Cardio-Ankle Vascular Index and Indices of Diabetic Polyneuropathy in Patients with Type 2 Diabetes

Abstract

The cardio-ankle vascular index (CAVI) is used to test vascular function and is an arterial stiffness marker and potential predictor of cardiovascular events. This study aimed to analyze the relation between objective indices of diabetic polyneuropathy (DPN) and the CAVI. One hundred sixty-six patients with type 2 diabetes mellitus were included in this study. We used nerve conduction studies (NCSs) and the coefficient of variation of the R-R interval to evaluate DPN. We estimated arteriosclerosis by the CAVI. Simple and multiple linear regression analyses were performed between neuropathy indices and the CAVI. In univariate analysis, the CAVI showed significant associations with sural sensory nerve conduction velocity and median F-wave conduction velocity. Multiple linear regression analysis for the CAVI showed that sural nerve conduction velocity and median F-wave conduction velocity were significant explanatory variables second only to age. In multiple linear regression analysis for sural nerve conduction velocity among neuropathy indices, the CAVI remained the most significant explanatory variable. In multiple linear regression analysis for median nerve F-wave conduction velocity among neuropathy indices, the CAVI remained the second most significant explanatory variable following HbA1c. These results suggest a close relationship between macroangiopathy and DPN.

Relationship between Systemic Vascular Characteristics and Retinal Nerve Fiber Layer Loss in Patients with Type 2 Diabetes

“…Several studies have evaluated the stiffness of vessel in diabetic patients and found that systemic vascular incompetence commonly occurs, wielding an influence on diabetic complications 8 , 9 . Shim et al .…”

Cutaneous Manifestations of Diabetes Mellitus and Prediabetes

“…These changes lead to a deregulated cardiovascular autonomic function with loss of vessel wall elasticity, insufficiency of the peripheral circulation and impairment of the neuronal function. 14,15 Currently, many studies have correlated diabetic polyneuropathy (DPN) with diabetic macroangiopathy, emphasizing the importance of vascular dysfunction, driven by metabolic change, as a cause of diabetic neuropathy. 14,16,17 There is a clear relation between macrovascular and microvascular impairment in type 2 diabetes.…”

“…14,15 Currently, many studies have correlated diabetic polyneuropathy (DPN) with diabetic macroangiopathy, emphasizing the importance of vascular dysfunction, driven by metabolic change, as a cause of diabetic neuropathy. 14,16,17 There is a clear relation between macrovascular and microvascular impairment in type 2 diabetes. Macrovascular damage together with microvascular change causes ischaemia and hypoxia in neural tissues because of disordered endothelial function, arterial stiffness, and stenosis.…”

“…Macrovascular damage together with microvascular change causes ischaemia and hypoxia in neural tissues because of disordered endothelial function, arterial stiffness, and stenosis. 14,15,18 Chronic ulcers and diabetic foot Chronic ulcers, including pressure ulcers and diabetic foot infections, are a major complication in diabetic patients, particularly in dependent elderly with altered consciousness. 10,19 According to the diabetic foot study of the National Health Insurance Claims in Taiwan, more than 94% of DM patients with diabetic foot had associated foot infections in hospital care, and the rates of lower extremity amputation remained persistently high.…”

Association of decreased variation of coefficient R–R interval with ischemic colitis and small bowel obstruction

“…CVRR is a variable that is derived from electrocardiography, which commonly used to evaluate the parasympathetic nerve system. CVRR is non-invasive and widely available and is thus used for the follow-up of the autonomic function of patients with diabetes and Parkinson's disease [5][6][7][8][9]. Kudoh et al reported that a decrease in CVRR is caused by the anticholinergic effects of chronic neuroleptics and that this parameter is useful for the evaluation of postoperative paralytic ileus in patients with chronic schizophrenic [10].…”