A Simple Chinese Risk Score Model for Screening Cardiovascular Autonomic Neuropathy

BACKGROUND The purpose of the present study was to develop and evaluate a risk score to predict people at high risk of cardiovascular autonomic dysfunction neuropathy (CAN) in Chinese population. METHODS AND MATERIALS A population-based sample of 2,092 individuals aged 30-80 years, without previously diagnosed CAN, was surveyed between 2011 and 2012. All participants underwent short-term HRV test. The risk score was derived from an exploratory set. The risk score was developed by stepwise backward multiple logistic regression. The coefficients from this model were transformed into components of a CAN score. This score was tested in a validation and entire sample. RESULTS The final risk score included age, body mass index, hypertension, resting hear rate, items independently and significantly (P<0.05) associated with the presence of previously undiagnosed CAN. The area under the receiver operating curve was 0.726 (95% CI 0.686-0.766) for exploratory set, 0.784 (95% CI 0.749-0.818) for validation set, and 0.756 (95% CI 0.729-0.782) for entire sample. In validation set, at optimal cutoff score of 5 of 10, the risk score system has the sensitivity, specificity, and percentage that needed subsequent testing were 69, 78, and 30%, respectively. CONCLUSION We developed a CAN risk score system based on a set of variables not requiring laboratory tests. The score system is simple fast, inexpensive, noninvasive, and reliable tool that can be applied to early intervention to delay or prevent the disease in China.