| Cardiovascular autonomic neuropathy and other complications in type 1 diabetes. | |
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MedLine Citation:
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PMID: 20354891 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE AND METHODS: This study deals with cardiovascular autonomic neuropathy (CAN) in type 1 diabetic patients and its association with other complications. We searched for CAN in 684 patients (age, 47 +/- 12 years; diabetes duration, 22 +/- 11 years) by cardiovascular responses to deep breathing and standing. Patients considered as positive had laboratory evaluation: "Ewing" tests (deep breathing, Valsalva, stand test, hand grip); heart rate variability (HRV) [low frequency (LF) and high frequency (HF) power] and spontaneous baroreflex slope (SBS). Logistic regression was used to identify the combination of patient characteristics, including other complications, most associated with CAN severity according to Ewing Score (ES 0-5). RESULTS: 66.2% presented no significant abnormality (ES 0-0.5), 21.5 % had mild abnormalities (ES 1-2), and 12.3% had confirmed autonomic failure (ES > 2). Decrease in LF, HF and SBS was highly correlated to CAN severity. In the stepwise regression, age, retinopathy, nephropathy, bladder dysfunction, erectile dysfunction, peripheral neuropathy and hypertension remained correlated with CAN, whereas digestive neuropathy, BMI and HbA1c were excluded. Despite a small number of events, we found a significant association between coronary disorders and CAN severity. CONCLUSIONS: Simple bedside tests can detect CAN. HRV and SBS provide additional elements on CAN severity. Diabetes duration did not discriminate sufficiently patients with CAN. The association with retinopathy is in favor of the role of poor glycemic control in CAN development. This study shows the interest of CAN detection and the need to look for extracardiac autonomic neuropathy and silent myocardial ischemia in patients with confirmed CAN. |
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Authors:
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Anne Pavy-Le Traon; Sébastien Fontaine; Gérard Tap; Brigitte Guidolin; Jean-Michel Senard; Hélène Hanaire |
Publication Detail:
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Type: Journal Article Date: 2010-03-31 |
Journal Detail:
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Title: Clinical autonomic research : official journal of the Clinical Autonomic Research Society Volume: 20 ISSN: 1619-1560 ISO Abbreviation: Clin. Auton. Res. Publication Date: 2010 Jun |
Date Detail:
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Created Date: 2010-05-13 Completed Date: 2010-08-03 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 9106549 Medline TA: Clin Auton Res Country: Germany |
Other Details:
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Languages: eng Pagination: 153-60 Citation Subset: IM |
Affiliation:
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CHU Toulouse, University of Toulouse, Toulouse, France. anne.pavy-letraon@chu-brest.fr |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adult Analysis of Variance Autonomic Nervous System Diseases / diagnosis, etiology, pathology* Baroreflex / physiology Blood Pressure / physiology Body Mass Index Diabetes Mellitus, Type 1 / complications*, epidemiology Diabetic Angiopathies / diagnosis, epidemiology, pathology* Diabetic Neuropathies / diagnosis, epidemiology, pathology* Electrocardiography Female Hand Strength / physiology Hemoglobin A, Glycosylated / metabolism Humans Logistic Models Male Middle Aged Models, Statistical Regression Analysis Respiratory Mechanics Valsalva Maneuver |
| Chemical | |
Reg. No./Substance:
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0/Hemoglobin A, Glycosylated |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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