Autonomic nerve antibodies and autonomic nerve function in type 1 and type 2 diabetic patients.
Complement-fixing adrenal medulla (CF-ADM), sympathetic ganglion (CF-SG), and vagal (CF-V) nerve antibodies were determined in diabetic patients. Among 74 patients with Type 1 diabetes, CF-ADM was detected in 7 (10%) cases, CF-SG in 14 (19%) cases, and CF-V in 8 (11%) cases. Among 38 patients with Type 2 diabetes, CF-ADM was detected in 5 (13%) cases, CF-SG in 4 (11%) cases, and CF-V in 6 (16%) cases. There were associations between autonomic nerve antibodies and autonomic nerve function. CF-ADM and/or CF-SG were significantly (P less than 0.002) less prevalent in Type 1 diabetic patients with autonomic neuropathy than in those without [5/44 (11%) vs. 14/30 (47%)] and, in agreement with this, the brake index, a sign of parasympathetic and sympathetic autonomic nerve function, was significantly (P less than 0.005) higher (more normal) in these patients (-0.56 +/- 0.13 vs. -1.04 +/- 0.12). In Type 2 diabetic patients, the E/I ratio, an index of parasympathetic nerve function, was significantly (P less than 0.03) lower (more abnormal) in those with CF-V than in those without (-1.81 +/- 0.17 vs. -1.20 +/- 0.11). In conclusion, the frequency of sympathetic nerve antibodies was decreased in Type 1 diabetic patients with autonomic neuropathy, while in Type 2 diabetic patients parasympathetic nerve antibodies were related to severe parasympathetic neuropathy.
Sundkvist
G
G
Department of Medicine, University of Lund, Malmö General Hospital, Sweden.
Lind
P
P
Bergström
B
B
Lilja
B
B
Rabinowe
S L
SL
D000313:Adrenal Medulla / Q000276:immunology; D000328:Adult; D000368:Aged; D001323:Autoantibodies / Q000097:blood*; D001327:Autoimmune Diseases / Q000276:immunology*; D001341:Autonomic Nervous System / Q000276:immunology* / Q000503:physiopathology; D003168:Complement Fixation Tests; D003430:Cross-Sectional Studies; D003922:Diabetes Mellitus, Type 1 / Q000276:immunology* / Q000503:physiopathology; D003924:Diabetes Mellitus, Type 2 / Q000276:immunology* / Q000503:physiopathology; D003929:Diabetic Neuropathies / Q000276:immunology*; D005260:Female; D005728:Ganglia, Sympathetic / Q000276:immunology; D006801:Humans; D008297:Male; D008875:Middle Aged; D014630:Vagus Nerve / Q000276:immunology
D001323:Autoantibodies