No abstract

Aim: To clarify whether autoantibodies against glutamic acid decarboxylase (GAD-ab) are associated with cardiac autonomic neuropathy (CAN). Methods: 319 consecutive patients with type 1 diabetes (DM1) were included. We assessed CAN by responses of heart rate variability to deep breathing (E/I index), Valsalva maneuver, standing (30:15 ratio), low-frequency activity (LFa), and high-frequency activity (HFa). We assayed GAD-ab by immunoprecipitation radioligand. Results: Mean age was of 40 ± 14 years, with 20 ± 12 years as mean duration of diabetes. Mean A1c was 7.2 ± 1.0%. We confirmed CAN in 66 patients resulting in a 21% (95% CI 17-25) prevalence of asymptomatic CAN. GAD-ab were present in 199 individuals (62%), with no significant differences as a function of the presence of CAN or not [44 (70%) vs. 144 (66%), respectively; P = 0.544]. GAD-ab titles were similar between both groups (431 ± 695 U/mL in CAN subjects vs. 390 ± 662 U/mL in subjects without CAN, P = 0.688). Considering all patients as a whole, GAD-ab titles only correlated with duration of DM1 (r = -0.346, P < 0.001). HFa correlated with age (r = -0.523, P < 0.001), duration of DM1 (r = -0.374, P < 0.001), and A1c (r = -0.261, P < 0.001), but not with GAD-ab. Similarly, LFa correlated with age (r = -0.473, P < 0.001), duration of DM1 (r = -0.223, P < 0.001), and A1c (r = -0.294, P < 0.001). Age, sex, A1c, duration of DM1, GAD-ab, and systolic blood pressure were introduced as independent variables into a binary regression analysis. The stepwise model (R2: 0.106, P < 0.001) retained only age (β: -0.933, 95% CI: 0.933-0.976) as the significant predictor of the presence of CAN. Conclusion: GAD-ab unlikely have a role as a CAN marker in patients with DM1. Disclosure L. Nattero-chávez: None. E. Lecumberri: None. H. F. Escobar-morreale: Consultant; Self; InsudPharma. M. Luque-ramírez: None. J. Quiñones silva: None. L. Montanez: None. E. Fernández durán: None. B. Dorado avendaño: None. C. Sánchez rodríguez: None. M. Lorenzo: None. M. Fernández argüeso: None. N. Bengoa rojano: None. Funding Menarini International Foundation

Aim: Describe the relationships between cardiovascular autonomic neuropathy (CAN) and glucose variability (GV) in patients with DM1 on continuous subcutaneous insulin infusion therapy (CSII). Methods Observational retrospective study (n=89). CAN was assessed by heart rate variability (HRV) in response to deep breathing, standing, Valsalva’s maneuver, and the amplitude of the low (LFa) and high (HFa) frequency of HRV. The standard deviation (SD), the coefficient of variation (CV) and time in range (TIR) were calculated from the capillary blood measurements downloaded of CSII (the mean of glucose capillary assessments was 5.8/day). Results The mean age was 38±13 and their average duration of DM1 was 22±10 years. The prevalence of CAN was 36% (95%CI: 27-46). The population characteristics according to the presence of CAN are summarized in Table 1. The age and the duration of diabetes correlated negatively with LFa (r= -0.496, P < 0.001) and HFa (r= -0.510, P < 0.001). Separate multivariate binary logistic models were constructed for clinical and GV parameters introducing CAN as dependent variable. Only the age (expB 1.1; CI 1.04-1.15. P < 0.001) was associated with CAN in the fully adjusted model. Conclusions Age and duration of diabetes, but not GV parameters, appear to be associated with CAN in our cohort of patients with DM1 on CSII. Disclosure L. Nattero-Chávez: None. J. Quiñones Silva: None. N. Bengoa: None. M. Fernández Argüeso: None. L. Montanez: None. E. Fernández Durán: None. B. Dorado: None. B. Arias Zamorano: None. E. Lecumberri: None. M. Luque Ramírez: None. Funding Menarini Group

Introduction: The MS might also be present in patients with DM1 worsening vascular prognosis. Objective: We aimed to determine the prevalence of MS and its association with microvascular disease and to describe the differences between patients with or without MS in markers of subclinical inflammation and adiposity. Methods: A cross-sectional study including 289 consecutive patients with DM1. MS was defined according to the criteria of the IDF but for the presence of fasting hyperglycemia or diabetes. Microvascular complications were assessed according to ADA. Serum inflammation markers such as high hsCRP, ESR, homocystein and fibrinogen were measured. Results: The mean age was 36 ± 12 years-old. 40% were female. Duration of DM1 was 20 ± 11 years. The mean HbA1c was 7.6±1.3% and the GFR was 94±18 ml/min/1.73m2. The prevalence of MS, as defined, was 12.5% (95% CI: 9.1 - 16.8). The odds of having microvascular complications was 2.4 higher among MS+ group [OR: 2.4 (1.0-5.7); P = 0.042] compared with MS- group, after adjusting for age and DM1 duration. Adiposity and markers of subclinical inflammation were significantly higher in MS+ group compared to their MS- counterparts (Table 1). Conclusions: The prevalence of MS was considerable in patients with DM1. MS was an independent risk factor for the presence of microvascular complications regardless of age and DM1 duration. The presence of MS in patients with DM1 is associated with adiposity and subclinical inflammation. Disclosure E. Lecumberri: None. M. Luque-Ramírez: None. J. Quiñones Silva: None. E. Fernández: None. S. Alonso Diaz: None. H. Escobar-Morreale: None. L. Nattero-Chávez: None. Funding Instituto de Salud Carlos III, Spanish Ministry of Economy and Competitiveness (PI1400649, PI151686, PIE1600050)