New screening technique analyzes voice changes to detect cystic fibrosis-related diabetes
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A novel, noninvasive tool that analyzes changes in voice characteristics was able to distinguish patients with cystic fibrosis-related diabetes from those without diabetes.
“Detection and appropriate treatment of cystic fibrosis-related diabetes is a key component of the medical care for a patient with cystic fibrosis,” Pichatorn Suppakitjanusant, MD, visiting research scholar in the division of endocrinology, metabolism and lipids at Emory University School of Medicine, said during a presentation at the North American Cystic Fibrosis Conference. “The standard test recommended by the Cystic Fibrosis Foundation for screening for cystic fibrosis-related diabetes is the oral glucose tolerance test. These tests require multiple blood draws and prolonged clinical visits; this can be hard to schedule and might lead to a delay in diagnosis.”
The researchers aimed to develop new techniques to detect changes in glucose by analyzing characteristics of the human voice, as elevated glucose levels can cause laryngeal soft tissue swelling and lead to changes in voice, Suppakitjanusant said.
The researchers’ previous research found a significant difference in voice characteristics between individuals with diabetes and those without diabetes, according to Suppakitjanusant.
The prospective, cross-sectional study included nine adults with cystic fibrosis-related diabetes (mean age, 35 years; 66% men) and seven adults with cystic fibrosis and no diabetes (mean age, 35 years; 71% men) recruited from the Emory Adult Cystic Fibrosis Clinic from March to April 2021.
Researchers recorded 3-second voice samples of a sustained “a” vowel and analyzed voice parameters using Computerized Speech Lab with the Multi-Dimensional Voice Program including fundamental frequency, jitter, shimmer, smoother amplitude perturbation quotient, noise-to-harmonic ratio, relative average perturbation and voice turbulence index, which measures the relative energy level of high frequency noise and correlates with turbulences caused by incomplete abduction of the vocal cords, according to the researchers.
Mean HbA1c level among patients with cystic fibrosis-related diabetes was 8.5%.
Results of an acoustic parameter analysis categorized by sex demonstrated that voice turbulence index in men with cystic fibrosis-related diabetes was higher compared with men with cystic fibrosis and no diabetes (0.07 vs. 0.04; P < .05). In addition, the voice turbulence index was associated with cystic fibrosis-related diabetes after controlling for age, BMI and presence of chronic sinusitis in multivariate analysis (P = .022), according to the results.
“As a result of diabetes myopathy and neuropathy, the patients with diabetes have reduced muscle strength. This can be caused by incomplete abduction of the vocal cords and is lower, especially in males. Based on this pilot study, there is potential to use these technologies as noninvasive tests for earlier detection of undiagnosed cystic fibrosis-related diabetes,” Suppakitjanusant said.
This study is currently ongoing and additional data on voice turbulence index in women with cystic fibrosis and cystic fibrosis-related diabetes will be collected, according to the researchers.