A Simple Chinese Risk Score Model for Screening Cardiovascular Autonomic Neuropathy

Abstract

BackgroundThe purpose of the present study was to develop and evaluate a risk score to predict people at high risk of cardiovascular autonomic dysfunction neuropathy (CAN) in Chinese population.Methods and MaterialsA population-based sample of 2,092 individuals aged 30–80 years, without previously diagnosed CAN, was surveyed between 2011 and 2012. All participants underwent short-term HRV test. The risk score was derived from an exploratory set. The risk score was developed by stepwise backward multiple logistic regression. The coefficients from this model were transformed into components of a CAN score. This score was tested in a validation and entire sample.ResultsThe final risk score included age, body mass index, hypertension, resting hear rate, items independently and significantly (P<0.05) associated with the presence of previously undiagnosed CAN. The area under the receiver operating curve was 0.726 (95% CI 0.686–0.766) for exploratory set, 0.784 (95% CI 0.749–0.818) for validation set, and 0.756 (95% CI 0.729–0.782) for entire sample. In validation set, at optimal cutoff score of 5 of 10, the risk score system has the sensitivity, specificity, and percentage that needed subsequent testing were 69, 78, and 30%, respectively.ConclusionWe developed a CAN risk score system based on a set of variables not requiring laboratory tests. The score system is simple fast, inexpensive, noninvasive, and reliable tool that can be applied to early intervention to delay or prevent the disease in China.

Increased prevalence of cardiac autonomic dysfunction at different degrees of glucose intolerance in the general population: the KORA S4 survey

“…Thus, particularly if the score result is negative, the presence of CAND can be ruled out with a high degree of certainty. A similar 'risk score' has recently been developed in a Chinese population, but its AUC (0.73), sensitivity (0.69) and specificity (0.78) were somewhat lower than ours [45]. Such simple screening scores could be used in clinical practice if equipment for measuring HRV is not readily available, but further validation is needed.…”

Analysis of a Screening System for Diabetic Cardiovascular Autonomic Neuropathy in China

“…However, few diabetes risk scores have been based on Asian populations [ 20 – 22 ]. In our previous studies, we developed a screening system to predict people with a high risk of cardiovascular autonomic dysfunction neuropathy (CAN) in the Chinese population but not in diabetic patients [ 23 , 24 ].…”

Development of clinical risk models for diabetic cardiovascular autonomic neuropathy in a Chinese population using logistic regression analysis

“…18 To the best of our knowledge, there have been no studies of DCAN risk models, although several screening models and clinical risk models have been developed for CAN. 10,[17][18][19] In the present study, the clinical risk models for DCAN consisted of glucose profiles (FPG, PBG, and DMD), whereas our previous CAN risk models did not include these parameters. Furthermore, in our previous studies, the screening system could not identify the proportion of the entire population that required subsequent testing due to small sample sizes.…”

“…As mentioned in our previous studies, 10,[17][18][19] the performance of the clinical risk models was evaluated in the study group and external cohort. A receiver-operating characteristic (ROC) curve and area under the curve (AUC) were produced.…”