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Vascular dysfunction and autonomic neuropathy in Type 2 diabetes.
Diabet Med. 2004 Jul; 21(7):746-51.DM

Abstract

AIMS

To test the hypothesis that arterial dysfunction in Type 2 diabetes is related to autonomic neuropathy.

METHODS

Arterial function and autonomic neuropathy were assessed over two consecutive days in 45 Type 2 diabetic and control subjects. Systemic arterial compliance (SAC), arterial stiffness (pulse-wave velocity, PWV) and carotid intima thickness (IMT) were assessed; these markers reflect early vascular disease and predict clinical vascular events. Autonomic neuropathy was assessed using heart rate variability with continuous ECG recording during various breathing and postural manoeuvres and an overall autonomic score was generated. Fasting metabolic parameters including glucose, insulin, HbA(1c) and lipid profile were measured.

RESULTS

Autonomic neuropathy tests were all repeatable in diabetic subjects. Compared with controls, diabetic subjects had arterial dysfunction with increased PWV (P = 0.009), IMT (P < 0.001) and reduced SAC (P = 0.053). After adjustment for age, central PWV correlated with fasting insulin (r(2) = 0.45, P < 0.05) and autonomic score (r(2) = 0.44, P < 0.05), peripheral PWV correlated with autonomic score (r(2) = 0.51, P < 0.005) and IMT correlated with fasting insulin (r(2) = 0.5, P < 0.005). The presence of autonomic neuropathy correlated with fasting insulin (P = 0.015), but not age, duration diabetes, lipids or blood pressure.

CONCLUSION

Using repeatable measures of autonomic neuropathy and vascular function in Type 2 diabetic subjects, we have demonstrated associations between autonomic neuropathy, vascular dysfunction and hyperinsulinaemia. This may help to explain the excess cardiovascular mortality seen in diabetic subjects with autonomic neuropathy.

Authors+Show Affiliations

Monash University Department of Medicine, Dandenong Hospital, David Street, Dandenong,Victoria 3175, Australia.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

15209768

Citation

Meyer, C, et al. "Vascular Dysfunction and Autonomic Neuropathy in Type 2 Diabetes." Diabetic Medicine : a Journal of the British Diabetic Association, vol. 21, no. 7, 2004, pp. 746-51.
Meyer C, Milat F, McGrath BP, et al. Vascular dysfunction and autonomic neuropathy in Type 2 diabetes. Diabet Med. 2004;21(7):746-51.
Meyer, C., Milat, F., McGrath, B. P., Cameron, J., Kotsopoulos, D., & Teede, H. J. (2004). Vascular dysfunction and autonomic neuropathy in Type 2 diabetes. Diabetic Medicine : a Journal of the British Diabetic Association, 21(7), 746-51.
Meyer C, et al. Vascular Dysfunction and Autonomic Neuropathy in Type 2 Diabetes. Diabet Med. 2004;21(7):746-51. PubMed PMID: 15209768.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Vascular dysfunction and autonomic neuropathy in Type 2 diabetes. AU - Meyer,C, AU - Milat,F, AU - McGrath,B P, AU - Cameron,J, AU - Kotsopoulos,D, AU - Teede,H J, PY - 2004/6/24/pubmed PY - 2004/9/29/medline PY - 2004/6/24/entrez SP - 746 EP - 51 JF - Diabetic medicine : a journal of the British Diabetic Association JO - Diabet Med VL - 21 IS - 7 N2 - AIMS: To test the hypothesis that arterial dysfunction in Type 2 diabetes is related to autonomic neuropathy. METHODS: Arterial function and autonomic neuropathy were assessed over two consecutive days in 45 Type 2 diabetic and control subjects. Systemic arterial compliance (SAC), arterial stiffness (pulse-wave velocity, PWV) and carotid intima thickness (IMT) were assessed; these markers reflect early vascular disease and predict clinical vascular events. Autonomic neuropathy was assessed using heart rate variability with continuous ECG recording during various breathing and postural manoeuvres and an overall autonomic score was generated. Fasting metabolic parameters including glucose, insulin, HbA(1c) and lipid profile were measured. RESULTS: Autonomic neuropathy tests were all repeatable in diabetic subjects. Compared with controls, diabetic subjects had arterial dysfunction with increased PWV (P = 0.009), IMT (P < 0.001) and reduced SAC (P = 0.053). After adjustment for age, central PWV correlated with fasting insulin (r(2) = 0.45, P < 0.05) and autonomic score (r(2) = 0.44, P < 0.05), peripheral PWV correlated with autonomic score (r(2) = 0.51, P < 0.005) and IMT correlated with fasting insulin (r(2) = 0.5, P < 0.005). The presence of autonomic neuropathy correlated with fasting insulin (P = 0.015), but not age, duration diabetes, lipids or blood pressure. CONCLUSION: Using repeatable measures of autonomic neuropathy and vascular function in Type 2 diabetic subjects, we have demonstrated associations between autonomic neuropathy, vascular dysfunction and hyperinsulinaemia. This may help to explain the excess cardiovascular mortality seen in diabetic subjects with autonomic neuropathy. SN - 0742-3071 UR - https://www.unboundmedicine.com/medline/citation/15209768/Vascular_dysfunction_and_autonomic_neuropathy_in_Type_2_diabetes_ L2 - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&amp;PAGE=linkout&amp;SEARCH=15209768.ui DB - PRIME DP - Unbound Medicine ER -