Premium
Relationship between autonomic cardiac activity, b‐cell function, anthropometrics and metabolic indices in type II diabetics
Author(s) -
Manzella Daniela,
Carbonella Marco,
Ragno Emilia,
Passariello Nicola,
Grella Rodolfo,
Paolisso Giuseppe
Publication year - 2002
Publication title -
clinical endocrinology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.055
H-Index - 147
eISSN - 1365-2265
pISSN - 0300-0664
DOI - 10.1046/j.1365-2265.2002.01596.x
Subject(s) - medicine , endocrinology , metabolic control analysis , c peptide , natriuretic peptide , heart rate variability , insulin , glucose clamp technique , diabetes mellitus , type 2 diabetes , atrial natriuretic peptide , insulin resistance , pancreatic hormone , heart rate , heart failure , blood pressure
Summary objective Recent studies have demonstrated that C‐peptide exerts beneficial effects on the diabetic state, including improvements in kidney and nerve function. Thus, we investigated the effect of residual pancreatic C‐peptide secretion on the cardiac autonomic nervous system in well‐ and poorly controlled type II diabetic patients. design Randomised cross‐sectional study. patients Forty type II diabetic patients free from diabetic neuropathy, with similar anthropometric parameters, volunteered for our study. measurements Insulin action, residual pancreatic C‐peptide secretion and the cardiac autonomic nervous system were investigated by euglycaemic hyperinsulinaemic clamp, glucagon bolus test and heart rate variability, respectively. M ‐values were used as an index of insulin sensitivity. High frequency (HF) and low frequency (LF) oscillations in heart rate were analysed. results The patients were categorized into those with good (HbA 1c ≤ 7·0) and poor (HbA 1c ≥ 8·0) metabolic control. The patients with good metabolic control had fasting plasma glucose and C‐peptide levels, plasma area under the curve ( auc ) insulin and C‐peptide levels, M ‐values, LF values and LF/HF ratio significantly lower than patients with poor metabolic control. In contrast, RR interval, total power and HF values had an opposite trend. Basal plasma C‐peptide correlated with LF/HF in patients with good ( r = −0·42; P < 0·05) and poor metabolic control ( r = −0·45; P < 0·05). An even stronger correlation between auc C‐peptide and LF/HF in patients with good ( r = −0·53, P < 0·002) and poor metabolic control ( r = −0·49; P < 0·03), as well as in the whole group ( r = −0·83; P < 0·001) was found. By multiple regression analyses performed in all patients, LF/HF were independently associated with auc C‐peptide (t = −8·618; P < 0·001) but not basal C‐peptide levels (t = −0·137; P < 0·88). conclusion Our study demonstrated that preserved C‐peptide secretion is associated with a well balanced cardiac autonomic activity in type II diabetic patients.