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Cardiovascular autonomic neuropathy associated with carotid atherosclerosis in Type 2 diabetic patients
Author(s) -
Gottsäter A.,
RydénAhlgren Å.,
Szelag B.,
Hedblad B.,
Persson J.,
Berglund G.,
Wroblewski M.,
Sundkvist G.
Publication year - 2003
Publication title -
diabetic medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.474
H-Index - 145
eISSN - 1464-5491
pISSN - 0742-3071
DOI - 10.1046/j.1464-5491.2003.00956.x
Subject(s) - medicine , cardiology , common carotid artery , diabetes mellitus , stenosis , type 2 diabetes , carotid arteries , endocrinology
Abstract Aims To clarify if cardiovascular autonomic neuropathy is associated with carotid artery atherosclerotic plaques in Type 2 diabetic patients. Methods Cardiovascular autonomic nerve function was related to carotid artery ultrasound in 61 Type 2 diabetic patients 5–6 years after diagnosis of diabetes. Results Cardiovascular autonomic neuropathy [abnormal age corrected expiration/inspiration (E/I) ratio or acceleration index (AI)] was found in 13/61 (21%) patients. Patients with cardiovascular autonomic neuropathy showed increased degree of stenosis in the common carotid artery (24.6 ± 13.2% vs. 14.7 ± 9.2%; P = 0.014) and a tendency towards a higher plaque score (4.0 ± 1.7 vs. 3.2 ± 1.6; P = 0.064). Controlled for age, AI correlated inversely with degree of stenosis ( r = −0.39; P = 0.005), plaque score ( r = −0.39; P = 0.005), and mean ( r = −0.33; P = 0.018) and maximum ( r = −0.39; P = 0.004) intima‐media thickness in the common carotid artery. In contrast, E/I ratio correlated only slightly with mean intima‐media thickness in the common carotid artery ( r = −0.28; P = 0.049). Conclusions Cardiovascular autonomic neuropathy was associated with carotid atherosclerosis in Type 2 diabetic patients. Abnormal E/I ratios reflect efferent structural damage to parasympathetic nerves whereas abnormal AI reflects afferent autonomic dysfunction possibly due to impaired baroreceptor sensitivity secondary to carotid atherosclerosis. Diabet. Med. 20, 495–499 (2003)