Autonomic Test by EZSCAN in the Screening for Prediabetes and Diabetes.docVIP

AutonomicTestbyEZSCANintheScreeningfor PrediabetesandDiabetes ZhiYang1,2.,BaihuiXu1,2.,JieliLu1,2,XiaoguangTian1,2,MianLi1,2,KanSun1,2,FeiHuang1,2,YuLiu1,2 , MinXu1,2,YufangBi1,2,WeiqingWang1,2 * 1KeyLaboratoryforEndocrineandMetabolicDiseasesofMinistryofHealth,Rui-JinHospital,ShanghaiJiaoTongUniversitySchoolofMedicine,E-InstituteofShanghai Universities, Shanghai, People’s Republic of China, 2Shanghai Clinical Center for Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases,DepartmentofEndocrinologyandMetabolism,Rui-JinHospital,ShanghaiJiaoTongUniversitySchoolofMedicine,Shanghai,People’sRepublicofChina Abstract Background: Autonomic neuropathy is common in diabetics and may occur in prediabetes. A new and noninvasive autonomictest-EZSCANevaluatessudomotorfunctionprecisely.NogenerallyacceptedEZSCANthresholdstoscreen for prediabetesanddiabeteshavebeendefined. MethodologyandPrincipalFindings:Cross-sectionalstudyof5,824Chineseadultsaged40andolderwasconductedin Shanghai,China.WeusedEZSCANtoevaluateautonomicfunctionindifferentglucosestatusandscreenforprediabetes anddiabetes.Theprevalenceofprediabetesanddiabeteswere21.9%and17.5%respectively.Comparedwiththelowest quintile,thehighestquintileofEZSCANvaluehadoddsratiosforhavingdysglycemia(prediabetesordiabetes)of2.08(95% CI1.67–2.58)intotalpopulation,2.89(95%CI2.06–4.05)inmenand1.70(95%CI1.28–2.25)inwomenafteradjustmentfor confoundingfactors.EZSCANvalueimprovedtheareasunderROCcurvefordetectionofdysglycemiaordiabetesbeyond the contribution of conventional risk factors by 0.8% and 12.9%. The cut-off point of EZSCAN value higher than 30% providedreasonablesensitivities(70.3–83.7%)todetectdysglycemianotonlyintotalpopulationregardlessofsexbutalso inindividualswithhighriskofdevelopingdiabetes. Conclusions and Significance: EZSCAN value higher than 30% indicate an increased risk of prevalent prediabetes and diabetes, suggesting that subjects with EZSCAN $30% should be further evaluated by or