Risk factors of diabetic cardiac autonomic neuropathy in patients with type 1 diabetes mellitus: a meta-analysis

Dafaalla, Mohamed; Nimir, Mohammed; Mohammed, Mosab I; Ali, Omer; Hussein, A.

doi:10.1136/openhrt-2015-000336

Cited by 24 publications

(18 citation statements)

References 21 publications

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“…The pathophysiological mechanism of CAN development is multifactorial, and several studies have reported the important role of cardiovascular risk factors [10,[48][49][50]. However, in our study, degree of glycemic control and diabetes duration were the most common risk factors for both T1D and T2D.…”

Section: Risk Factors Associated With the Severity Of Cancontrasting

confidence: 55%

Associations between adipocytokines and severity of cardiovascular autonomic neuropathy in well-controlled type 2 diabetes and prediabetes

Lai¹,

Chiu²,

Cheng³

et al. 2020

Preprint

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Background It is thought that adipocytokines contribute to autonomic dysfunction and cardiovascular risks in type 1 and type 2 diabetes mellitus (T1DM and T2DM, respectively). We aimed to identify adipocytokines that are associated with the severity of cardiovascular autonomic neuropathy (CAN) in patients with well-controlled T2DM and prediabetes. Methods The complete cardiovascular autonomic function and biomarkers were assessed for each patient. The severity of CAN was assessed using both the composite autonomic scoring scale (CASS) and the cardiac autonomic reflex tests (CARTs) score. Biomarkers included adipocytokines (leptin, chemerin, adiponectin, and vaspin), oxidative stress (thiols and thiobarbituric acid-reactive substance [TBARS]), endothelial dysfunction (sICAM-1 and sVCAM-1), and insulin resistance (triglyceride/high-density lipoprotein cholesterol [HDL-C] ratio and homeostasis model assessment of insulin resistance [HOMA-IR] index). Results A total of 107 patients were included in this study: 90 with diabetes and 17 with prediabetes. Stepwise logistic regression showed that diabetes duration and leptin level were independently associated with the presence of CAN. Leptin level was positively correlated with body mass index (r = 0.588, P < 0.0001), waist circumference (r = 0.504, P < 0.0001), urinary albumin-to-creatinine ratio (r = 0.351, P = 0.001), hs-CRP (r = 0.291, P = 0.006), TBARS (r = 0.259, P = 0.008), triglyceride/HDL-C ratio (r = 0.346, P < 0.0001), and HOMA-IR index (r = 0.304, P = 0.008) but negatively correlated with thiols (r=-0.25, P = 0.011) level. The leptin level was strongly associated with the CASS (r = 0.36, P < 0.0001) and CARTs (r = 0.356, P < 0.0001) scores. Stepwise linear regression analysis also showed that the leptin level was significantly associated with the CASS and CARTs scores, respectively. Conclusions As the leptin level is considered a prognostic factor in CAN, a longitudinal study is needed to confirm the association between a decrease in obesity and reduced leptin levels and CAN progression.

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Section: Risk Factors Associated With the Severity Of Cancontrasting

confidence: 55%

Associations between adipocytokines and severity of cardiovascular autonomic neuropathy in well-controlled type 2 diabetes and prediabetes

Lai¹,

Chiu²,

Cheng³

et al. 2020

Preprint

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“…It has been postulated that CAN and peripheral neuropathy have a common pathogenesis [1]. E-mail: a.farmer@qmul.ac.uk microalbuminuria, hypertension and BMI [4]. E-mail: a.farmer@qmul.ac.uk microalbuminuria, hypertension and BMI [4].…”

Section: Introductionmentioning

confidence: 99%

“…Risk factors for CAN include age, duration of diabetes, serum triglyceride levels, proliferative retinopathy, Correspondence to: Adam Farmer. E-mail: a.farmer@qmul.ac.uk microalbuminuria, hypertension and BMI [4]. Contemporaneously, in addition to clinical assessment, the most frequently used method for screening for CAN is time and/ or frequency domain analysis of 24-h heart rate variability (HRV) [5]; however, its recording and processing is timeconsuming and its interpretation necessitates considerable expertise [6].…”

Section: Introductionmentioning

confidence: 99%

Cardiac vagal tone, a non‐invasive measure of parasympathetic tone, is a clinically relevant tool in Type 1 diabetes mellitus

Brock

Jessen²,

Brock³

et al. 2017

Diabet. Med.

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“…In DM 1, risk factors of CAN include higher levels of HbA1c, hypertension, distal symmetrical polyneuropathy, retinopathy and hyperglycemic exposure [17]. Our study revealed that coexistence of diabetic retinopathy and CAN was in 1.2 times more often in cases of DM I, 31.2% patients with DM 2 were suffering from diabetic retinopathy without signs of CAN.…”

Section: Results and Their Discussionmentioning

confidence: 49%

Diagnosis of the Cardiac Autonomic Neuropathy in Diabetic Patient

Shuper

Rykova

et al. 2019

PEP

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Cardiac autonomic neuropathy (CAN) is a very common diabetes-related complication that has a major effect on CVD, mortality and morbidity in patients with DM. Careful and timely testing of CAN with easy standard bedside tests in patients with DM 1 and 2 is critically important for early diagnoses and prophylaxes of further CV complications. Aim of the study was to evaluate the CAN characteristics in DM 1 versus DM 2 patients and to identify the relationship between CAN and typical diabetic complications. Materials and methods. A descriptive and comparative cross-sectional study was developed with 75 patients with Diabetes Mellitus (DM 1 — 30 patients, DM 2 — 45 patients) who were hospitalized to the endocrinology department for treatment. All patients were investigated routinely – complains, anamnestic data, objective examination, lab and instrumental examination. For defining of CAN next five classical tests were done (cardiac autonomic reflex testing (CART)): Evaluating of the Resting tachycardia; Heart rate response to deep breathing; Valsalva maneuver; Systolic blood pressure response to standing; Diastolic blood pressure response to sustained handgrip. Results and discussions. Absence of CAN, according to proposed score, was defined in those patients without clinical features of CVD. 46.8% of all patients presented with early and definitive CAN, while the higher prevalence of definitive CAN was diagnosed in DM 2 patients. Severe CAN was confirmed more often in DM 2 patients also. Coexistence of CAN and peripheral neuropathy was higher in patients with DM 1 than in DM 2 patients. Among DM 1 patients with CAN only 11.8% persons had not sensory peripheral neuropathy, while 29.7% DM 2 patients with CAN, were free of sensory peripheral neuropathy. Positive correlations were found between the duration of the DM and manifestations of CAN in patients with DM II, the development of sensory polyneuropathy, retinopathy and CAN in patients with DM I, and this diabetic complication preceded the clinical manifestations of peripheral neuropathy. Thus, the proposed set of diagnostic measures should be obviously and easily used for the timely diagnosis of CAN in diabetic patients, especially in asymptomatic cases, and objectively assessing the effectiveness of the therapy.

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Risk factors of diabetic cardiac autonomic neuropathy in patients with type 1 diabetes mellitus: a meta-analysis

Cited by 24 publications

References 21 publications

Associations between adipocytokines and severity of cardiovascular autonomic neuropathy in well-controlled type 2 diabetes and prediabetes

Associations between adipocytokines and severity of cardiovascular autonomic neuropathy in well-controlled type 2 diabetes and prediabetes

Cardiac vagal tone, a non‐invasive measure of parasympathetic tone, is a clinically relevant tool in Type 1 diabetes mellitus

Diagnosis of the Cardiac Autonomic Neuropathy in Diabetic Patient

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