Deterioration of cardiac autonomic function over a period of one year in relation to cardiovascular and somatic neuropathy complications in type 2 diabetes mellitus

Abstract Aims Progression of cardiac autonomic dysfunction (CADF) in relation to severity of diabetic autonomic neuropathy is well documented. But its progression while coexisting with somatic neuropathy (PNP) and cardiovascular disease (CVD) is less described. We monitored CADF over a period of one...

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Bibliographic Details
Published in:Diabetes research and clinical practice 2012-08, Vol.97 (2), p.313-321
Main Authors: Subbalakshmi, N.K, Adhikari, P.M.R, Sathyanarayana Rao, K.N, Jeganathan, P.S
Format: Article
Language:English
Subjects:
Analysis of Variance
Autonomic Nervous System Diseases - epidemiology
Autonomic Nervous System Diseases - etiology
Autonomic Nervous System Diseases - physiopathology
Cardiovascular disease
Cross-Sectional Studies
Deterioration of cardiac autonomic function
Diabetes Mellitus, Type 2 - complications
Diabetes Mellitus, Type 2 - epidemiology
Diabetes Mellitus, Type 2 - physiopathology
Diabetic Neuropathies - epidemiology
Diabetic Neuropathies - physiopathology
Disease Progression
E:I ratio
Electrocardiography
Endocrinology & Metabolism
Female
Heart Rate
Humans
India - epidemiology
Male
Middle Aged
Respiratory Function Tests
SDNN
Somatic neuropathy
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Summary:Abstract Aims Progression of cardiac autonomic dysfunction (CADF) in relation to severity of diabetic autonomic neuropathy is well documented. But its progression while coexisting with somatic neuropathy (PNP) and cardiovascular disease (CVD) is less described. We monitored CADF over a period of one year in relation to PNP and CVD in patients with type 2 diabetes mellitus. Methods Cardiac autonomic function was assessed in 104 type 2 diabetics. Based on complications study subjects were divided into four subgroups: Group A (No complications); Group B (with CVD); Group C (with PNP); Group D (with CVD and PNP). The parameters measured were: Expiratory:Inspiratory ratio (E:I ratio) and standard deviation of all the N–N intervals (SDNN). These parameters were measured at the baseline and at follow-up. Data analysis was done by employing suitable statistical tests. Results In Group B: SDNN declined ( p < 0.001); E:I ratio did not change. In Group C: E:I ratio declined ( p < 0.01); SDNN did not change. In Group D: SDNN and E:I ratio declined significantly ( p < 0.001). Conclusion CADF coexisting with PNP and CVD deteriorates with time. E:I ratio and SDNN are suitable markers in monitoring CADF coexisting with PNP and CVD respectively in type 2 diabetes mellitus.
ISSN:0168-8227
1872-8227
DOI:10.1016/j.diabres.2012.05.001