Median Nerve Affection in Hypertensive Patients with and without Diabetes High-Resolution Ultrasound Assessment

Purpose: Diabetes is a documented risk factor for peripheral neuropathy. It was reported that associated hypertension could increase this risk. The present study aimed to assess the effect of hypertension and diabetes on median nerve using high-resolution ultrasound. Methods: The study includes 50 hypertensive patients (HTN group), 50 diabetic patients (DM group), 50 patients with coexisting diabetes and hypertension (HTN + DM group) and 50 healthy controls. Median nerve affection in the studied groups was studied by vibration perception thresholds (VPT). The median nerve cross-sectional area was determined at the nerve cross-sectional area of the median nerve at the carpal tunnel by high-resolution ultrasound. Clinical symptoms were assessed using Toronto Clinical Severity Score (TCSS). Results: There was significantly higher median nerve CSA in all patient groups in compar-ison to controls. HTN + DM group had significantly higher median nerve CSA when compared with DM group. Patients with peripheral neuropathy in HTN + DM and DM groups had significantly higher median nerve CSA than patients without. Using ROC curve analysis, it was shown that median CSA could successfully distinguish patients with periph-eral neuropathy from patients without in HTN + DM group [AUC (95% CI): 0.71 (0.54- 0.89)] and in DM group [AUC (95% CI): 0.86 (0.72-0.99)]. Conclusion: Hypertensive patients with and without diabetes have significantly higher median nerve CSA when compared with controls.

Automated summary

This study investigated the effect of hypertension and diabetes on the median nerve using high-resolution ultrasound. The results showed that hypertensive patients with and without diabetes had significantly higher median nerve cross-sectional area compared to controls. The cross-sectional area was even larger in patients with both hypertension and diabetes. The study also found that patients with peripheral neuropathy had significantly higher median nerve cross-sectional area than those without. The cross-sectional area of the median nerve could successfully distinguish patients with peripheral neuropathy from those without in both the hypertension and diabetes groups.