title: Association between Brachial-Ankle pulse wave velocity and cardiac autonomic neuropathy in type 2 diabetes.
abstract: BACKGROUND
  Cardiac autonomic neuropathy (CAN) is a common complication of type 2 diabetes mellitus (T2DM). Brachial-ankle pulse wave velocity (baPWV) is known to be a good surrogate marker of vascular damages. The goal of this study was to investigate the relationship between BaPWV and CAN in T2DM.
  
  
  METHODS
  A total of 148 patients who had no apparent history of cardiovascular condition were enrolled consecutively in this study. The correlation between increased baPWV and CAN was analyzed. CAN was evaluated by five standard cardiovascular reflex tests (CARTs) according to the Ewing's protocol: 1) heart rate variation during deep breathing, 2) heart rate response to standing, 3) Valsalva maneuver, 4) postural systolic blood pressure (BP) change, 5) Sustained handgrip test. CAN was defined as the presence of at least two abnormal tests.
  
  
  RESULTS
  The mean age of patients was 59.8 ± 7.8 years. The mean duration of diabetes was 6.0(2.0-11.0) years. The mean baPWV was 1665.5(1482.0-1940.0) cm/sec. Subjects with CAN were older and had high BMI, baPWV compared with those without CAN. The proportion of patients with diabetic peripheral neuropathy was higher in subjects with CAN. After adjusting for other confounding risk factors, baPWV (odds ratio = 8.496, 95% CI: 1.216-59.348; P = 0.031) remained as independent risk factors for CAN. The number of abnormal CARTs increased gradually with increasing baPWV (correlation coefficient =0.255, p = 0.002).
  
  
  CONCLUSIONS
  Increased baPWV was significantly correlated with CAN in patients with type 2 diabetes.
authors.affiliation: The Institute of Endocrinology and Diabetology, Huashan Hospital, Shanghai Medical College, Fudan University, 12 Middle Wulumuqi Road, Shanghai, China.
authors.forename: Nan
authors.initials: N
authors.lastname: Wu
authors.affiliation: The Emergency Department, Zhongshan Hospital, Shanghai Medical College, Fudan University, 180 Fenglin Road, Shanghai, China.
authors.forename: Xiaoling
authors.initials: X
authors.lastname: Cai
authors.affiliation: The Institute of Endocrinology and Diabetology, Huashan Hospital, Shanghai Medical College, Fudan University, 12 Middle Wulumuqi Road, Shanghai, China.
authors.forename: Kuanping
authors.initials: K
authors.lastname: Ye
authors.affiliation: The Institute of Endocrinology and Diabetology, Huashan Hospital, Shanghai Medical College, Fudan University, 12 Middle Wulumuqi Road, Shanghai, China.
authors.forename: Yintao
authors.initials: Y
authors.lastname: Li
authors.affiliation: The Institute of Endocrinology and Diabetology, Huashan Hospital, Shanghai Medical College, Fudan University, 12 Middle Wulumuqi Road, Shanghai, China.
authors.forename: Min
authors.initials: M
authors.lastname: He
authors.affiliation: The Institute of Endocrinology and Diabetology, Huashan Hospital, Shanghai Medical College, Fudan University, 12 Middle Wulumuqi Road, Shanghai, China.
authors.forename: Weiwei
authors.initials: W
authors.lastname: Zhao
authors.affiliation: The Institute of Endocrinology and Diabetology, Huashan Hospital, Shanghai Medical College, Fudan University, 12 Middle Wulumuqi Road, Shanghai, China.
authors.forename: Renming
authors.initials: R
authors.lastname: Hu
keywords: Brachial-ankle pulse wave velocity; Cardiac autonomic neuropathy; Type 2 diabetes