Cardiac autonomic neuropathy risk estimated by sudomotor function and arterial stiffness in Chinese subjects

The SUDOSCAN test was recently developed to detect diabetic autonomic neuropathy early and screen for cardiac autonomic neuropathy (CAN) through assessment of sudomotor function. The aim of this study was to investigate the relationship of cardiac autonomic dysfunction estimated by the SUDOSCAN test with arterial stiffness. A total of 4019 subjects without diabetes or established cardiovascular disease were tested with SUDOSCAN, central systolic blood pressure (cSBP) and brachial-ankle pulse wave velocity (baPWV). Hands mean electrochemical skin conductance (ESC) measured by SUDOSCAN was 70 +/- 17 mu S, feet mean ESC was 71 +/- 16 mu S and the CAN risk score was 21 +/- 10%. The levels of cSBP and baPWV increased across quartiles of CAN risk score (P for trend < 0.001 for all). In spearman correlation analyses, the CAN risk score was positively correlated with cSBP (r = 0.391, P < 0.001) and baPWV (r = 0.305, P < 0.001). In multivariable analyses, the values of cSBP and baPWV increased 0.17 mm Hg (P = 0.002) and 2.01 cm per second (P = 0.010), respectively, when CAN risk score increased 1%. The results were unchanged when stratified by glucose tolerance status. In conclusion, cardiac autonomic dysfunction estimated by sudomotor function was correlated with arterial stiffness independent of conventional factors and glucose tolerance status.