High and low vitamin D level is associated with cardiovascular autonomic neuropathy in people with Type 1 and Type 2 diabetes

2016 ◽  
Vol 34 (3) ◽  
pp. 364-371 ◽  
Author(s):  
C. S. Hansen ◽  
J. Fleischer ◽  
D. Vistisen ◽  
M. Ridderstråle ◽  
J. S. Jensen ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Vitamin D ◽  
Autonomic Neuropathy ◽  
Cardiovascular Autonomic Neuropathy

scholarly journals Leptin mediate central obesity on the severity of cardiovascular autonomic neuropathy in well-controlled type 2 diabetes and prediabetes

2020 ◽  
Vol 18 (1) ◽  
Author(s):  
Yun-Ru Lai ◽  
Meng Hsiang Chen ◽  
Wei Che Lin ◽  
Wen-Chan Chiu ◽  
Ben-Chung Cheng ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Autonomic Neuropathy ◽  
Central Obesity ◽  
Cardiovascular Autonomic Neuropathy ◽  
Mediation Model ◽  
Cardiovascular Risks ◽  
Cardiovascular Reflex ◽  
The Relationship

Abstract Background Evidences support the view that central obesity is an independently cardiovascular risk. It is thought that leptin contributes to autonomic dysfunction and cardiovascular risks in type 1 and type 2 diabetes mellitus (T1DM and T2DM). This raises the possibility that leptin might mediate the relationship between central obesity and the severity of cardiovascular autonomic neuropathy (CAN) in patients with well-controlled T2DM and prediabetes. Methods The complete cardiovascular reflex tests and biomarkers were assessed for each patient. The severity of CAN was assessed using composite autonomic scoring scale (CASS). A single-level three-variable mediation model was used to investigate the possible relationships among central obesity [as indicated by waist circumference (WC)], leptin level, and severity of CAN (as indicated by CASS value). Results A total of 107 patients were included in this study: 90 with diabetes and 17 with prediabetes. The results demonstrate that increased WC is associated with increased severity of CAN (r = 0.242, P = 0.017). We further discovered that leptin level is positively correlated with WC (r = 0.504, P < 0.0001) and the CASS value (r = 0.36, P < 0.0001). Further mediation analysis shows that leptin level serves as mediators between higher WC and higher CASS. Conclusions Our results highlighted the relationship among leptin, central obesity, and severity of CAN. As the leptin level serves as mediator between central obesity and severity of CAN, a longitudinal study is needed to confirm that control of WC can decrease leptin levels and can be effective in reducing CAN progression.

scholarly journals Association of Cardiovascular Autonomic Neuropathy and Distal Symmetric Polyneuropathy with All-Cause Mortality: A Retrospective Cohort Study

2021 ◽  
Vol 2021 ◽  
pp. 1-9
Author(s):  
Orsolya E. Vági ◽  
Márk M. Svébis ◽  
Beatrix A. Domján ◽  
Anna E. Körei ◽  
Ildikó Istenes ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Type 1 Diabetes ◽  
Autonomic Neuropathy ◽  
Cardiovascular Autonomic Neuropathy ◽  
Secondary Diabetes ◽  
Increased Risk ◽  
All Cause Mortality ◽  
Distal Symmetric Polyneuropathy

Background. People with diabetic cardiovascular autonomic neuropathy (CAN) have increased cardiovascular mortality. However, the association between distal symmetric polyneuropathy (DSPN) or CAN with all-cause mortality is much less investigated. Thus, we set out to examine the effect of CAN and DSPN on all-cause mortality in a well-phenotyped cohort. Methods. All diabetes cases ( n = 1,347 ) from the catchment area of a secondary diabetes care centre who had medical examination including neuropathy assessment between 1997 and 2016 were followed up for all-cause mortality in the NHS Hungary reimbursement database until 2018. We investigated the association of CAN (Ewing tests) and DSPN (Neurometer) with all-cause mortality using Cox models stratified by diabetes type. Results. Altogether, n = 131 / 1,011 persons with type 1/type 2 diabetes were included. Of the participants, 53%/43% were male, mean age was 46 ± 12 / 64 ± 10 years, diabetes duration was 13 ± 10 / 7 ± 8 years, 42%/29% had CAN, and 39%/37% had DSPN. During the 9 ± 5 / 8 ± 5 -year follow-up, n = 28 / 494 participants died. In fully adjusted models, participants with type 1 diabetes patients with versus without DSPN had an increased mortality (HR 2.99, 95% CI 1.4-8.63), while no association with CAN was observed. In type 2 diabetes, both DSPN and CAN independently increased mortality (HR 1.32, 95% CI: 1.07-1.64, and HR 1.44, 95% CI: 1.17-1.76). Conclusions. Our results are compatible with an increased risk of mortality in people with type 1 diabetes and DSPN. Furthermore, we report a similarly strong association between DSPN and CAN and all-cause mortality in type 2 diabetes mellitus.

321-OR: A Genetic Locus on Chromosome 1p36 Associated with Cardiovascular Autonomic Neuropathy in Type 2 Diabetes

Diabetes ◽  
2019 ◽  
Vol 68 (Supplement 1) ◽  
pp. 321-OR
Author(s):  
YALING TANG ◽  
HETAL SHAH ◽  
XIUQIN SUN ◽  
BRUCE A. PERKINS ◽  
MICHAEL J. WAGNER ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Autonomic Neuropathy ◽  
Genetic Locus ◽  
Cardiovascular Autonomic Neuropathy ◽  
Chromosome 1P36

scholarly journals A study of cardiological autonomic neuropathy in Type 2 Diabetes Mellitus with reference to QT interval for its diagnosis

2019 ◽  
Vol 7 (7) ◽  
pp. 2574
Author(s):  
Lakshmi Priya Inapakolla ◽  
Ramgopal Teja Kotla
Keyword(s):  
Type 2 Diabetes ◽  
Autonomic Neuropathy ◽  
Autonomic Dysfunction ◽  
Cardiovascular Autonomic Neuropathy ◽  
Cardiac Autonomic Neuropathy ◽  
P Value ◽  
Qtc Interval ◽  
Duration Of Diabetes ◽  
Cardiac Autonomic Dysfunction

Background: Presence of cardiac autonomic neuropathy (CAN) is responsible for silent myocardial infarction and sudden death in diabetics. Hence recognizing cardiac dysautonomia early, which is asymptomatic will help to delay or arrest its progression.Methods: A cross-sectional study to evaluate the Prevalence of Cardiovascular Autonomic Neuropathy in Type 2 diabetes and correlate it with duration of Diabetes and to investigate the relationship between cardiac autonomic dysfunction and corrected QT interval.Results: In the study population, the prevalence of definite CAN was 8%, 24% and 58% in group A, B and C respectively. The prevalence of definite CAN increases with increase in duration of diabetes. P value <0.001 significant.Conclusions: A significant correlation is present between Cardiovascular autonomic dysfunction and QTc prolongation. QTc interval in the ECG can be used to diagnose Cardiovascular autonomic neuropathy with a reasonable sensitivity and specificity.

scholarly journals The Association Between Continuous Glucose Monitoring-derived Metrics, Including Time in Range, and Cardiovascular Autonomic Neuropathy in Outpatients With Type 2 Diabetes

2020 ◽  
Author(s):  
Min Young Kim ◽  
Gyuri Kim ◽  
Ji Yun Park ◽  
Min Sun Choi ◽  
Ji Eun Jun ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Autonomic Neuropathy ◽  
Autonomic Function ◽  
Glucose Monitoring ◽  
Glycemic Variability ◽  
Cardiovascular Autonomic Neuropathy ◽  
Inverse Association ◽  
International Consensus ◽  
Time In Range

Abstract BackgroundContinuous glucose monitoring (CGM)-derived metrics including time in range (TIR) are attracting attention as new indicators of glycemic control and diabetes complications beyond hemoglobin A1c. This study investigated the association between CGM-derived TIR, hyperglycemia, hypoglycemia metrics, and cardiovascular autonomic neuropathy (CAN) in patients with type 2 diabetes.MethodsA total of 284 patients with type 2 diabetes who underwent CGM for three days and autonomic function tests within three months based on outpatient data were recruited. The definition of CGM-derived metrics was subject to the most recent international consensus. CAN was defined as an abnormal case in two or more parasympathetic and the severity of CAN was estimated as the sum of the scores of the five cardiovascular autonomic function tests.ResultsMultiple logistic regression analysis revealed that the odds ratio of definite CAN was 0.876 [95% confidence interval (CI): 0.79–0.98] per 10% increase in the TIR of 70 to 180 mg/dL, after adjusting for age, sex, diabetes duration, any medications, and glycemic variability. A 10% increase in TIR was significantly inversely associated with the presence of advanced CAN (OR: 0.89, 95% CI: 0.81–0.98). In addition, there was a strong inverse association between a 10% increase in the TIR and the total CAN score (p for trend = 0.001). Among the metrics of hyperglycemia, a time above range (TAR) of greater than 180 mg/dL was also independently correlated with the presence of definite CAN (OR: 1.013, 95% CI: 1.00–1.02) and advanced CAN (OR: 1.01, 95% CI: 1.00–1.02).ConclusionsA TIR value of 70 to 180 mg/dL and a TAR value of greater than 180 mg/dL were significantly associated with cardiovascular autonomic neuropathy in outpatients with type 2 diabetes.

scholarly journals Intensive risk factor management and cardiovascular autonomic neuropathy in type 2 diabetes: the ACCORD Trial

2020 ◽  
Author(s):  
Yaling Tang ◽  
Hetal Shah ◽  
Carlos Roberto Bueno Junior ◽  
Xiuqin Sun ◽  
Joanna Mitri ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Type 2 Diabetes ◽  
Cardiovascular Risk ◽  
Autonomic Neuropathy ◽  
Pressure Control ◽  
Cardiovascular Autonomic Neuropathy ◽  
Risk Factor Management ◽  
Traditional Risk Factors ◽  
Intensive Blood Pressure

<b>Objectives: </b>The effects of preventive interventions on cardiovascular autonomic neuropathy (CAN) remain unclear. We examined the effect of intensively treating traditional risk factors for CAN, including hyperglycemia, hypertension, and dyslipidemia, in persons with type 2 diabetes (T2D) and high cardiovascular risk participating in the Action to Control Cardiovascular Risk in Diabetes (ACCORD) trial. <p><b>Research Design and Methods: </b>CAN was defined as heart rate variability indices below the 5<sup>th</sup> percentile of the normal distribution. Of 10,250 ACCORD participants, 71% (n=7,275) had a CAN evaluation at study entry and at least once after randomization. The effects of intensive interventions on CAN were analyzed among these subjects through generalized linear mixed models. </p> <p><b>Results: </b>As compared to standard intervention, intensive glucose treatment reduced CAN risk by 16% (OR=0.84, 95%CI 0.75–0.94, p=0.003) – an effect driven by individuals without cardiovascular disease (CVD) at baseline (OR= 0.73, 95%CI 0.63–0.85, p<0.0001) rather than those with CVD (OR=1.10, 95%CI 0.91–1.34, p=0.34) (p for interaction=0.001). Intensive blood pressure intervention decreased CAN risk by 25% (OR=0.75, 95% CI 0.63–0.89, p=0.001), especially in patients ≥65 years old (OR=0.66, 95% CI 0.49–0.88, p=0.005) (p for interaction =0.05). Fenofibrate did not have a significant effect on CAN (OR=0.91, 95%CI 0.78–1.07, p=0.26). </p> <p><b>Conclusions: </b> These data confirm a beneficial effect of intensive glycemic therapy and demonstrate, for the first time, a similar benefit of intensive blood pressure control on CAN in T2D. A negative CVD history identifies T2D patients who especially benefit from intensive glycemic control for CAN prevention. </p>

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