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[Connection between microalbuminuria and subclinical cardiovascular autonomic neuropathy in diabetic children]
L Barkai1, L Madácsy, I Vámosi
1Borsod-Abaúj-Zemplén Megyei Kórház, Gyermekegészségügyi Központ-Orvostovábbképzö Egyetem II. Gyermekgyógyászati Tanszék.
Insights
Diabetic children, especially those with microalbuminuria, exhibit increased resting heart rate and decreased heart rate variability. Microalbuminuria is linked to more frequent autonomic dysfunction in diabetic children.
Area of Science:
- Pediatrics
- Cardiology
- Endocrinology
Context:
- Type 1 diabetes mellitus is a chronic condition affecting children.
- Diabetic autonomic neuropathy is a common complication.
- Microalbuminuria is an early marker of diabetic nephropathy.
Purpose:
- To investigate cardiovascular autonomic function in diabetic children with and without microalbuminuria.
- To compare autonomic function between diabetic children and healthy controls.
Summary:
- Diabetic children showed increased resting heart rate and decreased hyperventilatory arrhythmia compared to controls.
- Microalbuminuric diabetic children had a lower standing/lying heart rate ratio, pronounced orthostatic hypotension, and diminished blood pressure response to handgrip.
- Autonomic dysfunction was more prevalent in microalbuminuric diabetic children.
Impact:
- This study highlights the increased risk of cardiovascular autonomic dysfunction in diabetic children with microalbuminuria.
- Early detection and management of autonomic dysfunction are crucial for preventing cardiovascular complications in diabetic children.
Abstract:
Cardiovascular tests were investigated in 16 microalbuminuric, in 20 normoalbuminuric diabetic children and a control group of 20 healthy children. Comparing to the control group, in both of two diabetic groups a similar increase in resting heart rate (74.5 +/- 2.5/min vs. 87.8 +/- 3.5/min, p less than 0.01, and 83.6 +/- 3.2/min, p less than 0.05) and a decrease in hyperventilatory arrhythmia (32.3 +/- 1.2/min vs. 20.1 +/- 0.8/min, p less than 0.01, and 17.2 +/- 0.8/min, p less than 0.01) was observed. In the diabetic group with microalbuminuria in comparison with both the control group and the normoalbuminuric group there was a lower standing/lying heart rate ratio (1.02 +/- 0.03 vs. 1.30 +/- 0.05, p less than 0.01, and 1.22 +/- 0.05, p less than 0.05), a pronounced orthostatic decrease in blood pressure (15.1 +/- 0.3 mmHg vs. 2.0 +/- 0.1 mmHg, p less than 0.001, and 5.0 +/- 0.2 mmHg, p less than 0.01) and a diminished increase in blood pressure during sustained handgrip (6.3 +/- 0.2 mmHg vs. 14.0 +/- 0.3 mmHg, p less than 0.01, and 12.2 +/- 0.3 mmHg, p less than 0.05). The occurrence of cases with distinct autonomic dysfunction (3 or more abnormal cardiovascular tests) proved to be more frequent in the group with microalbuminuria than in the diabetic group with normal albumin excretion (6/16 vs. 1/20, p less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)