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Detection of relationships between SUDOSCAN with estimated glomerular filtration rate (eGFR) in Chinese patients with type 2 diabetes

  • Author Footnotes
    1 These authors contributed equally to this work.
    Fei Mao
    Footnotes
    1 These authors contributed equally to this work.
    Affiliations
    Department of Endocrinology and Metabolism, Huashan Hospital, Fudan University, Shanghai, China
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  • Author Footnotes
    1 These authors contributed equally to this work.
    Xiaoming Zhu
    Footnotes
    1 These authors contributed equally to this work.
    Affiliations
    Department of Endocrinology and Metabolism, Huashan Hospital, Fudan University, Shanghai, China
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  • Bin Lu
    Correspondence
    Corresponding authors at: Department of Endocrinology and Metabolism, Huashan Hospital, Fudan University, Shanghai, China (Y. Li).
    Affiliations
    Department of Endocrinology and Metabolism, Huashan Hospital, Fudan University, Shanghai, China
    Search for articles by this author
  • Yiming Li
    Correspondence
    Corresponding authors at: Department of Endocrinology and Metabolism, Huashan Hospital, Fudan University, Shanghai, China (Y. Li).
    Affiliations
    Department of Endocrinology and Metabolism, Huashan Hospital, Fudan University, Shanghai, China

    Department of Endocrinology and Metabolism, Jing’an District Center Hospital of Shanghai, China
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  • Author Footnotes
    1 These authors contributed equally to this work.
Published:February 03, 2018DOI:https://doi.org/10.1016/j.diabres.2018.01.036

      Abstract

      Objective

      SUDOSCAN (Impeto Medical, Paris, France) has been proved to be a new and non-invasive method in detecting renal dysfunction in type 2 diabetes mellitus (T2DM) patients. In this study, we sought to compare the result of diabetic kidney dysfunction score (DKD-score) of SUDOSCAN with estimated glomerular filtration rate (eGFR) by using quantile regression analysis, which was completely different from previous studies.

      Methods

      A total number of 223 Chinese T2DM patients were enrolled in the study. SUDOSCAN, renal function test (including blood urea nitrogen, creatinine and uric acid) and 99mTc-diethylenetriamine pentaacetic acid (99mTc-DTPA) renal dynamic imaging were performed in all T2DM patients. DKD-score of SUDOSCAN was compared with eGFR detected by 99mTc-DTPA renal dynamic imaging through quantile regression analysis. Its validation and utility was further determined through bias and precision test.

      Results

      The quantile regression analysis demonstrated the relationship with eGFR was inverse and significant for almost all percentiles of DKD-score. The coefficients decreased as the percentile of DKD-score increased. And in validation data set, both the bias and precision were increased with the eGFR (median difference, −21.2 ml/min/1.73 m2 for all individuals vs. −4.6 ml/min/1.73 m2 for eGFR between 0 and 59 ml/min/1.73 m2; interquartile range [IQR] for the difference, −25.4 ml/min/1.73 m2 vs. −14.7 ml/min/1.73 m2). The eGFR category misclassification rate were 10% in eGFR 0–59 ml/min/1.73 m2 group, 57.3% in 60–90 group, and 87.2% in eGFR > 90 ml/min/1.73 m2 group.

      Conclusion

      DKD-score of SUDOSCAN could be used to detect renal dysfunction in T2DM patients. A higher prognostic value of DKD-score was detected when eGFR level was lower.

      Abbreviations:

      T2DM (type 2 diabetes mellitus), BMI (body mass index), DKD (diabetic kidney dysfunction), WHR (waist hip ratio), SBP (systolic blood pressure), DBP (diastolic blood pressure), HbA1c (Hemoglobin A1c), BUN (blood urea nitrogen), GFR (glomerular filtrate rate), ESC (electrochemical skin conductance), eGFR (estimated glomerular filtrate rate), CI (confidence interval), MDRD (modification of diet in renal disease), EPI (epidemiology collaboration), EA (European Americans), AA (African Americans), μS (micro-Siemens), IQR (interquartile range), UACR (urine albumin: creatinine ratio), 99mTc-DTPA (99mTc-diethylenetriamine pentaacetic acid)

      Keywords

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      References

        • Casellini C.M.
        • Parson H.K.
        • Richardson M.S.
        • Nevoret M.L.
        • Vinik A.I.
        Sudoscan, a noninvasive tool for detecting diabetic small fiber neuropathy and autonomic dysfunction.
        Diabetes Technol Ther. 2013; 15: 948-953
        • Chen L.
        • Chen X.
        • Ding R.
        • Shi Jr., Q.
        • Hu D.
        Evaluation of EZSCAN as a screening tool for impaired glucose metabolism.
        Diabetes Res Clin Pract. 2013; 100: 210-214
        • Yajnik C.S.
        • Kantikar V.V.
        • Pande A.J.
        • Deslypere J.P.
        Quick and simple evaluation of sudomotor function for screening of diabetic neuropathy.
        ISRN Endocrinol. 2012; 2012: 103714
        • Ramachandran A.
        • Moses A.
        • Shetty S.
        • Thirupurasundari C.J.
        • Seeli A.C.
        • et al.
        A new non-invasive technology to screen for dysglycaemia including diabetes.
        Diabetes Res Clin Pract. 2010; 88: 302-306
      1. Zhu L, Zhao X, Zeng P, Zhu J, Yang S, et al. Study on autonomic dysfunction and metabolic syndrome in Chinese patients. J Diabetes Investig 2016.

        • Freedman B.I.
        • Bowden D.W.
        • Smith S.C.
        • Xu J.
        • Divers J.
        Relationships between electrochemical skin conductance and kidney disease in Type 2 diabetes.
        J Diabetes Complications. 2014; 28: 56-60
        • Luk A.O.
        • Fu W.C.
        • Li X.
        • Ozaki R.
        • Chung H.H.
        • et al.
        The clinical utility of SUDOSCAN in chronic kidney disease in chinese patients with type 2 diabetes.
        PLoS ONE. 2015; 10: e0134981
        • Ma Y.C.
        • Zuo L.
        • Zhang C.L.
        • Wang M.
        • Wang R.F.
        • et al.
        Comparison of 99mTc-DTPA renal dynamic imaging with modified MDRD equation for glomerular filtration rate estimation in Chinese patients in different stages of chronic kidney disease.
        Nephrol Dial Transplant. 2007; 22: 417-423
      2. Mao F, Liu S, Qiao X, Zheng H, Xiong Q, et al. Sudoscan is an effective screening method for asymptomatic diabetic neuropathy in Chinese type 2 diabetes mellitus patients. J Diabetes Investig 2016.

        • Vinik A.I.
        • Nevoret M.L.
        • Casellini C.
        The new age of sudomotor function testing: a sensitive and specific biomarker for diagnosis, estimation of severity, monitoring progression, and regression in response to intervention.
        Front Endocrinol (Lausanne). 2015; 6: 94
        • Calvet J.H.
        • Dupin J.
        • Winiecki H.
        • Schwarz P.E.
        Assessment of small fiber neuropathy through a quick, simple and non invasive method in a German diabetes outpatient clinic.
        Exp Clin Endocrinol Diabetes. 2013; 121: 80-83
        • Zeng Q.
        • Dong S.Y.
        • Wang M.L.
        • Xiang H.
        • Zhao X.L.
        Association of EZSCAN values with arterial stiffness in individuals without diabetes or cardiovascular disease.
        PLoS ONE. 2014; 9: e90854
        • Freedman B.I.
        • Smith S.C.
        • Bagwell B.M.
        • Xu J.
        • Bowden D.W.
        • et al.
        Electrochemical skin conductance in diabetic kidney disease.
        Am J Nephrol. 2015; 41: 438-447
        • Yang Z.
        • Xu B.
        • Lu J.
        • Tian X.
        • Li M.
        • et al.
        Autonomic test by EZSCAN in the screening for prediabetes and diabetes.
        PLoS ONE. 2013; 8: e56480
        • Papanas N.
        • Ziegler D.
        New vistas in the diagnosis of diabetic polyneuropathy.
        Endocrine. 2014; 47: 690-698
        • Raisanen A.
        • Eklund J.
        • Calvet J.H.
        • Tuomilehto J.
        Sudomotor function as a tool for cardiorespiratory fitness level evaluation: comparison with maximal exercise capacity.
        Int J Environ Res Public Health. 2014; 11: 5839-5848
        • Smith A.G.
        • Lessard M.
        • Reyna S.
        • Doudova M.
        • Singleton J.R.
        The diagnostic utility of Sudoscan for distal symmetric peripheral neuropathy.
        J Diabetes Complications. 2014; 28: 511-516
        • Selvarajah D.
        • Cash T.
        • Davies J.
        • Sankar A.
        • Rao G.
        • et al.
        SUDOSCAN: a simple, rapid, and objective method with potential for screening for diabetic peripheral neuropathy.
        PLoS ONE. 2015; 10: e0138224
        • Ozaki R.
        • Cheung K.K.
        • Wu E.
        • Kong A.
        • Yang X.
        • et al.
        A new tool to detect kidney disease in Chinese type 2 diabetes patients: comparison of EZSCAN with standard screening methods.
        Diabetes Technol Ther. 2011; 13: 937-943
        • Tesfaye S.
        • Boulton A.J.M.
        • Dyck P.J.
        • Freeman R.
        • Horowitz M.
        • et al.
        Diabetic neuropathies: update on definitions, diagnostic criteria, estimation of severity, and treatments.
        Diabetes Care. 2010; 33: 2285-2293
        • Schold J.D.
        • Navaneethan S.D.
        • Jolly S.E.
        • Poggio E.D.
        • Arrigain S.
        • et al.
        Implications of the CKD-EPI GFR estimation equation in clinical practice.
        Clin J Am Soc Nephrol. 2011; 6: 497-504
        • Teo B.W.
        • Koh Y.Y.
        • Toh Q.C.
        • Li J.
        • Sinha A.K.
        • et al.
        Performance of the CKD-EPI creatinine-Cystatin C glomerular filtration rate estimation equations in a multiethnic Asian population.
        Singapore Med J. 2014; 55: 656-659