Ultrasonographic measurement of cross-sectional area of the vagus nerve in patients with diabetic neuropathy: a systematic review and meta-analysis.
Level 3 - non-randomized controlled study
Systematic review of observational/cross-sectional diagnostic studies
PubMed 41675744 · doi:10.1097/MS9.0000000000004705
What was done
Authors conducted a systematic review and meta-analysis following PRISMA guidelines across PubMed, Scopus, Embase, and Web of Science. They included 6 studies encompassing 604 participants (347 diabetic patients and 257 controls) to evaluate the diagnostic utility of ultrasonographic vagus nerve (VN) cross-sectional area (CSA) in diabetic neuropathy.
What was found
Pooled CSA showed no statistically significant differences between diabetic neuropathy patients and controls for either the left VN (MD: -0.02 mm², 95% CI: -0.80 to 0.75, P = 0.95) or the right VN (MD: -0.39 mm², 95% CI: -1.09 to 0.31, P = 0.28). Excluding one outlier study resulted in a significantly higher right VN CSA in diabetic patients (MD: 0.26 mm², P < 0.01). Significant CSA differences were seen in subgroups with BMI <27 kg/m², age >50 years, and diabetes duration <9 years, amidst high overall heterogeneity (I² > 95%).
Why it matters
Vagus nerve cross-sectional area measured by high-resolution ultrasound is not currently reliable as an isolated diagnostic biomarker for diabetic autonomic neuropathy.
Limits
The total number of studies is small (n = 6). There was extreme between-study heterogeneity (I² > 95%) likely driven by non-standardized ultrasound protocols and demographic differences, and positive right-sided findings required post-hoc outlier exclusion.
Cited by
- supports Sustained high blood sugars cause vagus nerve damage in individuals with diabetes.