Cardiac autonomic neuropathy risk estimated by sudomotor function and arterial stiffness in Chinese subjects

Abstract

The SUDOSCAN test was recently developed to detect diabetic autonomic neuropathy early and screen for cardiac autonomic neuropathy (CAN) through assessment of sudomotor function. The aim of this study was to investigate the relationship of cardiac autonomic dysfunction estimated by the SUDOSCAN test with arterial stiffness. A total of 4019 subjects without diabetes or established cardiovascular disease were tested with SUDOSCAN, central systolic blood pressure (cSBP) and brachial-ankle pulse wave velocity (baPWV). Hands mean electrochemical skin conductance (ESC) measured by SUDOSCAN was 70±17 μS, feet mean ESC was 71±16 μS and the CAN risk score was 21±10%. The levels of cSBP and baPWV increased across quartiles of CAN risk score (P for trend <0.001 for all). In spearman correlation analyses, the CAN risk score was positively correlated with cSBP (r=0.391, P<0.001) and baPWV (r=0.305, P<0.001). In multivariable analyses, the values of cSBP and baPWV increased 0.17 mm Hg (P=0.002) and 2.01 cm per second (P=0.010), respectively, when CAN risk score increased 1%. The results were unchanged when stratified by glucose tolerance status. In conclusion, cardiac autonomic dysfunction estimated by sudomotor function was correlated with arterial stiffness independent of conventional factors and glucose tolerance status.

Cardiac vagal tone, a non‐invasive measure of parasympathetic tone, is a clinically relevant tool in Type 1 diabetes mellitus

“…Firstly, it is a simple measure which requires very little training to use. Finally, the equipment and consumables needed to measure CVT are cheaper than other measures, such as Sudoscan [20]. Thirdly, it does not necessitate labourious data extraction or expertise in its interpretation.…”

“…Fourthly, in healthy participants CVT has been shown to be reproducible after 12 months, suggesting that it is a stable measure [14], and therefore could be potentially used as a longitudinal biomarker for disease/complication progression. Finally, the equipment and consumables needed to measure CVT are cheaper than other measures, such as Sudoscan [20]. These potential advantages must be tempered, however, by the fact that CVT is a relatively new measure, ultimately derived from imputations based on changes in RR intervals, and its comparison to more traditional/more established measures of HRV is largely not known.…”

The Relationship between Cardiovascular Autonomic Dysfunction and Ocular Abnormality in Chinese T2DM

“…A large cross-sectional study involving 4109 people, suggesting that CAN-RS was associated with arterial stiffness independent of traditional risk factors and glucose tolerance [17]. Zhu et al showed that there was a link between CAN-RS and the incidence and composition of metabolic syndrome [16].…”

“…SUDOSCAN can also be used for the efficient screening of CAN by means of its proprietary cardiovascular autonomic neuropathy risk score (CAN-RS) [13–15], which is derived from ESC, HbA1c, age, and BMI. Many studies have been published which investigate the relationship between CAN-RS and diseases such as metabolic syndrome [16] and arterial stiffness [17], but its association with diabetic oculopathy remains unexplored. The previous studies usually focus mainly on DR in diabetic patients; however, other types of ocular abnormality are rarely investigated.…”

Integrating heart rate variability and electrochemical skin conductance as severity screening of cardiovascular autonomic neuropathy in type 2 diabetes

“…Although HRV and ESC are validated and can serve as screening tools for CAN in patients with diabetes [5,[12][13][14][15][16], there is paucity of information that focuses on its role in estimating CAN severity in patients with diabetes who was already diagnosed with CAN in outpatient clinics, owing to the possible bene ts of exploring the role of the CV autonomic function on subsequent CV events and the consequent development of therapeutic strategies to reduce the prevalence of CV events.…”