Sympathetic sudomotor disturbance in early type 1 diabetes mellitus is linked to lipid peroxidation

Risk Factors and Comorbidities in Diabetic Neuropathy: An Update 2015

“…Low vitamin E/lipid ratio tended to predict a decrease in peroneal motor NCV and an increase in malleolar VPT. Hoeldtke et al showed that malondialdehyde (MDA) excretion in urine, a marker of lipid peroxidation, and plasma nitrite and nitrate, markers of nitrosative stress, were associated with sweating abnormalities, while sensory function tests correlated inconsistently with MDA excretion [75][76][77]. Further studies are required to determine whether optimized patient selection strategies showing increased levels of oxidative stress biomarkers such as superoxide generation could be of value in identifying those patients who may respond better to antioxidant treatment.…”

Oxidative stress and autonomic nerve function in early type 1 diabetes

“…Because of their young age and short duration of diabetes they were in excellent health, except for hyperglycemia, and minimally affected by the above-mentioned cardiovascular risk factors that have been linked to oxidative stress in patients with long-standing disease. Our patient population, therefore, provided a unique opportunity to focus on the relationship between hyperglycemia, oxidative stress and autonomic nerve function [17]. All subjects gave informed consent allowing us to proceed with this study.…”

“…We performed a comprehensive assessment of peripheral nerve function [15] but focused on the autonomic nervous system. We assessed parasympathetic innervation of the heart by measuring high frequency (0.15-0.4 Hz) power spectral analysis of heart rate variability [15,17]. We also measured beat to beat variation with deep breathing, an alternative index of parasympathetic cardiovascular control [18].…”

“…We also measured beat to beat variation with deep breathing, an alternative index of parasympathetic cardiovascular control [18]. We assessed sympathetic function by measuring the heart rate response to the Valsalva maneuver (tachycardia/bradycardia ratio), renin biosynthesis (the renin/prorenin ratio), and sudomotor function (the Quantitative Sudomotor Axon Reflex, QSART) [17]. We measured renin and prorenin and calculated the renin/prorenin ratio which reflects the integrity of the sympathetic innervation of the kidneys [18]; the QSART assesses the integrity of the sympathetic nerve terminals which innervate sweat glands [17].…”

“…We assessed sympathetic function by measuring the heart rate response to the Valsalva maneuver (tachycardia/bradycardia ratio), renin biosynthesis (the renin/prorenin ratio), and sudomotor function (the Quantitative Sudomotor Axon Reflex, QSART) [17]. We measured renin and prorenin and calculated the renin/prorenin ratio which reflects the integrity of the sympathetic innervation of the kidneys [18]; the QSART assesses the integrity of the sympathetic nerve terminals which innervate sweat glands [17]. We assessed cardiac sympathetic function by measuring intermediate frequency (0.04-0.15 Hz) power spectral analysis of heart rate variability.…”