title: The degree of autonomic modulation is associated with the severity of microvascular complications in patients with type 1 diabetes.
abstract: OBJECTIVE
  The objective of this study was to elucidate whether the degree of autonomic modulation is associated with the degree of microvascular complications in patients with type 1 diabetes.
  
  
  METHODS
  A total of 290 type 1 individuals with diabetes were randomly recruited during normal visits to outpatient clinics at 4 Danish hospitals. The degree of autonomic modulations was quantified by measuring heart rate variability (HRV) during passive spectral analysis and active tests (valsalva ratio [VT], response to standing [RT], and deep breathing [E:I]). To describe possible associations between severity of microvascular complications and measures of autonomic modulation, multivariate analysis was performed.
  
  
  RESULTS
  After adjusting for diabetes duration, sex, age, pulse pressure, heart rate, and smoking, autonomic dysfunction remained significantly correlated with severity of retinopathy, nephropathy, and peripheral neuropathy in individuals with type 1 diabetes patients.
  
  
  CONCLUSIONS
  Autonomic dysfunction is present in early stages of retinopathy, nephropathy, and peripheral neuropathy in patients with type 1 diabetes.
authors.affiliation: Medical Research Laboratory, Department of Clinical Medicine, Aarhus University and Department of Endocrinology and Internal Medicine, Aarhus University Hospital, Aarhus, Denmark Jesper.fleischer@clin.au.dk.
authors.forename: Jesper
authors.initials: J
authors.lastname: Fleischer
authors.affiliation: Medical Research Laboratory, Department of Clinical Medicine, Aarhus University and Department of Endocrinology and Internal Medicine, Aarhus University Hospital, Aarhus, Denmark.
authors.forename: Simon Lebech
authors.initials: SL
authors.lastname: Cichosz
authors.affiliation: Department of Endocrinology, Aalborg University Hospital, Aalborg, Denmark.
authors.forename: Poul Erik
authors.initials: PE
authors.lastname: Jakobsen
authors.affiliation: Department of Endocrinology, Odense University Hospital, Odense, Denmark.
authors.forename: Knud
authors.initials: K
authors.lastname: Yderstraede
authors.affiliation: Steno Diabetes Center, Gentofte, Denmark.
authors.forename: Elisabeth
authors.initials: E
authors.lastname: Gulichsen
authors.affiliation: Department of Biomedical Engineering, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark.
authors.forename: Hans
authors.initials: H
authors.lastname: Nygaard
authors.affiliation: Department of Internal Medicine and Endocrinology, Herlev Hospital, University of Copenhagen, Copenhagen, Denmark.
authors.forename: Ebbe
authors.initials: E
authors.lastname: Eldrup
authors.affiliation: Department of Endocrinology, Aalborg University Hospital, Aalborg, Denmark.
authors.forename: Hans Henrik
authors.initials: HH
authors.lastname: Lervang
authors.affiliation: Steno Diabetes Center, Gentofte, Denmark.
authors.forename: Lise
authors.initials: L
authors.lastname: Tarnow
authors.affiliation: Medical Research Laboratory, Department of Clinical Medicine, Aarhus University and Department of Endocrinology and Internal Medicine, Aarhus University Hospital, Aarhus, Denmark.
authors.forename: Niels
authors.initials: N
authors.lastname: Ejskjaer
mesh_terms: D001341:Autonomic Nervous System / Q000503:physiopathology*; D001342:Autonomic Nervous System Diseases / Q000209:etiology / Q000503:physiopathology*; D003430:Cross-Sectional Studies; D003718:Denmark; D003922:Diabetes Mellitus, Type 1 / Q000150:complications / Q000503:physiopathology*; D003925:Diabetic Angiopathies / Q000503:physiopathology*; D003928:Diabetic Nephropathies / Q000503:physiopathology; D003929:Diabetic Neuropathies / Q000503:physiopathology; D003930:Diabetic Retinopathy / Q000503:physiopathology; D005260:Female; D006339:Heart Rate; D006801:Humans; D008297:Male; D008833:Microcirculation; D008875:Middle Aged; D012119:Respiration; D014636:Valsalva Maneuver
keywords: heart rate variability (HRV); microvascular complications; type 1 diabetes