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[Autonomic neuropathy in patients with type 2 diabetes and microalbuminuria]
P Boucek1, A Jirkovská, T Pelikánová
1Centrum diabetologie, Institut klinické a experimentální medicíny, Praha.
Background:
Microalbuminuria (MAU) represents in patients with type 2 diabetes a risk factor for total and cardiovascular mortality and morbidity, whose principal pathogenic mechanism is the development of atherosclerosis. Other factors may also participate, e.g., cardiovascular vegetative neuropathy, which is supposed to be an independent risk factor. The aim of the study was the analysis of the cardiovascular autonomic regulations in patients with type 2 diabetes and microalbuminuria.
Methods And Results:
16 patients with type 2 diabetes and microalbuminuria and 23 healthy controls were included in the study. Heart rate variability was tested (during short-term recording at rest, deep breathing, orthostasis and Valsalva manoeuvre) and spectral analysis of telemetric records of heart rate in three positions (lying--standing--lying) was employed. In the group of patients with type 2 diabetes and MAU, in comparison with patients without MAU and controls, significant differences in heart rate variability during deep breathing were found. In comparison to controls, differences were found also during the Valsalve manoeuvre. In parameters of reaction of the heart rate to orthostasis, both groups of diabetic patients differed from controls. When comparing patients with MAU and controls significant differences were also found in spectral analysis of the heart rate variability, namely in total spectral power and the power of the low frequency band in both recumbent positions. In the same parameters, significant differences were found also between patients with and without MAU. The later were not different from the controls.
Conclusions:
The presented results indicate the existence of a significant impairment of the autonomic nervous system in patients with type 2 diabetes and microalbuminuria. This fact may contribute to the higher cardiovascular risk in this group of diabetic patients.
Insights
Patients with type 2 diabetes and microalbuminuria show impaired autonomic nervous system function. This autonomic dysfunction may increase cardiovascular risk in this diabetic population.
Area of Science:
- Cardiology
- Endocrinology
- Neurology
Context:
- Microalbuminuria (MAU) is a significant risk factor for cardiovascular mortality in type 2 diabetes.
- Cardiovascular autonomic neuropathy is a potential independent risk factor.
- Understanding autonomic regulation is crucial for managing cardiovascular risk in diabetic patients.
Purpose:
- To analyze cardiovascular autonomic regulations in type 2 diabetes patients with microalbuminuria.
- To compare autonomic function between diabetic patients with and without microalbuminuria and healthy controls.
Summary:
- 16 type 2 diabetes patients with MAU and 23 controls underwent heart rate variability testing, including deep breathing, orthostasis, and Valsalva maneuver.
- Significant differences in heart rate variability were observed in diabetic patients with MAU during deep breathing and Valsalva maneuvers compared to controls.
- Spectral analysis revealed distinct differences in heart rate variability between patients with MAU and controls, and between patients with and without MAU.
Impact:
- Results indicate significant autonomic nervous system impairment in type 2 diabetes patients with microalbuminuria.
- This impairment may contribute to the elevated cardiovascular risk observed in this patient group.
- Findings highlight the importance of assessing autonomic function in diabetic patients with MAU.