Estimating the Risk of Cardiac Autonomic Neuropathy in Chinese Subjects through Sudomotor Function and Arterial Stiffness

The aim of this study was to investigate the association between cardiac autonomic neuropathy (CAN) risk score estimated by the SUDOSCAN test and arterial stiffness. The study included 4019 subjects without diabetes or established cardiovascular disease. The hands and feet mean electrochemical skin conductance (ESC) measured by SUDOSCAN were 70±17 μS and 71±16 μS, respectively, and the CAN risk score was 21±10%. The levels of central systolic blood pressure (cSBP) and brachial-ankle pulse wave velocity (baPWV) increased as the CAN risk score quartiles increased (P for trend <0.001 for all). Spearman correlation analyses showed that the CAN risk score was positively correlated with cSBP (r=0.391, P<0.001) and baPWV (r=0.305, P<0.001). Multivariable analyses showed that the values of cSBP and baPWV increased 0.17 mm Hg (P=0.002) and 2.01 cm per second (P=0.010), respectively, for every 1% increase in CAN risk score. The association remained unchanged when stratified by glucose tolerance status. In conclusion, the study found that cardiac autonomic dysfunction estimated by sudomotor function was positively associated with arterial stiffness, independent of conventional factors and glucose tolerance status.