Risk factors cardiovascular autonomi c neuropathy in type 2 diabetes mellitus

Abstract

Cardiac autonomic neuropathy (CAN) is one of the lifethreatening complications of diabetes mellitus (DM), increasing the mortality of patients with diabetes, cardiovascular morbidity and chronic kidney disease. The aim of this study was to investigate risk factors of CAN in patients with type 2 diabetes mellitus. Materials and methods. We examined 127 patients, 51 men and 76 women with type 2 DM. The diagnosis of CAN was performed by studying the heart rate variability (R-R intervals on the electrocardiogram) based on 5 cardiovascular tests for D. Ewing and the Poly-SpectrumRhythm.NET program module. The diagnosis of CAN was confirmed in patients who had 2 positive tests of 5 and a definite CAN — 3 and more positive of 5.The data analysis by SPSS statistical package version 23.0 for Windows. Results. CAN was diagnosed in 81,9% patients, definite CAN in 55,1% patients with type 2 DM. We found positive correlation between the definite CAN with glomerular filtration rate (OR=7,01, p<0,05) and body mass index (OR=1,69, p<0,05), negative correlation between the definite CAN with age (OR= -2,66, p<0,05), diabetes duration (OR= -2,59, p<0,05) and diastolic blood pressure (OR= -5,07, p<0,05). Conclusion. We found such risk factors for cardiovascular autonomic neuropathy in type 2 DM as age, duration of diabetes, BMI, GFR, DBP, therefore presence of diabetic nephropathy and arterial hypertension. These data can suggest the pathogenetic role of the impairment of autonomic nervous system and somatic nervous damage are different.