title: Prevalence and clinical features of atrial fibrillation in diabetic neuropathy: a cross-sectional, observational study.
abstract: OBJECTIVE
  This cross-sectional, observational study investigated prevalence and clinical features of atrial fibrillation (AF) in diabetic patient groups with or without autonomic neuropathy.
  
  
  METHODS
  One hundred and fourteen consecutive patients with pharmacologically treated type-II diabetes mellitus were enrolled for this study in our institution between January 2010 and December 2010. All patients underwent 12-lead electrocardiography on the day of enrollment for AF detection. All diabetic patients underwent neurologic examination for the presence of diabetic autonomic neuropathy (DAN). Following clinical evaluation, sympathetic skin responses (SSR) and RR interval variability (RRIV) analysis were used for the detection of autonomic neurologic involvement. Patients were divided into two groups according to presence (Group 1) or absence (Group 2) of DAN. Patient groups with or without DAN were compared for AF occurrence. Continuous and categorical data were compared with independent samples t- test and Chi-square statistical tests respectively.
  
  
  RESULTS
  Atrial fibrillation prevalence was 24% (n=29) in study population. Diabetic autonomic neuropathy was diagnosed in 47 (39%) patients. Basal characteristics of patients with or without DAN were comparable except glycosylated hemoglobin A (HbA1c) levels. HbA1c levels were found significantly higher in patients with DAN. Atrial fibrillation was diagnosed in 14 patients in Group 1 and in 15 patients in Group 2. Significantly increased AF prevalence (31.9% vs. 20.8%, p=0.014, in groups with and without DAN respectively) was observed in patient group with diabetic autonomic neuropathy.
  
  
  CONCLUSIONS
  The results of this study demonstrated an increased prevalence of AF in patients with diabetic autonomic neuropathy compared with non-neuropathic, diabetic patients. Further investigation of this relation with prospective studies is needed to demonstrate a causal relationship between diabetic autonomic neuropathy and AF.
authors.affiliation: Clinic of Cardiology, Atatürk Education and Research Hospital, İzmir-Turkey.
authors.forename: İdil Gökçen
authors.initials: İG
authors.lastname: Koçağra Yağız
authors.forename: Serdar
authors.initials: S
authors.lastname: Bayata
authors.forename: Murat
authors.initials: M
authors.lastname: Yeşil
authors.forename: Tülay
authors.initials: T
authors.lastname: Kurt İncesu
authors.forename: Erdinç
authors.initials: E
authors.lastname: Arıkan
authors.forename: Nursen
authors.initials: N
authors.lastname: Postacı
mesh_terms: D001281:Atrial Fibrillation / Q000097:blood / Q000453:epidemiology* / Q000503:physiopathology; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2; D003929:Diabetic Neuropathies; D004562:Electrocardiography; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D015995:Prevalence; D014421:Turkey / Q000453:epidemiology
chemical_list: D006442:Glycated Hemoglobin; C517652:hemoglobin A1c protein, human