[Autonomic neuropathy in a diabetic population. Validity of cardiovascular tests and correlations with the complications].
The disfunction of the autonomic system nervous is a frequent finding in diabetes mellitus. Among objective tests proposed for its diagnosis, those assessing cardiovascular reflexes (cardiovascular tests: CVTs) explore the autonomic functionality by means of a group of standardized manoeuvres of relatively easy execution that study the baroreceptorial reflex arc. In our study, CVTs were performed in a population of 207 diabetic patients with no symptoms of autonomic neuropathy. A computerized automatic system (Cardionomic) was utilized. CTVs included: Deep Breathing, Lying to Standing, Valsalva Manoeuvre, Orthostatic Hypotension, Standing to Lying and Cough Test. Diabetic patients were broken down in groups according to: a) age, b) HbA1c levels, c) disease duration. We have then compared the presence of diabetic complications between the group of diabetics positive for cardiovascular disautonomia (CVD+) with another group of diabetics who were negative for cardiovascular disautonomia (DCV-). Our results show a remarkable correlation between autonomic neuropathy and patients age, HbA1c levels and disease duration. Also they show a strong positive correlation between CDV+ and the severity of arteriopathy. We conclude that autonomic neuropathy may play an important role in the pathogenesis of diabetic arteriopathy.
Latini
A
A
Unità Operativa di Medicina Interna, Ospedale Regina Apostolorum, Albano Laziale.
Martin
L S
LS
Limiti
G
G
Magarelli
M
M
Polidori
L
L
Tramutoli
R
R
Papini
E
E
Rinaldi
R
R
Guglielmi
R
R
Petrucci
L
L
Panunzi
C
C
Pagano
A
A
D000328:Adult; D001161:Arteriosclerosis / Q000175:diagnosis / Q000209:etiology; D001342:Autonomic Nervous System Diseases / Q000175:diagnosis* / Q000209:etiology; D003925:Diabetic Angiopathies / Q000175:diagnosis / Q000209:etiology; D003929:Diabetic Neuropathies / Q000175:diagnosis* / Q000209:etiology; D003936:Diagnosis, Computer-Assisted / Q000379:methods; D003935:Diagnostic Techniques, Cardiovascular; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D012680:Sensitivity and Specificity