About EZSCAN

Cardiometabolic risk, a growing concern

Cardiovascular diseases and Diabetes are two of the major health problems affecting the world. Both are closely linked. In fact, at least 65 percent of people with diabetes die from heart disease or stroke [1].

Cardiovascular diseases (CVD) are the single most important cause of death globally. An estimated 4.3 million people die from CVD each year in Europe [2]. Smoking, unhealthy diet, physical inactivity and alcohol abuse increase the risk of heart attacks and strokes [3].

More than 220 million people suffer from diabetes. People with diabetes are two to four times more likely to develop cardiovascular diseases.

Diabetes and its complications can be prevented by timely screening and early detection [4][5].

What is cardiometabolic risk?

Cardiometabolic risk aggregates various risk factors, which may lead to type 2 diabetes and cardiovascular diseases (CVD). Specific risk factors include obesity (particularly central), hyperglycemia, hypertension, insulin resistance
and dyslipoproteinemia [6].
Patients with multiple cardiometabolic risk factors run a seven times higher risk of developing diabetes and are twice as likely to die from a cardiovascular disease [7][8].
The identification and follow-up of cardiometabolic risk can assist health professionals, clinicians and individuals in determining the appropriate prevention strategies for delaying or avoiding the onset of diabetes and cardiovascular diseases.

Diabetes is often detected late when tissue damages and insulin resistance have already set in. Adapted from Type 2 Diabetes BASICS. Minneapolis, MN : International Diabetes Center; 2000.

Insulin resistance and Type 2 diabetes as major risk factors

Insulin resistance syndrome is characterized by decreased tissue sensitivity to the action of insulin, leading to a compensatory increase in insulin secretion. This metabolic dysfunction leads to a cluster of abnormalities with
serious clinical consequences including cardiovascular diseases, hypertension and stroke. When insulin resistant individuals cannot maintain the degree of hyperinsulinemia needed to overcome the resistance, type 2 diabetes develops [9].

Small fiber neuropathy and cardiometabolic risk

Several studies have proven that small fiber neuropathies are common in people with insulin resistance and prediabetes (IGT) [10][11].
Sudomotor function is known to reflect sympathetic activity and to provide insight into postganglionic autonomic innervation. Its assessment represents a useful tool to evaluate autonomic disorders [12].

Investigation of sudomotor function can help in early detection of cardiometabolic risk.

---

[1]  Know the facts, get the stats 2007. American Heart Association

[2]  European cardiovascular disease statistics. British Heart Association. 2008

[3]  World Health Organization. Fact sheet n°317, January 2011

[4]  World Health Organization. Fact sheet n°312, January 2011

[5]   Diabetes Prevention Programme Research Group. Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. N Engl J Med. 2002;346:393-403

[6]   Brunzell et al. Lipoprotein Management in Patients With Cardiometabolic Risk: Consensus. J. Am. Coll. Cardiol. 2008;51:1512-1524

[7]   Wilson et al. Metabolic syndrome as a precursor of cardiovascular disease and type 2 diabetes mellitus. Circulation. 2005;112:3066-3072

[8]   Ford et al. Metabolic syndrome and incident diabetes: current state of the evidence. Diabetes Care. 2008;31:1898-1904

[9]   American College of Endocrinology Position Statement on the Insulin resistance syndrome. Endocrine practice. 2003;9:236-251

[10]   Tavee at al. Small fiber neuropathy : a burning problem. Cleveland clinic journal of medicine. 2009;76:297-305

[11]   Putz et al. Non invasive evaluation of neural impairment in subjects with impaired glucose tolerance. Diabetes care. 2009;32:181-183

[12]   Low et al. Evaluation of sudomotor function. Clinical Neurophysiology. 2004;115:1506-1513