The Relationship Between Sural Nerve Morphometric Findings and Measures of Peripheral Nerve Function in Mild Diabetic Neuropathy

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Abstract
The morphological findings in sural nerve biopsy specimens from 15 diabetic patients with mild neuropathy were compared with control biopsies from eight non‐neuropathic, nondiabetic subjects, and correlations were sought with electrophysiological studies and quantitative sensory tests for vibration, thermal, and current perception thresholds. Myelinated fibre density was reduced compared with control biopsies (4042 ± 2090 (±SD) vs 6800 ± 1100 mm−2; p < 0.01). A strong correlation existed between myelinated fibre density and sural sensory conduction velocity (r = 0.84, p < 0.001), sural action potential amplitude (r = 0.74, p < 0.001), peroneal motor conduction velocity (r = 0.58, p < 0.02), and median sensory amplitude (r = 0.64, p < 0.01) but there was no correlation between myelinated fibre density and any quantitative sensory test. We conclude that conventional electrophysiological tests in the lower limb are reliable surrogate measures for structural abnormalities in early diabetic neuropathy.