title: Association of EZSCAN values with arterial stiffness in individuals without diabetes or cardiovascular disease.
abstract: BACKGROUND
  The EZSCAN test was recently developed to screen for early dysglycemia through an assessment of sudomotor function. Given the associations of dysglycemia and autonomic dysfunction with the development of arterial stiffness, EZSCAN may also detect early arterial stiffness. The aim of this study was to investigate the association of EZSCAN with arterial stiffness across blood glucose levels.
  
  
  RESULTS
  A total of 5532 participants without diabetes or established cardiovascular disease were evaluated with EZSCAN. Their central systolic blood pressure (cSBP), brachial-ankle pulse wave velocity (baPWV), and ankle-brachial index (ABI) were also measured. Multivariate linear regression analyses were used to assess the association between the EZSCAN value and the cSBP, baPWV, and ABI measurements in all of the participants, with additional subgroup analysis that separated participants into a normal glucose tolerance (NGT) group and an impaired glucose regulation (IGR) group. The frequency of the IGRs increased with quartiles of the EZSCAN value (P for trend <0.0001). The levels of cSBP and baPWV increased while the levels of ABI decreased across quartiles of EZSCAN value in both NGT and IGR individuals (P for trend <0.0001 for all). In multivariable analyses, the EZSCAN value was positively associated with cSBP (log-transformed beta = 8.20, P<0.0001) and baPWV (log-transformed beta = 1.82, P<0.0001) but inversely associated with ABI (log-transformed beta = -0.043, P<0.0001) and was independent of conventional factors. Further adjustment for fasting and postprandial glucoses did not attenuate the associations. The results were also unchanged when stratified by IGR.
  
  
  CONCLUSIONS
  The EZSCAN results were associated with arterial stiffness independent of conventional factors, blood glucose levels, and glucose tolerance status, suggesting a probable link between the EZSCAN value and arterial stiffness through autonomic dysfunction. The EZSCAN test may help us detect the development of arterial stiffness in high risk individuals to prevent unfavorable cardiovascular events.
authors.affiliation: International Medical Center, Chinese PLA General Hospital, Beijing, China.
authors.forename: Qiang
authors.initials: Q
authors.lastname: Zeng
authors.affiliation: International Medical Center, Chinese PLA General Hospital, Beijing, China.
authors.forename: Sheng-Yong
authors.initials: SY
authors.lastname: Dong
authors.affiliation: Center of Biomedical Analysis, Tsinghua University, Beijing, China.
authors.forename: Man-Liu
authors.initials: ML
authors.lastname: Wang
authors.affiliation: International Medical Center, Chinese PLA General Hospital, Beijing, China.
authors.forename: Hang
authors.initials: H
authors.lastname: Xiang
authors.affiliation: Southwest Hospital, Third Military Medical University, Chongqing, China.
authors.forename: Xiao-Lan
authors.initials: XL
authors.lastname: Zhao
mesh_terms: D055109:Ankle Brachial Index; D001341:Autonomic Nervous System / Q000503:physiopathology*; D001794:Blood Pressure; D002318:Cardiovascular Diseases / Q000175:diagnosis*; D044882:Glucose Metabolism Disorders / Q000175:diagnosis*; D006801:Humans; D016014:Linear Models; D008403:Mass Screening / Q000379:methods*; D015999:Multivariate Analysis; D011237:Predictive Value of Tests; D063177:Pulse Wave Analysis; D059289:Vascular Stiffness / Q000502:physiology*