title: Carotid intima-media thickness in type 2 diabetes mellitus patients with cardiac autonomic neuropathy.
abstract: BACKGROUND
  Cardiac autonomic neuropathy (CAN) is an important complication of type 2 diabetes mellitus (T2DM). Accelerated atherosclerosis is also common in T2DM. Carotid intima media thickness (CIMT) is a surrogate marker of atherosclerosis. We conducted a study to assess the CIMT in T2DM patients with CAN.
  
  
  METHODS
  In 84 T2DM patients cardiac autonomic function was assessed by five clinical tests including: 1) heart rate variation during deep breathing, 2) hear rate response to standing, 3) Valsalva ratio, 4) postural fall in systolic blood pressure (BP) three minutes after standing, and 5) resting heart rate. CAN was defined as two or more positive tests out of five for cardiac autonomic function. CIMT was measured by two dimensional (2D) ultrasound. We also examined for presence of any atherosclerotic plaque over intima of carotid artery as well as within the carotid bulb.
  
  
  RESULTS
  Thirty six (42.85 percent) out of 84 patients were detected to have CAN. CAN was significantly associated with duration of disease after its detection (P = 0.0253), high LDL cholesterol (P = 0.0418), low HDL cholesterol (P = 0.0001), fasting blood sugar (FBS) level (P = 0.0012) and CIMT (P = 0.0001) equal to or more than 69 mm.
  
  
  CONCLUSIONS
  Increased CIMT equal to or more than 69 mm is associated with high occurrence of CAN in diabetic population. Duration of diabetes, abnormal lipid tests and FBS level significantly influence the development of CAN.
authors.affiliation: Dept. of Medicine, Medical College, 88 College Street, Kolkata-700073.
authors.forename: Pradip Kumar
authors.initials: PK
authors.lastname: Sinha
authors.forename: Gouranga
authors.initials: G
authors.lastname: Santr
authors.forename: Dibyendu
authors.initials: D
authors.lastname: De
authors.forename: Avishek
authors.initials: A
authors.lastname: Sah
authors.forename: Kaushik
authors.initials: K
authors.lastname: Biswas
authors.forename: Prithwiraj
authors.initials: P
authors.lastname: Bhattachary
authors.forename: Pramit
authors.initials: P
authors.lastname: Ghosh
mesh_terms: D000328:Adult; D000368:Aged; D001342:Autonomic Nervous System Diseases / Q000150:complications* / Q000000981:diagnostic imaging; D001794:Blood Pressure / Q000502:physiology; D059168:Carotid Intima-Media Thickness; D008078:Cholesterol, LDL; D003924:Diabetes Mellitus, Type 2 / Q000150:complications* / Q000000981:diagnostic imaging; D003929:Diabetic Neuropathies / Q000503:physiopathology*; D005260:Female; D006334:Heart Function Tests; D006339:Heart Rate / Q000502:physiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D015995:Prevalence; D012307:Risk Factors; D012680:Sensitivity and Specificity
chemical_list: D008078:Cholesterol, LDL