出汗功能障碍作为糖尿病自主神经和心血管风险的早期标志物：来自使用SUDOSCAN的横断面研究的见解

Sudomotor Dysfunction as an Early Marker of Autonomic and Cardiovascular Risk in Diabetes: Insights from a Cross-Sectional Study Using SUDOSCAN.

作者信息

Anghel Larisa, Cobuz Claudiu, Benchea Laura-Cătălina, Maciuc Vasile, Cobuz Maricela, Sascău Radu-Andy, Stătescu Cristian

机构信息

Internal Medicine Department, "Grigore T. Popa" University of Medicine and Pharmacy, 700503 Iași, Romania.

Cardiology Department, Cardiovascular Diseases Institute "Prof. Dr. George I. M. Georgescu", 700503 Iași, Romania.

出版信息

Biosensors (Basel). 2025 Jun 10;15(6):372. doi: 10.3390/bios15060372.

DOI:10.3390/bios15060372

PMID:40558453

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12191207/

Abstract

BACKGROUND

Diabetic neuropathy, particularly in its autonomic form, is often underdiagnosed despite its clinical significance. Electrochemical skin conductance (ESC), measured by SUDOSCAN, offers a non-invasive way to assess the autonomic dysfunction.

METHODS

A total of 288 diabetic patients were assessed using SUDOSCAN to measure ESC in the hands and feet. Clinical and laboratory parameters, including glycated hemoglobin (HbA1c), body mass index (BMI), blood pressure, lipid profile, and cardiovascular risk, were analyzed for correlations with ESC. Neuropathy status was evaluated, and ROC analysis was performed to assess diagnostic accuracy.

RESULTS

Sudomotor dysfunction was prevalent, particularly in patients with a diabetes duration exceeding 20 years ( < 0.05). Men showed significantly higher right foot ESC than women (76.5 ± 13.1 vs. 74.0 ± 13.5 µS, = 0.041). A strong inverse correlation was found between cardiovascular risk score and right foot ESC (r = -0.455, < 0.001). Left foot ESC also correlated inversely with cardiovascular risk (r = -0.401, < 0.001) and HbA1c (r = -0.150, = 0.049), while a weak positive correlation was seen with BMI (r = 0.145, = 0.043). ROC analysis showed the highest area under the curve (AUC) in right foot ESC for autonomic neuropathy (AUC = 0.750, 95% CI: 0.623-0.877, < 0.001).

CONCLUSIONS

This study is among the few to systematically correlate ESC with validated cardiovascular risk scores in a diabetic outpatient cohort, highlighting its potential as a novel early screening biomarker for autonomic and cardiovascular complications.

摘要

背景

糖尿病神经病变，尤其是自主神经病变形式，尽管具有临床意义，但常常未被充分诊断。通过SUDOSCAN测量的电化学皮肤电导（ESC）提供了一种评估自主神经功能障碍的非侵入性方法。

方法

总共288名糖尿病患者使用SUDOSCAN进行评估，以测量手足的ESC。分析临床和实验室参数，包括糖化血红蛋白（HbA1c）、体重指数（BMI）、血压、血脂谱和心血管风险，以确定其与ESC的相关性。评估神经病变状态，并进行ROC分析以评估诊断准确性。

结果

泌汗功能障碍很普遍，尤其是在糖尿病病程超过20年的患者中（<0.05）。男性右脚ESC显著高于女性（76.5±13.1对74.0±13.5μS，=0.041）。发现心血管风险评分与右脚ESC之间存在强烈的负相关（r=-0.455，<0.001）。左脚ESC也与心血管风险（r=-0.401，<0.001）和HbA1c（r=-0.150，=0.049）呈负相关，而与BMI呈弱正相关（r=0.145，=0.043）。ROC分析显示，右脚ESC对自主神经病变的曲线下面积（AUC）最高（AUC=0.750，95%CI：0.623-0.877，<0.001）。