Estimation of the cut-off value in cardiovascular autonomic nervous function tests: not-age-related criteria or the age-related 5th percentile

J Diabetes Complications. 1997 May-Jun;11(3):145-50. doi: 10.1016/1056-8727(95)00126-3.

Abstract

The aim of the study was to estimate the cut-off value of cardiovascular tests using not-age-related criteria or the age-related 5th percentile in 165 diabetic patients. The cANP, pANP, and smNP were assessed using previously recommended standardized test procedures. Prevalence of overall definite (borderline) cANP was 35.2% (23.0%) when using the 5th percentile or 16.4% (27.9%) when using not age-related criteria (p for the difference < 0.0001) (p = 0.3205). Prevalence of pANP was 54.0% and of smNP 37.0%. Concerning cANP, the number of test results below the 5th percentile (N5) correlated significantly with the number of abnormal test results using not age-related criteria (Nnar) (p < 0.000001) but the slope of the regression line differed substantially from 1. Using the 5th percentile as the cut-off value for cANP testing, sensitivity and specificity were calculated for not age-related criteria for respiratory sinus arrhythmia (90.5%, 80.2%), Valsalva test (30.4%, 98.0%), lying-to-standing test (46.3%, 98.7%), orthostatic systolic blood pressure fall (69.0%, 78.3%), and overall definite cANP (44.8%, 92.8%). The statistical analysis revealed that the age-related 5th percentile is superior to the not-age-related cut-off values in diabetic patients. We therefore suggest that age-related normal values (percentiles) have to be applied when cANP is estimated.

Publication types

  • Comparative Study

MeSH terms

  • Adolescent
  • Adult
  • Age Factors
  • Aged
  • Aged, 80 and over
  • Autonomic Nervous System / physiology*
  • Blood Pressure Determination
  • Cardiovascular Physiological Phenomena*
  • Diabetes Complications*
  • Diabetes Mellitus / physiopathology
  • Diabetic Angiopathies / diagnosis*
  • Diabetic Angiopathies / epidemiology
  • Diabetic Angiopathies / physiopathology
  • Diabetic Neuropathies / diagnosis*
  • Diabetic Neuropathies / epidemiology
  • Diabetic Neuropathies / physiopathology
  • Female
  • Heart Rate / physiology
  • Humans
  • Male
  • Middle Aged
  • Neurologic Examination
  • Predictive Value of Tests
  • Prevalence
  • Pupil / physiology
  • Respiratory Function Tests
  • Sensitivity and Specificity