Document Detail

Early progression of the autonomic dysfunction observed in pediatric type 1 diabetes mellitus.
MedLine Citation:
PMID:  19805636     Owner:  NLM     Status:  MEDLINE    
To focus on early cardiac and vascular autonomic dysfunction that might complicate type 1 diabetes mellitus in children, we planned an observational, cross-sectional study in a population of 93 young patients, under insulin treatment, subdivided in 2 age subgroups (children: 11.5+/-0.4 years; adolescents: 19.3+/-0.2 years). Time and frequency domain analysis of RR interval and systolic arterial pressure variability provided quantitative indices of the sympatho-vagal balance regulating the heart period, of the gain of cardiac baroreflex, and of the sympathetic vasomotor control. Sixty-eight children of comparable age served as a reference group. At rest, systolic arterial pressure and the power of its low-frequency component were greater in patients than in controls, particularly in children (14.0+/-2.3 versus 3.1+/-0.3 mm Hg2). Moreover, baroreflex gain was significantly reduced in both subgroups of patients. Standing induced similar changes in the autonomic profiles of controls and patients. A repeat study after 1 year showed a progression in low-frequency oscillations of arterial pressure and a shift toward low frequency in RR variability. Data in young patients with type 1 diabetes mellitus show a significant increase in arterial pressure, a reduced gain of the baroreflex regulation of the heart period, and an increase of the low-frequency component of systolic arterial pressure variability, suggestive of simultaneous impairment of vagal cardiac control and increases of sympathetic vasomotor regulation. A repeat study after 1 year shows a further increase of sympathetic cardiac and vascular modulation, suggesting early progression of the autonomic dysfunction.
Daniela Lucini; Gianvincenzo Zuccotti; Mara Malacarne; Andrea Scaramuzza; Sara Riboni; Carlo Palombo; Massimo Pagani
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't     Date:  2009-10-05
Journal Detail:
Title:  Hypertension     Volume:  54     ISSN:  1524-4563     ISO Abbreviation:  Hypertension     Publication Date:  2009 Nov 
Date Detail:
Created Date:  2009-10-22     Completed Date:  2009-11-12     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7906255     Medline TA:  Hypertension     Country:  United States    
Other Details:
Languages:  eng     Pagination:  987-94     Citation Subset:  IM    
Centro Ricerca Terapia Neurovegetativa, University of Milan, Milan, Italy.
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MeSH Terms
Age Distribution
Analysis of Variance
Autonomic Nervous System Diseases / diagnosis,  epidemiology,  etiology
Baroreflex / physiology
Blood Glucose / analysis
Cross-Sectional Studies
Diabetes Complications / diagnosis,  epidemiology
Diabetes Mellitus, Type 1 / complications*,  diagnosis*,  drug therapy
Diabetic Angiopathies / epidemiology*,  etiology,  physiopathology
Diabetic Neuropathies / epidemiology*,  etiology,  physiopathology
Disease Progression
Hemoglobin A, Glycosylated / analysis
Insulin / therapeutic use
Reference Values
Risk Assessment
Severity of Illness Index
Sex Distribution
Statistics, Nonparametric
Time Factors
Reg. No./Substance:
0/Blood Glucose; 0/Hemoglobin A, Glycosylated; 11061-68-0/Insulin

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