Endocrine Abstracts

Background: Sudomotor function is used to assessperipheral autonomic system. Electrochemical Skin Conductancemeasurement using electrochemical reaction betweenchloride ions in sweat and stainless steel plate electrodes is a simple, non-invasive and quick method. Several factors, including age, sex, BMI, glycemic status influence sweat function.

Aim: Our aim was to determineprevalence of peripheral (DPN) and cardiac autonomic neuropathy (CAN) in hypertensive pre-diabetic patients by Sudoscan.

Methods: Based on their glycemia status participants (n = 70) were divided into 2 groups (Gr.):Gr.1– n = 38, 20 men/18 women (mean age 63.2 ± 4.3 yrs) had impaired fasting glucose (IFG) or impaired glucose tolerance (IGT) or IFG + IGT and hypertension; Gr. 2–n = 32, 18 men/14 women (mean age 62.8 ± 3.6 yrs) had hypertension, but no IFG/IGT or IFG + IGT. Following tests/analysis were performed in all thd patients: Sudoscan test, HbA1c, oral glucose tolerance test (OGTT), BMI, LDL-C, TG, systolic and diastolic blood pressure (SBP, DBP). According to Sudoscan results neuropathy is defined as: 1) no neuropathy: >70 (feet)/>60 (hands); 2) moderate neuropathy: 50–70 feet/40–60 hands; 3) severe neuropathy <50 (feet)/<40 (hands). CAN was defined according to CAN risk score: <30–no risk of CAN; ≥ 30 – at risk of CAN. There was no significant difference in sex, age, SBP/DBP between the groups.

Results: Among Gr.1 patients with pre-diabetes and hypertension prevalence of moderate or severe neuropathy, both DPN and CAN, was more prevalent (no neuropathy – 4 patients/10%; moderate neuropathy – 20 patients/52%; severe neuropathy – 14 patients/36%; CAN–<30–29 patients/76%; ≥ 30–9 patients/23%), than in Gr. 2 ones without IFG or IGT, or IFG + IGT (no neuropathy – 16 patients/50%, moderate – 12 patients/37.5%, severe-4 patients/12.5%; CAN <30–4 patients/12%; ≥ 30–28 patients/87%). HbA1c (%) and OGTT were higher in Gr.1, than in Gr.2 patients (5.9 ± 0.3 vs 4.1 ± 0.5, P = 0.005). There was no statistically significant difference in LDL-C/mmol/l (2.32 ± 0.9 vs2.14 ± 0.4, P = 0.85) and TG/mmol/l (2.02 ± 1.2 vs 1.9 ± 0.9, P = 0.93) levels between the groups, while BMI(kg/m²) was higher in Gr.1 compared to Gr.2 (33.7 ± 2.3 vs 27.2 ± 1.2, P = 0.01).

Conclusion: The overall prevalence of DPN and CAN was higher in hypertensive patients with pre-diabetes than in those without pre-diabetes. Thus, Sudoscan is an easy, non-invasive and quick method to detect DPN or CAN in an early stage. Though further studies are necessary to approve Sudoscan advantage over other well-known diagnostic methods.