{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,5,14]],"date-time":"2025-05-14T01:25:22Z","timestamp":1747185922519,"version":"3.40.5"},"reference-count":27,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2022,5,10]],"date-time":"2022-05-10T00:00:00Z","timestamp":1652140800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100004837","name":"Ministerio de Ciencia e Innovaci\u00f3n","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100004837","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004587","name":"Instituto de Salud Carlos III","doi-asserted-by":"publisher","award":["PIE1600050","PI1801122"],"award-info":[{"award-number":["PIE1600050","PI1801122"]}],"id":[{"id":"10.13039\/501100004587","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Diabetes Invest"],"published-print":{"date-parts":[[2022,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Aims<\/jats:title><jats:p>Assessment for cardiovascular autonomic neuropathy (CAN) in patients with type 1 diabetes mellitus remains time\u2010consuming in the clinical setting. We aimed to examine the diagnostic performance of a portable point\u2010of\u2010care diagnostic tool (POCD) for assessing sural nerve conduction during the screening of CAN.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Nerve amplitude (AMP<jats:sub>POCD<\/jats:sub>) and conduction velocity (CV<jats:sub>POCD<\/jats:sub>) were measured in a cross\u2010sectional study including 198 asymptomatic patients with type 1 diabetes. CAN was diagnosed by the Ewing score and power spectral heart rate [low\u2010frequency (LF) and high\u2010frequency (HF) activity]. Diagnostic accuracy was determined by ROC curves.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>CV<jats:sub>POCD<\/jats:sub> and AMP<jats:sub>POCD<\/jats:sub> showed positive correlations with LF and HF, and a negative correlation with age. Overall, AMP<jats:sub>POCD<\/jats:sub> had an 81.7% accuracy in identifying CAN [AUC\u2009=\u20090.817 (95% CI 0.692\u20130.942)] with an AMP<jats:sub>POCD<\/jats:sub>\u2009\u22646\u2009\u03bcV showing 90% sensitivity and 73% specificity. In a stepwise binary logistic regression analysis, the model (<jats:italic>R<\/jats:italic><jats:sup>2<\/jats:sup>: 0.297; <jats:italic>P<\/jats:italic> &lt;\u20090.001) retained the duration of type 1 diabetes [\u03b2: 1.131 (95% CI: 1.051\u20131.216); <jats:italic>P<\/jats:italic>\u2009=\u20090.001) and A<jats:sub>1c<\/jats:sub> [\u03b2: 2.131 (95% CI: 1.060\u20134.283); <jats:italic>P<\/jats:italic>\u2009=\u20090.034) as significant predictors of CAN. The combination of AMP<jats:sub>POCD<\/jats:sub>\u2009\u22646\u2009\u03bcV\u2009+\u2009a type 1 diabetes duration of \u22658\u2009years maximized the sensitivity, showing a diagnostic performance of 87% [AUC\u2009=\u20090.867 (95% CI 0.769\u20130.965)] with 90%, 76%, and 99%,\u2009sensitivity, specificity, and NPV, respectively. Adding A<jats:sub>1c<\/jats:sub>\u2009\u2265\u20097% to this model maintained accuracy [AUC\u2009=\u20090.867 (95% CI: 0.788\u20130.963) and NPV (99%), while increasing specificity to 84%.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The combination of AMP<jats:sub>POCD<\/jats:sub> with A<jats:sub>1c<\/jats:sub> and the duration of type 1 diabetes mellitus showed a good performance for the detection of asymptomatic CAN, making POCD an easy and rapid test for its routine screening in the clinical setting.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jdi.13803","type":"journal-article","created":{"date-parts":[[2022,4,7]],"date-time":"2022-04-07T14:56:31Z","timestamp":1649343391000},"page":"1347-1356","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Point\u2010of\u2010care sural nerve conduction could predict the presence of cardiovascular autonomic neuropathy in type 1 diabetes mellitus"],"prefix":"10.1111","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9758-9397","authenticated-orcid":false,"given":"L\u00eda","family":"Nattero\u2010Ch\u00e1vez","sequence":"first","affiliation":[{"name":"Department of Endocrinology and Nutrition Hospital Universitario Ram\u00f3n y Cajal  Madrid Spain"},{"name":"University of Alcal\u00e1  Madrid Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6002-4237","authenticated-orcid":false,"given":"Manuel","family":"Luque\u2010Ram\u00edrez","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Nutrition Hospital Universitario Ram\u00f3n y Cajal  Madrid Spain"},{"name":"University of Alcal\u00e1  Madrid Spain"},{"name":"Diabetes, Obesity, and Human Reproduction Research Group Instituto Ram\u00f3n y Cajal de Investigaci\u00f3n Sanitaria (IRYCIS) &amp; Universidad de Alcal\u00e1, Centro de Investigaci\u00f3n Biom\u00e9dica en Red de Diabetes y Enfermedades Metab\u00f3licas Asociadas (CIBERDEM) del Instituto de Salud Carlos III  Madrid Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jhonatan","family":"Qui\u00f1ones\u2010Silva","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Nutrition Hospital Universitario Ram\u00f3n y Cajal  Madrid Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Laura","family":"Mont\u00e1nez","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Nutrition Hospital Universitario Ram\u00f3n y Cajal  Madrid Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elena","family":"Fern\u00e1ndez\u2010Dur\u00e1n","sequence":"additional","affiliation":[{"name":"Diabetes, Obesity, and Human Reproduction Research Group Instituto Ram\u00f3n y Cajal de Investigaci\u00f3n Sanitaria (IRYCIS) &amp; Universidad de Alcal\u00e1, Centro de Investigaci\u00f3n Biom\u00e9dica en Red de Diabetes y Enfermedades Metab\u00f3licas Asociadas (CIBERDEM) del Instituto de Salud Carlos III  Madrid Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Beatriz","family":"Dorado\u2010Avenda\u00f1o","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Nutrition Hospital Universitario Ram\u00f3n y Cajal  Madrid Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"H\u00e9ctor F.","family":"Escobar\u2010Morreale","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Nutrition Hospital Universitario Ram\u00f3n y Cajal  Madrid Spain"},{"name":"University of Alcal\u00e1  Madrid Spain"},{"name":"Diabetes, Obesity, and Human Reproduction Research Group Instituto Ram\u00f3n y Cajal de Investigaci\u00f3n Sanitaria (IRYCIS) &amp; Universidad de Alcal\u00e1, Centro de Investigaci\u00f3n Biom\u00e9dica en Red de Diabetes y Enfermedades Metab\u00f3licas Asociadas (CIBERDEM) del Instituto de Salud Carlos III  Madrid Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2022,5,10]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1007\/s001250050739"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1056-8727(01)00164-7"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.dsx.2014.05.002"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.4239\/wjd.v9.i1.1"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.4239\/wjd.v12.i6.855"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2018-02729"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.2337\/diacare.8.5.491"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1007\/s13300-020-00795-0"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.artmed.2013.04.007"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1210\/er.2018-00107"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/jdi.13007"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0196647"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc21-S002"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.numecd.2010.07.005"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1002\/dmrr.1239"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1002\/dmrr.3088"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc21-S011"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc16-2042"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.1002\/dmrr.2830"},{"key":"e_1_2_8_21_1","doi-asserted-by":"publisher","DOI":"10.1111\/psyp.12027"},{"key":"e_1_2_8_22_1","doi-asserted-by":"publisher","DOI":"10.1080\/17434440.2017.1305266"},{"key":"e_1_2_8_23_1","doi-asserted-by":"publisher","DOI":"10.5114\/aoms.2016.59265"},{"key":"e_1_2_8_24_1","doi-asserted-by":"publisher","DOI":"10.1373\/clinchem.2004.031823"},{"key":"e_1_2_8_25_1","doi-asserted-by":"publisher","DOI":"10.1111\/jns.12366"},{"key":"e_1_2_8_26_1","doi-asserted-by":"publisher","DOI":"10.1089\/dia.2013.0129"},{"key":"e_1_2_8_27_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.diabet.2012.09.004"},{"key":"e_1_2_8_28_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0138224"}],"container-title":["Journal of Diabetes Investigation"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jdi.13803","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/jdi.13803","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jdi.13803","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,23]],"date-time":"2023-08-23T21:49:02Z","timestamp":1692827342000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/jdi.13803"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,5,10]]},"references-count":27,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2022,8]]}},"alternative-id":["10.1111\/jdi.13803"],"URL":"https:\/\/doi.org\/10.1111\/jdi.13803","archive":["Portico"],"relation":{},"ISSN":["2040-1116","2040-1124"],"issn-type":[{"type":"print","value":"2040-1116"},{"type":"electronic","value":"2040-1124"}],"subject":[],"published":{"date-parts":[[2022,5,10]]},"assertion":[{"value":"2022-02-23","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-04-05","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-05-10","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}