title: Relationship between cardiovascular autonomic neuropathy and coronary artery calcification in patients with type 2 diabetes.
abstract: To test the hypothesis that cardiovascular autonomic neuropathy (CAN) in Type 2 diabetes is a risk factor of coronary artery calcification (CAC), in this cross-sectional study, 118 patients (60 males, 58 females) with type 2 diabetes mellitus were randomly selected from the diabetes clinic of Kyungpook National University Hospital, Daegu, Korea, between January, 2008 and September, 2008. The subjects, whose mean age was 56.9+/-1.1 years, were tested for CAN by Ewing's method which employs five non-invasive tests of autonomic function. The coronary calcium score (CCS) was determined by Multi Detector-row Computed Tomography (MDCT). Statistical analysis was performed by using SPSS 13.0 (SPSS, Inc., Chicago,-Illinois). CAN was found in 31/118 (26.3%) patients. Compared to the patients without CAN, the patients with CAN were significantly older and had significantly higher triglyceride levels, blood pressure, pulse pressure, fasting c-peptide levels, CAN scores, and log-transformed coronary calcium scores [ln(CCS+1)]. The CAN scores correlated positively with ln(CCS+1) values (r = 0.214; P = 0.028). Multiple regression analysis using ln(CCS+1) as a dependent variable showed that CAN score (beta coefficient 0.623, 95% CI 0.059 approximately 1.188, P = 0.031) associated independently with ln(CCS+1). In conclusion, CAN was associated independently with CAC, which suggests that CAN is a risk factor of coronary atherosclerosis in patients with type 2 diabetes. This may help to explain the excess cardiovascular mortality seen in diabetic patients with CAN.
authors.affiliation: Department of Endocrinology and Metabolism, Kyungpook National University Hospital, Jungu, Daegu, Korea. drmoonss@hanmail.net
authors.forename: Seong-Su
authors.initials: SS
authors.lastname: Moon
authors.forename: Yeon-Kyung
authors.initials: YK
authors.lastname: Choi
authors.forename: Hyun-Ae
authors.initials: HA
authors.lastname: Seo
authors.forename: Jae-Han
authors.initials: JH
authors.lastname: Jeon
authors.forename: Jung-Eun
authors.initials: JE
authors.lastname: Lee
authors.forename: Ji-Yun
authors.initials: JY
authors.lastname: Jeong
authors.forename: Ju-Young
authors.initials: JY
authors.lastname: Lee
authors.forename: Duk-Hee
authors.initials: DH
authors.lastname: Lee
authors.forename: Wan-Ju
authors.initials: WJ
authors.lastname: Park
authors.forename: Jung-Guk
authors.initials: JG
authors.lastname: Kim
authors.forename: Bo-Wan
authors.initials: BW
authors.lastname: Kim
authors.forename: In-Kyu
authors.initials: IK
authors.lastname: Lee
mesh_terms: D002114:Calcinosis / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000209:etiology*; D009202:Cardiomyopathies / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000209:etiology*; D003331:Coronary Vessels / Q000473:pathology*; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000150:complications* / Q000000981:diagnostic imaging / Q000453:epidemiology; D003929:Diabetic Neuropathies / Q000150:complications* / Q000000981:diagnostic imaging / Q000453:epidemiology; D005260:Female; D006321:Heart / Q000000981:diagnostic imaging / Q000294:innervation*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012044:Regression Analysis; D012307:Risk Factors; D014057:Tomography, X-Ray Computed / Q000379:methods