Electrochemical Skin Conductance May Be Used to Screen for Diabetic Cardiac Autonomic Neuropathy in a Chinese Population with Diabetes

Abstract

Aims . This study aimed to assess whether the electrochemical skin conductance (ESC) could be used to screen for diabetic cardiac autonomic neuropathy (DCAN) in a Chinese population with diabetes. Methods . We recruited 75 patients with type 2 diabetes mellitus (T2DM) and 45 controls without diabetes. DCAN was diagnosed by the cardiovascular autonomic reflex tests (CARTs) as gold standard. In all subjects ESCs of hands and feet were also detected by SUDOSCAN™ as a new screening method. The efficacy was assessed by receiver operating characteristic (ROC) curve analysis. Results . The ESCs of both hands and feet were significantly lower in T2DM patients with DCAN than those without DCAN (<mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML" id="M1"><mml:mn fontstyle="italic">67.33</mml:mn><mml:mo>±</mml:mo><mml:mn fontstyle="italic">15.37</mml:mn></mml:math>versus<mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML" id="M2"><mml:mn fontstyle="italic">78.03</mml:mn><mml:mo>±</mml:mo><mml:mn fontstyle="italic">13.73</mml:mn></mml:math>,<mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML" id="M3"><mml:mi>P</mml:mi><mml:mo>=</mml:mo><mml:mn fontstyle="italic">0.002</mml:mn></mml:math>, and<mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML" id="M4"><mml:mn fontstyle="italic">57.77</mml:mn><mml:mo>±</mml:mo><mml:mn fontstyle="italic">20.99</mml:mn></mml:math>versus<mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML" id="M5"><mml:mn fontstyle="italic">75.03</mml:mn><mml:mo>±</mml:mo><mml:mn fontstyle="italic">11.41</mml:mn></mml:math>,<mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML" id="M6"><mml:mi>P</mml:mi><mml:mo>&lt;</mml:mo><mml:mn fontstyle="italic">0.001</mml:mn></mml:math>). The ROC curve analysis showed the areas under the ROC curve were both 0.75 for ESCs of hands and feet in screening DCAN. And the optimal cut-off values of ESCs, sensitivities, and specificities were 76 μ S, 76.7%, and 75.6% for hands and 75 μ S, 80.0%, and 60.0% for feet, respectively. Conclusions . ESC measurement is a reliable and feasible method to screen DCAN in the Chinese population with diabetes before further diagnosis with CARTs.