Abstract:
:The role cardiac autonomic neuropathy (CAN) plays in diabetes is not well known. The aim of this study was to identify the factors involved in CAN in diabetic patients. One hundred patients, 44 insulin-dependent (IDDM) and 56 non-insulin-dependent (NIDDM), were investigated, using five standard tests. Three of these tests were for parasympathetic control (cardiac response to the lying-to-standing, deep breathing, and Valsalva tests), and the other two measured sympathetic control (testing for orthostatic hypotension and evaluating heart and blood pressure response to the handgrip test). Results were compared to those found in a series of 40 healthy volunteers. An age-adjusted comparison with the controls, showed that 34 patients had one abnormal parasympathetic test, 23 had two, and 6 patients had three. Cardiac parasympathetic neuropathy was thus present in 63% of the patients. The handgrip test was completed by 84 diabetic patients. There was evidence of orthostatic hypotension and/or an abnormal cardiac response to the handgrip in 15 of these patients, who all had a parasympathetic abnormality as well. There was no significant association between the type of diabetes and the presence of CAN. The duration of diabetes was significantly longer in patients with CAN (9.3 +/- 0.9 years) (p < 0.01) than in those with all three parasympathetic tests normal (5.8 +/- 0.9 years) (p < 0.01). The HbA1c level was also higher in patients with CAN than in those with three normal parasympathetic tests (9.95 +/- 0.35% versus 8.17 +/- 0.42%, p < 0.005). There was a significant association between the presence of retinopathy, observed by angiofluorography, and the presence of peripheral neuropathy confirmed by the electrophysiological investigation and the presence of CAN (p < 0.001). However, more than half the patients without retinopathy or nephropathy had CAN, and 11 of the 31 patients with a normal electrophysiological investigation also had CAN. Eighteen patients (6 IDDM) without retinopathy and nephropathy, who had been diabetic for less than 2 years, also had CAN. This study shows that CAN occurs early and is frequently found in a population of unselected diabetic patients. Metabolic factors may play an important role in its occurrence. CAN is significantly associated with the presence of retinopathy, which suggests that an impairment of autonomic peripheral blood flow control might be a contributing factor in the formation of microvascular lesions.
journal_name
J Diabetes Complicationsjournal_title
Journal of diabetes and its complicationsauthors
Valensi P,Huard JP,Giroux C,Attali JRdoi
10.1016/s1056-8727(97)00005-6subject
Has Abstractpub_date
1997-05-01 00:00:00pages
180-7issue
3eissn
1056-8727issn
1873-460Xpii
S1056-8727(97)00005-6journal_volume
11pub_type
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journal_title:Journal of diabetes and its complications
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journal_title:Journal of diabetes and its complications
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journal_title:Journal of diabetes and its complications
pub_type: 杂志文章
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journal_title:Journal of diabetes and its complications
pub_type: 杂志文章
doi:10.1016/s1056-8727(99)00046-x
更新日期:1999-07-01 00:00:00
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journal_title:Journal of diabetes and its complications
pub_type: 杂志文章
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更新日期:2017-07-01 00:00:00
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journal_title:Journal of diabetes and its complications
pub_type: 杂志文章
doi:10.1016/j.jdiacomp.2018.09.011
更新日期:2019-01-01 00:00:00
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journal_title:Journal of diabetes and its complications
pub_type: 杂志文章
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更新日期:2001-09-01 00:00:00
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journal_title:Journal of diabetes and its complications
pub_type: 杂志文章
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更新日期:2019-10-01 00:00:00
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journal_title:Journal of diabetes and its complications
pub_type: 杂志文章
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journal_title:Journal of diabetes and its complications
pub_type: 杂志文章
doi:10.1016/j.jdiacomp.2011.10.002
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journal_title:Journal of diabetes and its complications
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journal_title:Journal of diabetes and its complications
pub_type: 杂志文章
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journal_title:Journal of diabetes and its complications
pub_type: 临床试验,杂志文章,随机对照试验
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更新日期:2000-01-01 00:00:00
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journal_title:Journal of diabetes and its complications
pub_type: 杂志文章
doi:10.1016/j.jdiacomp.2008.10.002
更新日期:2010-01-01 00:00:00
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journal_title:Journal of diabetes and its complications
pub_type: 杂志文章,评审
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更新日期:2013-05-01 00:00:00
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journal_title:Journal of diabetes and its complications
pub_type: 杂志文章
doi:10.1016/j.jdiacomp.2009.07.001
更新日期:2010-11-01 00:00:00
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journal_title:Journal of diabetes and its complications
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journal_title:Journal of diabetes and its complications
pub_type: 杂志文章,随机对照试验
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journal_title:Journal of diabetes and its complications
pub_type: 杂志文章,meta分析
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更新日期:2006-01-01 00:00:00
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journal_title:Journal of diabetes and its complications
pub_type: 杂志文章
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更新日期:1999-09-01 00:00:00
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journal_title:Journal of diabetes and its complications
pub_type: 杂志文章,随机对照试验
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journal_title:Journal of diabetes and its complications
pub_type: 杂志文章
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更新日期:1997-07-01 00:00:00
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journal_title:Journal of diabetes and its complications
pub_type: 杂志文章
doi:10.1016/j.jdiacomp.2013.02.004
更新日期:2013-07-01 00:00:00
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journal_title:Journal of diabetes and its complications
pub_type: 杂志文章
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更新日期:2012-03-01 00:00:00
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journal_title:Journal of diabetes and its complications
pub_type: 杂志文章
doi:10.1016/j.jdiacomp.2005.03.003
更新日期:2005-09-01 00:00:00
abstract::Since the discovery of the hepatitis C virus (HCV) in 1989, attention has been paid to the association of chronic HCV infection and the development of diabetes. The risk factors for diabetes include older age, HCV genotype 3, severe liver fibrosis, family history of diabetes, and liver/kidney transplantation. Emerging...
journal_title:Journal of diabetes and its complications
pub_type: 杂志文章,评审
doi:10.1016/j.jdiacomp.2006.01.001
更新日期:2006-03-01 00:00:00
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journal_title:Journal of diabetes and its complications
pub_type: 杂志文章
doi:10.1016/j.jdiacomp.2020.107702
更新日期:2020-12-01 00:00:00
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journal_title:Journal of diabetes and its complications
pub_type: 杂志文章
doi:10.1016/j.jdiacomp.2017.07.017
更新日期:2017-11-01 00:00:00