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

Ying Xue, Yubao Lv, Zihui Tang, Jingcheng Dong

Department of Integrative Medicine, Huashan Hospital, Fudan University, Shanghai, China (mainland)

Med Sci Monit 2017; 23:5354-5362

DOI: 10.12659/MSM.905240

Available online:

Published: 2017-11-10

BACKGROUND: The aim of this study was to create a screening system for diabetic cardiovascular autonomic neuropathy (DCAN) in diabetic patients.
MATERIAL AND METHODS: A Chinese cohort of 455 diabetic participants was recruited between 2011 and 2013. Short-term heart rate variability testing was used to evaluate cardiovascular autonomic function. A simple model was developed using multiple variable regression to include only significant risk factors that were simple and easily assessed. A DCAN score was determined based on the coefficients of the multiple variable model. This score was tested on the entire cohort of 455 diabetic patients and another independent, external cohort of 115 diabetic patients.
RESULTS: The screening system consisted of age, body mass index, duration of diabetes mellitus, and resting heart rate, and these factors were significantly (P<0.05) associated with DCAN. Receiver operating characteristic (ROC) curve analysis was done. The areas under the ROC curve were 0.798, 0.756, and 0.729 for the total sample, validation cohort, and external set, respectively. A cutoff DCAN score of 12 out of 25 produced optimal results for sensitivity (80.36%), specificity (58.27%), and percentage of patients that needed subsequent testing (43.55%) for the validation set.
CONCLUSIONS: The study concludes that a simple and practical DCAN screening can be applied for early intervention to delay or prevent the disease in the Chinese population.

Keywords: China, Diabetic Neuropathies, Multiphasic Screening, Risk Assessment