Shanghai Key Laboratory of Health Identification and Assessment/Laboratory of Traditional Chinese Medicine Four Diagnostic Information, Shanghai University of Traditional Chinese Medicine, Shanghai, China.
Department of Pharmaceutical Sciences, College of Pharmacy, University of South Florida, Tampa, FL, United States.
JMIR Mhealth Uhealth. 2019 Apr 23;7(4):e11959. doi: 10.2196/11959.
We should pay more attention to the long-term monitoring and early warning of type 2 diabetes and its complications. The traditional blood glucose tests are traumatic and cannot effectively monitor the development of diabetic complications. The development of mobile health is changing rapidly. Therefore, we are interested in developing a new noninvasive, economical, and instant-result method to accurately diagnose and monitor type 2 diabetes and its complications.
We aimed to determine whether type 2 diabetes and its complications, including hypertension and hyperlipidemia, could be diagnosed and monitored by using pulse wave.
We collected the pulse wave parameters from 50 healthy people, 139 diabetic patients without hypertension and hyperlipidemia, 133 diabetic patients with hypertension, 70 diabetic patients with hyperlipidemia, and 75 diabetic patients with hypertension and hyperlipidemia. The pulse wave parameters showing significant differences among these groups were identified. Various machine learning models such as linear discriminant analysis, support vector machines (SVMs), and random forests were applied to classify the control group, diabetic patients, and diabetic patients with complications.
There were significant differences in several pulse wave parameters among the 5 groups. The parameters height of tidal wave (h), time distance between the start point of pulse wave and dominant wave (t), and width of percussion wave in its one-third height position (W) increase and the height of dicrotic wave (h) decreases when people develop diabetes. The parameters height of dominant wave (h), h, and height of dicrotic notch (h) are found to be higher in diabetic patients with hypertension, whereas h is lower in diabetic patients with hyperlipidemia. For detecting diabetes, the method with the highest out-of-sample prediction accuracy is SVM with polynomial kernel. The algorithm can detect diabetes with 96.35% accuracy. However, all the algorithms have a low accuracy when predicting diabetic patients with hypertension and hyperlipidemia (below 70%).
The results demonstrated that the noninvasive and convenient pulse-taking diagnosis described in this paper has the potential to become a low-cost and accurate method to monitor the development of diabetes. We are collecting more data to improve the accuracy for detecting hypertension and hyperlipidemia among diabetic patients. Mobile devices such as sport bands, smart watches, and other diagnostic tools are being developed based on the pulse wave method to improve the diagnosis and monitoring of diabetes, hypertension, and hyperlipidemia.
我们应该更加关注 2 型糖尿病及其并发症的长期监测和预警。传统的血糖检测具有创伤性,无法有效监测糖尿病并发症的发展。移动医疗的发展日新月异。因此,我们有兴趣开发一种新的非侵入性、经济实惠且即时的方法,以准确诊断和监测 2 型糖尿病及其并发症。
我们旨在确定是否可以使用脉搏波来诊断和监测 2 型糖尿病及其并发症,包括高血压和高血脂。
我们从 50 名健康人、139 名无高血压和高血脂的糖尿病患者、133 名高血压糖尿病患者、70 名高血脂糖尿病患者和 75 名高血压和高血脂糖尿病患者中收集了脉搏波参数。确定了这些组之间存在显著差异的脉搏波参数。应用线性判别分析、支持向量机(SVM)和随机森林等各种机器学习模型对对照组、糖尿病患者和有并发症的糖尿病患者进行分类。
5 组之间的几个脉搏波参数存在显著差异。当人们患上糖尿病时,脉搏波的几个参数(潮波高度(h)、脉搏波起点与主波之间的时间距离(t)、主波三分之一高度处的拍击波宽度(W)增加,而 dicrotic 波高度(h)减小。高血压糖尿病患者的主波高度(h)、h 和 dicrotic 波切迹高度(h)较高,而高血脂糖尿病患者的 h 较低。用于检测糖尿病的方法中,基于多项式核的 SVM 具有最高的样本外预测准确性。该算法可以以 96.35%的准确率检测糖尿病。然而,所有算法在预测高血压和高血脂糖尿病患者时的准确性都较低(低于 70%)。
结果表明,本文描述的无创、便捷的脉象诊断具有成为一种低成本、准确的监测糖尿病发展方法的潜力。我们正在收集更多的数据,以提高对糖尿病患者高血压和高血脂的检测准确性。正在基于脉搏波方法开发运动带、智能手表和其他诊断工具等移动设备,以改善糖尿病、高血压和高血脂的诊断和监测。