Association of cardiac autonomic neuropathy with arterial stiffness in type 2 diabetes mellitus patients

Abstract

BackgroundDiabetic patients are at the risk of cardiac autonomic neuropathy (CAN) and arterial stiffness. This study aimed to investigate the association of heart rate variability (HRV) as an index for CAN and pulse wave velocity (PWV) as an index for arterial stiffness.MethodsUncomplicated diabetes type-2 patients who had no apparent history of cardiovascular condition underwent HRV and PWV measurements and the results were compared with the control group consisting of non-diabetic peers. Also, the findings were adjusted for the cardiovascular risk factors and other confounding factors.ResultsA total of 64 diabetic patients (age= 52.08±8.50 years; males=33 [51.6%]) were compared with 57 controls (age= 48.74±6.18 years; males=25 [43.9%]) in this study. Hypertension, dyslipidemia, and thereby systolic blood pressure and statin use were significantly more frequent in the diabetic group, while the serum levels of cholesterol, HDL-C and LDL-C were significantly higher in the controls. Pulse wave was significantly increased in the diabetic patients (p<0.001). Main HRV parameters were significantly lower in diabetics than in controls. After adjustment for the confounders, PWV and HRV remained significantly different between the groups (p=0.01 and p=0.004, respectively). Multiple logistic regression of the association between pulse wave velocity and HRV index was independently significant both in diabetics and controls.ConclusionsThere exists a significant relationship between heart rate variability and arterial stiffness as a measure for atherosclerosis in diabetic patients, although the role of the confounding factors is noteworthy.

Data-analytically derived flexible HbA1c thresholds for type 2 diabetes mellitus diagnostic

“…[43,70] All four quantities can be directly assayed. [71] Unlike all above-mentioned, one study [72] compares diabetic (T2DM) participants to non-diabetic counterparts, so it implements exactly the same sampling approach as in the current research. The use of statins was accounted for, although it was not a trial, and the authors report the following: "Rate of hypertension, dyslipidaemia, and thereby systolic blood pressure and statin use were significantly higher in the diabetic group, while the serum levels of cholesterol, HDL-C and LDL-C were significantly higher in the control group."…”

Clinical Significance of Arterial Stiffness and Thickness Biomarkers in Type 2 Diabetes Mellitus: An Up-To-Date Meta-Analysis

“…In the current study, a total of 14 case-control eligible studies with 1222 T2DM patients and 1094 health control subjects were included in our meta-analysis [ 3 , 4 , 11 , 16 – 26 ]. The main characteristics of these studies were shown in Table 1 .…”

“…Carotid IMT, an important biomarker for arterial thickness, presents a strong relationship with cardiovascular disease risk factors and can also be used to predict cardiovascular events [ 9 , 10 ]. PWV and AIX are widely used biomarkers for arterial stiffness and increased arterial stiffness is associated with the incidence of coronary atherosclerosis and worse cardiovascular prognosis [ 11 ]. Additionally, accumulating researches have displayed that the BP control was beneficial for patients with DM and lower BP could reduce cardiovascular morbidity and mortality [ 12 , 13 ].…”

“…Although some studies have been conducted to detect the associations between the main biomarkers of arterial stiffness and thickness in T2DM [ 3 , 4 , 11 , 16 – 26 ], the results are often inconsistent and incomprehensive. Herein, we performed a meta-analysis to investigate whether patients with T2DM were associated with LDL-C, HDL-C, SBP, DBP and the main biomarkers related to arterial stiffness and thickness, including carotid IMT, PWV and AIX.…”

Cardiac Involvement in Peripheral Neuropathies

“…10 HRV is considered as a good measure of CAN in patients with DM, and its decrease can be associated with increased risk of mortality and morbidity. 20 Diabetic patients without CAN have higher cardiac sympathetic modulation and preserved HRV. 21 Diabetic patients with PN may have lower HRV indices than patients without PN and are at higher risk for CAN.…”