Correlation between sweat function and cardiovascular autonomic neuropathy in patients with type 2 diabetes

Abstract

Objective To evaluate the correlation between sweating function and cardiovascular autonomic neuropathy (CAN) in patients with type 2 diabetes mellitus (T2DM). Methods A total of 326 hospitalized patients with T2DM in the Department of Endocrinology, General Hospital of Eastern Theater Command from August 2017 to February 2018 were enrolled, with an average age of (54.1±12.46) years. According to the diagnostic criteria of standard cardiovascular reflex test (CARTs), the patients were divided into two groups:225 cases with CAN and 101 cases without CAN (NCAN). Clinical biochemical indexes and sweat functions were compared between two groups to evaluate the relationship between Sudoscan and CAN. Kruskal-Wallis test and t test were used for comparison between groups. Spearman correlation analysis and binary logistic regression analysis were performed. Results Electrochemical skin conductance (ESC) of hand (HESC) and feet (FESC) using Sudoscan test in CAN group and NCAN group were (64.8±15.71) vs (69.98±13.75) μs and (67.46±18.64) vs (71.47±17.39) μs, respectively. There were significant differences between two groups (Z=-2.965, P=0.003; Z=-2.196, P=0.028). Spearman correlation analysis showed that HESC and FESC were positively correlated with heart rate variability (r value: 0.142-0.172, 0.117-0.196, all P<0.05). Age, durationof disease, HESC, FESC, CAN risk and other factors were included in the stepwise regression analysis. Results showed that age, HESC and postural diastolic pressure were independent factors of CAN (β=0.062, -0.02, 0.037, all P<0.05). Conclusions Sudoscan test is an objective, simple and quantitative method which showed potential in the early screening of diabetic cardiovascular autonomic neuropathy. Key words: Diabetes mellitus, type 2; Cardiovascular autonomic neuropathy; Sweat function; Electrochemical skin conductance