title: Transcutaneous oxygen pressure (TcPO₂): a novel diagnostic tool for peripheral neuropathy in type 2 diabetes patients.
abstract: OBJECTIVE
  The assessment of transcutaneous oxygen pressure (TcPO2) may serve as a non-invasive and lower-cost alternative to nerve conduction studies (NCSs) for the diagnosis of diabetic peripheral neuropathy (DPN). The aim of this study was to determine whether the measurement of TcPO2 is useful for evaluating DPN.
  
  
  METHODS
  We performed a cross-sectional study of 381 consecutive hospitalized diabetic patients classified by clinical examination and NCS as having DPN. Anthropometric and metabolic parameters were assessed. The TcPO2 examination was performed in both supine and sitting positions.
  
  
  RESULTS
  Three hundred and one patients had DPN. The TcPO2 in both the supine and sitting positions was highest in the Non-DPN group and lower in the confirmed DPN group than the other three groups (p<0.001). The Non-DPN group had the lowest sitting-supine position difference in TcPO2 among the groups (p<0.001). The risk factors strongly associated with DPN included sitting-supine position difference in TcPO2 (OR=4.971, p<0.001), diabetic retinopathy (DR) (odds ratio [OR]=3.794, p=0.002), and HbA1c (OR=1.534, p=0.033). The area under the curve (AUC) of the sitting-supine position difference in TcPO2 was 0.722 and revealed an optimal cut-off point for the identification of DPN (19.5 mmHg) that had a sensitivity of 0.611 and a specificity of 0.738 based on AUC analysis.
  
  
  CONCLUSIONS
  This large study of diabetic patients confirms that the sitting-supine position difference in TcPO2 is higher in DPN patients than control subjects, indicating that TcPO2 examination is a promising valuable diagnostic tool for DPN.
authors.affiliation: Department of Endocrinology and Metabolism, Southwest Hospital, Third Military Medical University, Chongqing 400038, China; Department of Endocrinology, The Second Affiliated Hospital, Chongqing Medical University, Chongqing 400010, China. Electronic address: dwq_cq@126.com.
authors.forename: Wuquan
authors.initials: W
authors.lastname: Deng
authors.affiliation: Department of Endocrinology and Metabolism, Southwest Hospital, Third Military Medical University, Chongqing 400038, China.
authors.forename: Xiaoying
authors.initials: X
authors.lastname: Dong
authors.affiliation: Department of Endocrinology and Metabolism, Southwest Hospital, Third Military Medical University, Chongqing 400038, China.
authors.forename: Yuping
authors.initials: Y
authors.lastname: Zhang
authors.affiliation: Department of Endocrinology and Metabolism, Southwest Hospital, Third Military Medical University, Chongqing 400038, China.
authors.forename: Youzhao
authors.initials: Y
authors.lastname: Jiang
authors.affiliation: Department of Endocrinology and Metabolism, Southwest Hospital, Third Military Medical University, Chongqing 400038, China.
authors.forename: Debin
authors.initials: D
authors.lastname: Lu
authors.affiliation: Department of Endocrinology and Metabolism, Southwest Hospital, Third Military Medical University, Chongqing 400038, China.
authors.forename: Qinan
authors.initials: Q
authors.lastname: Wu
authors.affiliation: Department of Endocrinology and Metabolism, Southwest Hospital, Third Military Medical University, Chongqing 400038, China.
authors.forename: Ziwen
authors.initials: Z
authors.lastname: Liang
authors.affiliation: Department of Endocrinology, The Second Affiliated Hospital, Chongqing Medical University, Chongqing 400010, China.
authors.forename: Gangyi
authors.initials: G
authors.lastname: Yang
authors.affiliation: Department of Endocrinology and Metabolism, Southwest Hospital, Third Military Medical University, Chongqing 400038, China. Electronic address: chenbing3@medmail.com.cn.
authors.forename: Bing
authors.initials: B
authors.lastname: Chen
mesh_terms: D000368:Aged; D015415:Biomarkers / Q000097:blood; D001785:Blood Gas Monitoring, Transcutaneous; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000150:complications*; D003929:Diabetic Neuropathies / Q000097:blood / Q000175:diagnosis*; D004576:Electromyography; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009431:Neural Conduction / Q000502:physiology; D011187:Posture / Q000502:physiology*; D012680:Sensitivity and Specificity
chemical_list: D015415:Biomarkers
keywords: Diabetic peripheral neuropathy; Nerve conduction study; Transcutaneous oxygen pressure