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Aims To clarify if cardiovascular autonomic neuropathy is associated with carotid artery atherosclerotic plaques in Type 2 diabetic patients. Methods Cardiovascular autonomic nerve function was related to carotid artery ultrasound in 61 Type 2 diabetic patients 5–6 years after diagnosis of diabetes. Results Cardiovascular autonomic neuropathy [abnormal age corrected expiration/inspiration (E/I) ratio or acceleration index (AI)] was found in 13/61 (21%) patients. Patients with cardiovascular autonomic neuropathy showed increased degree of stenosis in the common carotid artery (24.6 ± 13.2% vs. 14.7 ± 9.2%; P = 0.014) and a tendency towards a higher plaque score (4.0 ± 1.7 vs. 3.2 ± 1.6; P = 0.064). Controlled for age, AI correlated inversely with degree of stenosis (r = −0.39; P = 0.005), plaque score (r = −0.39; P = 0.005), and mean (r = −0.33; P = 0.018) and maximum (r = −0.39; P = 0.004) intima‐media thickness in the common carotid artery. In contrast, E/I ratio correlated only slightly with mean intima‐media thickness in the common carotid artery (r = −0.28; P = 0.049). Conclusions Cardiovascular autonomic neuropathy was associated with carotid atherosclerosis in Type 2 diabetic patients. Abnormal E/I ratios reflect efferent structural damage to parasympathetic nerves whereas abnormal AI reflects afferent autonomic dysfunction possibly due to impaired baroreceptor sensitivity secondary to carotid atherosclerosis. Diabet. Med. 20, 495–499 (2003)

Objective: To prospectively follow the concentrations of plasma adiponectin (p-adiponectin) and serum advanced glycation end-products (s-AGE) in relation to plasma lipids and retinopathy over 3 years in type 2 diabetic patients. Design and methods: P-adiponectin, s-AGE, plasma lipids and diabetic retinopathy were prospectively evaluated in 61 type 2 diabetic patients at baseline and at follow up 3 years later. Results: Mean p-adiponectin (from 8.84^5.14 to 11.05^6.16 mg/ml; P ¼ 0.006) and s-AGE (from 637^242 to 781^173 ng/ml; P , 0.0001) concentrations had increased at follow up. In addition, HbA1c (7.7^1.7 to 7.4^1.4%; P ¼ 0.0045) and fasting C-peptide (1.00^0.38 to 0.81^0.35 nM; P ¼ 0.019) had decreased and all lipid variables had significantly improved at follow up. P-adiponectin correlated inversely with fasting C-peptide (r s ¼ 20.273; P ¼ 0.045) and low-density lipoprotein (LDL)/high-density lipoprotein (HDL) ratio (r s ¼ 20.362; P ¼ 0.011), and directly with plasma HDL cholesterol (r s ¼ 0.381; P ¼ 0.005) at follow up. Analysis of variance with adiponectin and s-AGE as dependent variables and fasting C-peptide, plasma HDL and plasma LDL cholesterol as covariates demonstrated that the increase in s-AGE was independent (P ¼ 0.001) and the increase in p-adiponectin dependent on covariate changes (P ¼ 0.862). There was a slight correlation between s-AGE at baseline versus the degree of retinopathy at follow up (r s ¼ 0.281; P ¼ 0.0499).

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