title: Cardiovascular autonomic neuropathy, autonomic symptoms and diabetic complications in 674 type 2 diabetes.
abstract: 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.
authors.affiliation: Division of Endocrinology and Metabolism, Yangming Branch, Taipei City Hospital, Taipei, Taiwan.
authors.forename: Hung-Ta
authors.initials: HT
authors.lastname: Chen
authors.forename: Hong-Da
authors.initials: HD
authors.lastname: Lin
authors.forename: Justin G S
authors.initials: JG
authors.lastname: Won
authors.forename: Chen-Hsen
authors.initials: CH
authors.lastname: Lee
authors.forename: Shiao-Chi
authors.initials: SC
authors.lastname: Wu
authors.forename: Jiun-Dian
authors.initials: JD
authors.lastname: Lin
authors.forename: Li-Ying
authors.initials: LY
authors.lastname: Juan
authors.forename: Low-Tone
authors.initials: LT
authors.lastname: Ho
authors.forename: Kam-Tsun
authors.initials: KT
authors.lastname: Tang
mesh_terms: 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