Cardiovascular autonomic neuropathy, autonomic symptoms and diabetic complications in 674 type 2 diabetes.
OBJECTIVE
To determine the relationships between cardiovascular autonomic neuropathy (CAN) and autonomic symptoms, clinical parameters and diabetic complications in type 2 diabetes (T2DM).


METHODS
The results of autonomic symptoms, clinical parameters, diabetes complications and cardiovascular reflex (CVR) tests of 674 T2DM were analyzed.


RESULTS
Significant correlations were found between CAN risk and age (p=0.019), duration of diabetes (p=0.008), HbA1c (p<0.001), systolic blood pressure (p=0.006), nephropathy (p<0.001), retinopathy (p<0.001), and QTc interval (p<0.001), but not BMI and hyperlipidemia. Patients with retinopathy or proteinuria had increase risk of CAN, and proliferative diabetic retinopathy (PDR) was the most significant risk factor (odds ratio: 6.85; 95% CI: 2.32-20.20) for CAN. Eighty-three percent of patients complained of autonomic symptoms; and the more symptoms complained, the higher the prevalence of CAN. Impotence was the only single symptom associated with CAN risk. Additional CAN risks were also observed when patients with multiple symptoms and/or complications in combinations.


CONCLUSIONS
Our results implied that patients with multiple symptoms and/or complications in combinations have increased CAN risk, and this may provide additional information for clinicians to identify T2DM at risk of having CAN.
Chen
Hung-Ta
HT
Division of Endocrinology and Metabolism, Yangming Branch, Taipei City Hospital, Taipei, Taiwan.
Lin
Hong-Da
HD
Won
Justin G S
JG
Lee
Chen-Hsen
CH
Wu
Shiao-Chi
SC
Lin
Jiun-Dian
JD
Juan
Li-Ying
LY
Ho
Low-Tone
LT
Tang
Kam-Tsun
KT
D001341:Autonomic Nervous System / Q000473:pathology; D048909:Diabetes Complications; D003924:Diabetes Mellitus, Type 2 / Q000150:complications* / Q000453:epidemiology; D003929:Diabetic Neuropathies / Q000453:epidemiology / Q000209:etiology*; D003930:Diabetic Retinopathy / Q000453:epidemiology / Q000209:etiology; D005260:Female; D006801:Humans; D008297:Male; D012307:Risk Factors