期刊
BIOMEDICAL ENGINEERING ONLINE
卷 19, 期 1, 页码 -出版社
BMC
DOI: 10.1186/s12938-020-00823-x
关键词
Diabetes; Prediabetes; Impaired glucose regulation; Screening
资金
- Shanghai Natural Science Foundation [20ZR1410200]
- National Key R&D Program of China [2017YFC1309801]
- National Natural Science Foundation of China [81471073]
- Shanghai Science and Technology Committee [13441900303]
- Excellent Member Program of Zhongshan Hospital Fudan University [2015ZSYXGG15]
- Shanghai Municipal Commission of Health and Family Planning [201740092]
- Special Project of Integrating Traditional Chinese and Western Medicine in Shanghai General Hospital from the Shanghai Municipal Commission of Health and Family Planning and Shanghai TCM Development Office [ZY(2018-2020)-FWTX-3019]
Background Screening for prediabetes and asymptomatic diabetes is important for preventing development to an irreversible stage. The current diagnosis of prediabetes and diabetes is based on blood glucose or HbA1c (an invasive method). The aim of this study was to assess the efficacy and safety of DS21, a new noninvasive technology, for noninvasive screening for prediabetes and diabetes. Methods A total of 939 subjects were divided into a normal control group (NC,n = 308), impaired glucose regulation group (IGR,n = 312), and diabetes (DM) group (n = 319). All subjects underwent the DS21 test, and mean hands-feet, hand, and feet conductance values were analyzed. The diagnostic accuracy of the conductance value was analyzed by receiver-operating characteristic (ROC) curve. Results The conductance values for hands-feet, hands, and feet in the DM and IGR groups were significantly lower than those in the NC group (allP < 0.01). The area under the ROC curve (AUCROC) for distinguishing NC/IGR was highest when using hands-feet conductance values (0.766 [95% confidence interval, CI 0.730, 0.803]). However, the AUCROCs of distinguishing NC/abnormal glucose metabolism (AGM, including IGR+DM), non-diabetes (NDM)/DM, and IGR/DM were highest when using conductance values for hands at 0.782 [95% CI 0.752, 0.812], 0.688 [95% CI 0.653, 0.723] and 0.573 [95% CI 0.528, 0.617], respectively (allP < 0.01). Hand conductance of values 75.0 (sensitivity 0.769, specificity 0.660), 77.1 (sensitivity 0.718, specificity 0.695), 68.4 (sensitivity 0.726, specificity 0.555), and 58.1 (sensitivity 0.384, specificity 0.744) were recommended as the screening thresholds for NC/AGM, NC/IGR, NDM/DM, and IGR/DM, respectively. A hand conductance value 66.0 was also recommended to distinguish NC/AGM due to its high sensitivity and high PPV. No adverse events occurred in the test. Conclusions DS21 is fast, noninvasive, low cost, reliable and safe, which makes it a feasible device for screening for prediabetes and diabetes, especially in a large population.
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