Document Detail


Diabetic retinopathy is associated with early autonomic dysfunction assessed by exercise-related heart rate changes.
MedLine Citation:
PMID:  19148374     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Diabetic retinopathy has been associated with cardiac autonomic dysfunction in both type 1 and type 2 diabetes mellitus (DM) patients. Heart rate (HR) changes during exercise testing indicate early alterations in autonomous tonus. The aim of the present study was to investigate the association of diabetic retinopathy with exercise-related HR changes. A cross-sectional study was performed on 72 type 2 and 40 type 1 DM patients. Autonomic dysfunction was assessed by exercise-related HR changes (Bruce protocol). The maximum HR increase, defined as the difference between the peak exercise rate and the resting rate at baseline, and HR recovery, defined as the reduction in HR from the peak exercise to the HR at 1, 2, and 4 min after the cessation of the exercise, were determined. In type 2 DM patients, lower maximum HR increase (OR = 1.62, 95%CI = 1.03-2.54; P = 0.036), lower HR recovery at 2 (OR = 2.04, 95%CI = 1.16-3.57; P = 0.012) and 4 min (OR = 2.67, 95%CI = 1.37-5.20; P = 0.004) were associated with diabetic retinopathy, adjusted for confounding factors. In type 1 DM, the absence of an increase in HR at intervals of 10 bpm each during exercise added 100% to the odds for diabetic retinopathy (OR = 2.01, 95%CI = 1.1-3.69; P = 0.02) when adjusted for DM duration, A1c test and diastolic blood pressure. In conclusion, early autonomic dysfunction was associated with diabetic retinopathy. The recognition of HR changes during exercise can be used to identify a high-risk group for diabetic retinopathy.
Authors:
C K Kramer; C B Leitão; M J Azevedo; F B Valiatti; T C Rodrigues; L H Canani; J L Gross
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Brazilian journal of medical and biological research = Revista brasileira de pesquisas médicas e biológicas / Sociedade Brasileira de Biofísica ... [et al.]     Volume:  41     ISSN:  1414-431X     ISO Abbreviation:  Braz. J. Med. Biol. Res.     Publication Date:  2008 Dec 
Date Detail:
Created Date:  2009-01-16     Completed Date:  2009-10-08     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8112917     Medline TA:  Braz J Med Biol Res     Country:  Brazil    
Other Details:
Languages:  eng     Pagination:  1110-5     Citation Subset:  IM    
Affiliation:
Serviço de Endocrinologia, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brasil. ckkramer@terra.com.br
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MeSH Terms
Descriptor/Qualifier:
Adult
Autonomic Nervous System / physiopathology*
Blood Pressure / physiology
Cohort Studies
Cross-Sectional Studies
Diabetes Mellitus, Type 1 / physiopathology*
Diabetes Mellitus, Type 2 / physiopathology*
Diabetic Retinopathy / etiology,  physiopathology*
Exercise Test
Female
Heart Rate / physiology*
Humans
Male
Middle Aged
Odds Ratio

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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