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Clinical risk model assessment for cardiovascular autonomic dysfunction in the general Chinese population

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Abstract

Background

The aim of this study was to evaluate the prevalence of cardiovascular autonomic (CA) dysfunction in the general Chinese population (instead of focusing on only patients with diabetes) and to develop a clinical risk model for the disease.

Methods and materials

We evaluated CA dysfunction prevalence in a dataset based on a population sample consisting of 2,092 individuals. Clinical risk models were derived from exploratory sets using multiple logistic regression analysis. The performance of the clinical risk models was tested in the validation sets.

Results

CA dysfunction prevalence was 18.50 % in the general Chinese population, while the prevalence was 24.14 % in individuals aged ≥60 years. Its prevalence was 31.17, 24.69, and 21.26 % in patients with diabetes, and hypertensive, and metabolic syndrome populations, respectively. Finally, we developed clinical risk models involving seven risk factors. The mean area under the receiver-operating curve was 0.758 (95 % CI 0.724–0.793) for these models. The mean sensitivity and specificity of the clinical risk models was 75.0 and 66.2 %, respectively.

Conclusion

CA dysfunction prevalence was high in the general Chinese population, and its prevalence was more frequent in individuals with diabetes, and hypertensive, and metabolic syndrome. Clinical risk models with a high value for predicting CA dysfunction were developed. CA dysfunction has become a major public health problem in China that requires strategies aimed at the prevention and treatment of the disease.

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Abbreviations

AUC:

Area under the receiver-operating curve

BP:

Blood pressure

BMI:

Body mass index

BSA:

Body surface area

CA:

Cardiovascular autonomic

Ccr:

Creatinine clearance rate

CI:

Confidence intervals

Cr:

Creatinine

DM:

Diabetes

FPG:

Fasting plasma glucose

HbAlc:

Glycosylated hemoglobin

HDL:

High-density lipoprotein cholesterol

HF:

High frequency

HL:

Hosmer–Lemeshow

HOMA-IR:

Homeostasis model assessment insulin resistance estimate

HRV:

Heart rate variability

IDF:

International Diabetes Federation

LDL:

Low-density lipoprotein cholesterol

LF:

Low frequency

LR:

Logistic linear regression

MetS:

Metabolic syndrome

OGTT:

Oral glucose tolerance test

OR:

Odds ratios

PBG:

Postprandial blood glucose

PH:

Hypertension

RACE:

Rapid autonomic cardiovascular evaluation

TC:

Serum total cholesterol

TG:

Triglyceride

WC:

Waist circumference

UA:

Uric acid

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Acknowledgments

This study was supported by the grant from China National Grant on Science and Technology (Grant Number: 30570740). We thank the grant from the China National Grant on Science and Technology to support the study.

Conflict of interest

All authors have no conflicts of interest.

Author information

Authors and Affiliations

  1. Department of Endocrinology and Metabolism, Huashan Hospital of Fudan University, Building 0#, NO. 12 Wulumuqi Mid Road, Shanghai, 200040, China

    L. Zhang, Z.-H. Tang, F. Zeng, Z. Li, L. Zhou & Y. Li

Authors
  1. L. Zhang
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  2. Z.-H. Tang
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  3. F. Zeng
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  4. Z. Li
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  5. L. Zhou
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  6. Y. Li
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Corresponding author

Correspondence to Y. Li.

Additional information

L. Zhang and Z.-H. Tang contributed equally to this work.

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Cite this article

Zhang, L., Tang, ZH., Zeng, F. et al. Clinical risk model assessment for cardiovascular autonomic dysfunction in the general Chinese population. J Endocrinol Invest 38, 615–622 (2015). https://doi.org/10.1007/s40618-014-0229-8

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  • DOI: https://doi.org/10.1007/s40618-014-0229-8

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