Abril - 2017

ienov

326

ssoc

ras

2017; 63(4):324-331

tendon, just above its insertion on the calcaneus, with

the patient seated and with his legs dangling (Achilles

reflex). As for feet abnormalities and presence of ulcer-

ation, one point was awarded to each if the sign was

present and zero point if it was absent. On the other

results, one point was given when the response was absent;

half a point when presented with reinforcement or de-

creased and zero point when present, even with reinforce-

ment (Figure 1). In all, the points were added and a cut-

off of 2.5 or more (cutoff validated for the MNSI) was

defined as suggestive of neuropathy.

Statistical analysis

The statistical analysis plan was defined prior to data

acquisition.

Then, a univariate descriptive analysis was performed,

in which all the quantitative data were described using

medians and the qualitative data were described by its

frequency. All categorical data were tested using Chi-square

test or Fisher’s exact test, if appropriate. Continuous

variables were first tested using the Shapiro-Wilk test

followed by Student’s t-test to compare the average in

case of normal distribution of the data. Mann-Whitney

test was used when the distribution was not normal. Sig-

nificant difference was considered when p≤0.05.

After the univariate analysis, a Poisson regression

analysis was performed to assess which of the factors

studied were independently associated with the occurrence

of PPN. The combination of measures was evaluated us-

ing a prevalence ratio with 95% confidence interval. Vari-

ables included in the model were those that in the uni-

variate analysis had a result of p≤0.2. The statistical

program used was SPSS for Windows, version 18.

esults

In our study, all patients with physical exam positive for

PPN presented at least one symptom of neuropathy. An

11% prevalence (n=24) of PPN was found in non-diabetic

Ob-II,III,MetS individuals. In this study, 81.2% of indi-

viduals with obesity grade II and III with MetS and wi-

thout DM were female. In Table 1, we verified features

of the 218 individuals evaluated for PPN presence, ac-

cording to MNSI.

According to the data obtained, there was a tendency

towards higher frequency of low HDL-cholesterol in the

neuropathy group compared to the non-neuropathy group

(p=0.057). In both groups, most subjects had grade III

obesity (75% vs. 73.2%, respectively). There were no sig-

nificant differences between neuropathic and non-neu-

ropathic patients regarding number of individuals with

systemic arterial hypertension (SAH) (p=0.239), high

levels of LDL-cholesterol (p=0.341), hypertriglyceridemia

(p=0.219), impaired fasting glucose (p=0.610), use of met-

formin (p=0.606) and pre-diabetes or IGT (p=0.954).

Normal foot

Yes

(0)

(1)

Ulceration

Absent

(0)

Present

(1)

........

Achilles reflex

Present

(0)

Present on

reinforcement

(0.5)

Absent

(1)

........

Vibration perception

Present

(0)

Decreased

(0.5)

Absent

(1)

........

Monofilament 10 g

Present

(0)

Decreased

(0.5)

Absent

(1)

........

Total = ......../10 points

FIGURE 1

Physical exam of the MNSI.