Abstract
Clinical diagnosis of diabetes mellitus (DM) is time-consuming and invasive. This study aimed to investigate the efficacy and accuracy of EZSCAN in detecting impaired glucose tolerance (IGT) and diabetes mellitus (DM) in Chinese population, and explore a diagnosis formula based on an autonomic test using EZSCAN measurement and anthropometric data. Eligible subjects (n = 1547) had the following data collected: those of anthropometric and EZSCAN measurements and biochemical tests including FPG, OGTT, HbA1c, and serum lipid tests. The support vector machine (SVM) algorithm method was used to derive a diagnostic formula. In this study, 452 and 263 subjects were diagnosed with T2DM and IGT, respectively, while 832 had normal glucose tolerance (NGT). The sensitivity rates for the formula were 77.2% for T2DM and 80.4% for IGT. The diagnostic formula was found to correlate strongly with EZSCAN values. The diagnostic formula based on autonomic test and anthropometric data appears to be a convenient and accurate routine screening option in the Chinese population.
Highlights
Diabetes mellitus (DM) is among the most common metabolic disorders, with more than 400 million adults affected worldwide in 20171,2
There is clear evidence to suggest that sudomotor dysfunction due to small-fibres injury can develop early in diabetes and be detected in diabetic patients during standard clinical evaluation or even earlier in patients with IGT11
We demonstrated clear associations of the EZSCAN value with some conventional risk factors, including older age and higher systolic blood pressure (SBP)
Summary
Diabetes mellitus (DM) is among the most common metabolic disorders, with more than 400 million adults affected worldwide in 20171,2. One study reported a sensitivity and specificity of 75% and 100%, respectively, for assessing sudomotor dysfunction using EZSCAN in a French population[11]. In an Indian population, EZSCAN device yielded sensitivity rates of 75% and 70% for the detection of DM and IGT using a cut-off point of 50%17. Chen et al reported optimal cut-off points of 37% and 50% for the detection of IGT and DM, respectively, the sensitivity (53%) and specificity rates (59%) in their case. Studies suggest that in comparison with the French and Indian populations, a lower EZSCAN threshold would be adequate for the diagnosis of IGT and DM in Chinese individuals at reasonable levels of sensitivity and specificity
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