Autonomic and peripheral nerve function in adolescents with and without diabetes.
In this study reference ranges were established for autonomic and peripheral nerve tests in 122 non-diabetic adolescents. Regression analysis was used to evaluate the effect of age and gender on neurological function. Increasing age was associated with: less heart rate variability during deep breathing (p = 0.03), higher thermal threshold for cold at the wrist (p = 0.009), and higher vibration threshold at the toe (p = 0.001) and medial malleolus (p = 0.01). Male gender was associated with higher Valsalva ratio (p = 0.0004), higher thermal threshold for hot at the foot (p = 0.002), and higher vibration threshold at the malleolus (p = 0.03). The REFVAL programme was used to determine parametric or non-parametric reference limits: the 5% limits for autonomic and 95% limits for peripheral tests. One hundred and eighty-one adolescents with diabetes were studied under identical conditions and similar effects of age and gender were found. Twenty-eight percent of the group with diabetes had at least one abnormal autonomic test result out of four (expected 18.5%); 24% had at least one abnormal peripheral test result out of six (expected 26.5%). Glycaemic control was associated with autonomic (p = 0.04) but not peripheral abnormalities. Using multiple regression analysis and adjusting for age and gender, there was no effect of diabetes duration or glycaemic control on neurological function.
Donaghue
K C
KC
Ray Williams Institute of Paediatric Endocrinology, Royal Alexandra Hospital for Children, Sydney, Australia.
Bonney
M
M
Simpson
J M
JM
Schwingshandl
J
J
Fung
A T
AT
Howard
N J
NJ
Silink
M
M
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D001341:Autonomic Nervous System / Q000502:physiology* / Q000503:physiopathology*; D001794:Blood Pressure; D002648:Child; D003922:Diabetes Mellitus, Type 1 / Q000097:blood / Q000503:physiopathology*; D003929:Diabetic Neuropathies / Q000503:physiopathology; D005260:Female; D005528:Foot; D006442:Glycated Hemoglobin / Q000032:analysis; D006339:Heart Rate; D006801:Humans; D008297:Male; D010525:Peripheral Nerves / Q000502:physiology* / Q000503:physiopathology*; D012016:Reference Values; D012044:Regression Analysis; D012119:Respiration; D012684:Sensory Thresholds; D012737:Sex Factors; D012867:Skin / Q000294:innervation; D014636:Valsalva Maneuver; D014953:Wrist
D006442:Glycated Hemoglobin