Obesity, Microalbuminuria, Hyperinsulinemia, and Increased Plasminogen Activator Inhibitor 1 Activity Associated With Parasympathetic Neuropathy in Type 2 Diabetes

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From: Diabetes Care(Vol. 22, Issue 11)
Publisher: American Diabetes Association
Document Type: Article
Length: 913 words

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An abnormally low degree of heart-rate variation (the electrocardiographic R-R interval variation recorded during 1 min of six maximal expirations and inspirations) during deep breathing is a feature of parasympathetic neuropathy [1] that may be found in subjects with impaired glucose tolerance [2] and in type 2 diabetic patients at the time of diagnosis of diabetes [3]. Recently, Toyry et al. [4] reported that the frequency of parasympathetic neuropathy increases with the duration of type 2 diabetes. This prompted us to evaluate the prevalence of parasympathetic neuropathy, including its relation to cardiovascular risk factors, in 79 type 2 diabetic patients (age 53 [plus or minus] 7 years [range 40-64]) from a previous study [5] 4-5 years after the diagnosis of diabetes. The expiration-to-inspiration (E/I) ratio (age-corrected values [abnormal Z score] less than -- 1.64 SD) was used as a test of the RR interval variation [1]. Plasminogen activator inhibitor 1 (PAI-1) activity (reference values 0-16 U/ml) wa s measured with the Spectrolyse (Biopool, Umea, Sweden).

Parasympathetic neuropathy, i.e., an abnormal E/I ratio, was found in 9 of 79 (12%) patients. Table 1 shows that the frequency of microalbuminuria was significantly increased in patients with parasympathetic neuropathy. Table 1 also shows that mean BMI, mean fasting plasma C-peptide, and mean PAI-1 activity were significantly higher in patients with parasympathetic neuropathy than in those without.

In our current study, the...

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Gale Document Number: GALE|A57604089