Application Value of Electromyography Combined With Heart Rate Variability in the Diagnosis of Diabetic Peripheral Neuropathy

Purpose: To explore the clinical value of Electromyography (EMG) and Heart Rate Variability (HRV) in the diagnosis of early DPN and provide the basis for early diagnosis, treatment, and prevention of DPN. Methods: 105 patients with type 2 diabetes mellitus (T2DM) in the Changji People’s Hospital were treated from January 2023 to December 2023. They were stratified into DPN-symptomatic (DPN group, n=55) and DPN-asymptomatic (NDPN group, n=50) cohorts based on the presence or absence of clinically confirmed diabetic peripheral neuropathy. The clinical biochemical indicators, nerve electromyography, and HRV parameters were obtained from electronic medical records, and differences in detection results were compared between the two groups. Logistic regression was applied to analyze the influencing factors of DPN in diabetes patients. The receiver operating characteristic (ROC) curve was applied to analyze the diagnostic value of EMG combined with other parameters for DPN. Results: From the results of the general information, diabetes duration, glycosylated hemoglobin (HbA1c), low-density lipoprotein cholesterol (LDL-C), total cholesterol (TC) and FBG in the DPN group were significantly differences compared with the NDPN group (p<0.05). There were no statistically significant differences in gender, age years, uric acid, and other general data (p>0.05). Compared with the NDPN group, the motor nerve conduction velocity (MNCV), sensory nerve conduction velocity (SNCV) of the ulnar nerve, median nerve, and tibial nerve in the DPN group were statistically significant (p>0.05). The DPN group had higher average F wave latency and H wave latency in the tested nerve, with statistical significance (p<0.05). HRV parameters decreased significantly (SDNN, rMSSD, PNN50, and SDANN, all p <0.05). ROC analysis showed that the area under the ROC curve (AUC) of the combined diagnosis of DPN by duration of diabetes, HbA1c, EMG, and HRV was the accuracy was 82.86%, the sensitivity was 78.00 . The AUC of the combined diagnosis of the four parameters for DPN was significantly higher than that of each alone (p<0.05). Conclusion: The combination of EMG and HRV has a high value in the assessment of DPN and can be used for early assessment of the extent of the lesion.