappa=0.49-0.71). Although VPTs increased with stature and male gender, no effect on VPT reproducibility was observed. However, obesity was associated with lower VPT values and poorer concordance.
  
  
  CONCLUSIONS
  These findings suggest that the reproducibility of VPTs is lower in the high-risk patients for early subclinical PDN development, who need a regular follow-up.
authors: Diabetic Clinic, Second Pediatric Department University of Athens, "P&A Kyriakou" Children's Hospital, Athens, Greece. Electronic address: mlouraki@hotmail.com.
authors: M
authors: M
authors: Louraki
authors: Diabetic Clinic, Second Pediatric Department University of Athens, "P&A Kyriakou" Children's Hospital, Athens, Greece.
authors: C
authors: C
authors: Tsentidis
authors: Diabetic Clinic, Second Pediatric Department University of Athens, "P&A Kyriakou" Children's Hospital, Athens, Greece.
authors: D
authors: D
authors: Kallinikou
authors: Neurologic Department, "Aghia Sophia" Children's Hospital, Athens, Greece.
authors: M
authors: M
authors: Katsalouli
authors: Diabetes Center, Division of Endocrinology, Diabetes and Metabolism, First Department of Pediatrics, University of Athens, "Aghia Sophia" Children's Hospital, Athens, Greece.
authors: C
authors: C
authors: Kanaka-Gantenbein
authors: Department of Immunology, 'Laiko' General Hospital, Greece.
authors: N
authors: N
authors: Kafassi
authors: Department of Pediatric Endocrinology, "P&A Kyriakou" Children's Hospital, Athens, Greece.
authors: A
authors: A
authors: Papathanasiou
authors: Diabetic Clinic, Second Pediatric Department University of Athens, "P&A Kyriakou" Children's Hospital, Athens, Greece. Electronic address: kkarav@yahoo.gr.
authors: K
authors: K
authors: Karavanaki
mesh_terms: D000293:Adolescent; D000367:Age Factors; D015415:Biomarkers / Q000097:blood; D016022:Case-Control Studies; D002648:Child; D003922:Diabetes Mellitus, Type 1 / Q000097:blood / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D003929:Diabetic Neuropathies / Q000175:diagnosis* / Q000209:etiology / Q000503:physiopathology; D042241:Early Diagnosis; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D008297:Male; D009460:Neurologic Examination / Q000379:methods*; D011237:Predictive Value of Tests; D015203:Reproducibility of Results; D012307:Risk Factors; D012684:Sensory Thresholds; D055698:Touch Perception; D014732:Vibration; D055815:Young Adult
chemical_list: D015415:Biomarkers; D006442:Glycated Hemoglobin; D007004:Hypoglycemic Agents; C517652:hemoglobin A1c protein, human
keywords: Diabetic neuropathy; Reproducibility; Vibration sense