Autonomic dysfunction assessed by EZSCAN and subclinical atherosclerosis

J Diabetes. 2014 Sep;6(5):409-16. doi: 10.1111/1753-0407.12135. Epub 2014 Mar 27.


Background: The present study aimed to explore the association between autonomic dysfunction and measurements of atherosclerosis in a middle-aged and elderly Chinese population.

Methods: A population-based cross-sectional study was performed in Shanghai, China, from March to August 2010, with 5076 participants included in the analysis. Autonomic function was assessed by a novel EZSCAN test based on sudomotor function analysis. Carotid intima-media thickness (CIMT) was measured using B-mode ultrasonography and brachial-ankle pulse wave velocity (ba-PWV) was measured using an autonomic device. Participants were divided into three groups based on EZSCAN values: Group 1: EZSCAN 0-24; Group 2, EZSCAN 25-49; and Group 3, EZSCAN 50-100. These groups denoted autonomic dysfunction risk groups as follows: no risk, moderate risk and high risk, respectively.

Results: The prevalence of elevated CIMT and ba-PWV increased markedly with increasing EZSCAN values (elevated CIMT 7.4%, 17.5%, and 29.7%, elevated ba-PWV 3.2%, 19.7%, and 36.5%, in Groups 1, 2, and 3, respectively; both Ptrend < 0.0001). Logistic regressions revealed that EZSCAN values ≥50 were associated with a non-significantly higher risk of elevated CIMT (odds ratio [OR] = 1.43; 95% confidence interval [CI] 0.98-2.07) and a significantly higher risk of elevated ba-PWV (OR = 2.16; 95% CI 1.25-3.71) compared with EZSCAN values <25, after controlling for conventional risk factors.

Conclusion: A higher EZSCAN value (≥50), an index of high autonomic dysfunction risk, was associated with an increased risk of elevated ba-PWV and CIMT. Such associations were partially explained by traditional atherosclerotic risk factors.

Keywords: EZSCAN test; atherosclerosis; autonomic dysfunction; brachial-ankle pulse wave velocity; carotid intima-media thickness; 关键词:动脉粥样硬化,自主神经紊乱,肱踝脉搏波传导速度,颈动脉内中膜厚度,EZSCAN 检测.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Ankle Brachial Index
  • Asymptomatic Diseases
  • Atherosclerosis / diagnosis*
  • Atherosclerosis / diagnostic imaging
  • Atherosclerosis / epidemiology
  • Atherosclerosis / physiopathology
  • Autonomic Nervous System / physiopathology*
  • Autonomic Nervous System Diseases / diagnosis*
  • Autonomic Nervous System Diseases / epidemiology
  • Autonomic Nervous System Diseases / physiopathology
  • Carotid Intima-Media Thickness
  • China / epidemiology
  • Chlorides / analysis
  • Cross-Sectional Studies
  • Female
  • Humans
  • Logistic Models
  • Male
  • Middle Aged
  • Odds Ratio
  • Predictive Value of Tests
  • Prevalence
  • Pulse Wave Analysis
  • Risk Factors
  • Sweat / chemistry
  • Sweat Glands / innervation*


  • Chlorides