Application Of COMPosite Autonomic Symptom Score(COMPASS31)in The Evaluation Of Autonomic Neuropathy In Type 2 Diabetes Mellitus

Objective:Composite Autonomic Symptom Score(COMPASS31)is a questionnaire used to evaluate the symptoms of autonomic neuropathies.This study explored the correlation between COMPASS31 score and cardiac autonomic neuropathy,diabetic bladder,and the application of COMPASS31 in the evaluation of type 2 diabetic autonomic neuropathy.Methods:This study collected 85 patients with type 2 diabetes who were hospitalized in the Department of Endocrinology,Liyang People’s Hospital from January 2018 to June 2019,and 52 patients in the Department of Endocrinology,Shanghai Sixth People’s Hospital.A total of 137 patients were enrolled in this study.A unified questionnaire survey was conducted with Composite Autonomic Symptom Score 31(COMPASS31).The patients’autonomic nervous function was assessed.Physical examination was performed.Blood pressure,heart rate,weight,height,waist circumference,hip circumference were recorded.Fasting blood glucose,fasting C-peptide,2-hour postprandial C-peptide,glycosylated hemoglobin,liver and kidney function,blood lipid,urinary albumin/urinary creatinine were measured.Heart rate variability(HRV)of 24-hour ambulatory electrocardiogram was measured in each patient,and the total standard deviation of RR interval of 24-hour sinus beats was recorded.Each patient underwent bladder ultrasound residual urine examination to record residual urine.All collected data were analyzed by SPSS23 statistical software.Normal distribution data were tested by independent sample T test,non-normal distribution data by non-parametric test,and counting data by chi-square test.Logistic regression analysis was used to find out the possible related factors of autonomic nervous dysfunction,and the regression analysis was carried out.Finally,the correlation between COMPASS31 and SDNN and residual urine was analyzed by Spearman.Results:1,Comparing diabetic group without cardiac autonomic neuropathy with cardiac autonomic neuropathy group,the COMPASS31 score were significantly higher in the CAN group.Logistic regression showed that the total score of COMPASS31 scale was an independent risk factor of SDNN abnormality.2,Comparing diabetic group without bladder dysfunction with neurogenic bladder group,the COMPASS31 score were significantly higher in the neurogenic bladder group.Logistic regression showed that the total score of COMPASS31 was an independent influencing factor of residual urine abnormality.Conclusion:1,The total score of COMPASS31 was correlated with SDNN and residual urine.The higher the total score of COMPASS31,the greater the possibility of SDNN abnormality and residual urine abnormality.2,COMPASS31 scale has certain value in the evaluation of diabetic autonomic neuropathy and can be used in clinical screening of autonomic neuropathy.