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Progression of Cardiovascular Autonomic Dysfunction in Patients With Type 2 Diabetes: A 7-year follow-up study

OBJECTIVE—We investigated whether cardiovascular autonomic dysfunction was associated with glycemic control status over time in patients with type 2 diabetes. RESEARCH DESIGN AND METHODS—From 1999 to 2000, cardiovascular autonomic nerve function testing (AFT) was performed on patients with type 2 di...

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Autores principales: Ko, Seung-Hyun, Park, Shin-Ae, Cho, Jae-Hyoung, Song, Ki-Ho, Yoon, Kun-Ho, Cha, Bong-Yun, Son, Ho-Young, Yoo, Ki-Dong, Moon, Keon-Woong, Park, Yong-Moon, Ahn, Yu-Bai
Formato: Texto
Lenguaje:English
Publicado: American Diabetes Association 2008
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2518354/
https://www.ncbi.nlm.nih.gov/pubmed/18509202
http://dx.doi.org/10.2337/dc08-0682
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author Ko, Seung-Hyun
Park, Shin-Ae
Cho, Jae-Hyoung
Song, Ki-Ho
Yoon, Kun-Ho
Cha, Bong-Yun
Son, Ho-Young
Yoo, Ki-Dong
Moon, Keon-Woong
Park, Yong-Moon
Ahn, Yu-Bai
author_facet Ko, Seung-Hyun
Park, Shin-Ae
Cho, Jae-Hyoung
Song, Ki-Ho
Yoon, Kun-Ho
Cha, Bong-Yun
Son, Ho-Young
Yoo, Ki-Dong
Moon, Keon-Woong
Park, Yong-Moon
Ahn, Yu-Bai
author_sort Ko, Seung-Hyun
collection PubMed
description OBJECTIVE—We investigated whether cardiovascular autonomic dysfunction was associated with glycemic control status over time in patients with type 2 diabetes. RESEARCH DESIGN AND METHODS—From 1999 to 2000, cardiovascular autonomic nerve function testing (AFT) was performed on patients with type 2 diabetes (n = 1,021) and was followed-up in 2006 and February 2008. Tests for cardiovascular autonomic functions measured heart rate variability parameters (expiration-to-inspiration [E/I] ratio, responses to the Valsalva maneuver, and standing). AFT scores were determined from the results of the each test as follows: 0 for normal and 1 for abnormal. We began with those who had a score of 0 and assessed the changes in total score along with biannual A1C levels. RESULTS—At follow-up, the development of cardiovascular autonomic dysfunction was 34.5% (E/I ratio 21.9%, Valsalva maneuver 77.8%, and posture 58.9%; n = 783). The development of cardiovascular autonomic dysfunction was higher in older patients (P < 0.001); in those with longer duration of diabetes (P < 0.001); of hypertension (P = 0.005), and of diabetic retinopathy (P < 0.001); and in those who had higher levels of microalbuminuria (P = 0.002). Logistic regression analysis revealed that the development of cardiovascular autonomic dysfunction was strongly associated with the mean A1C level during the follow-up period (mean A1C >9.0% vs. ≤7.0%, odds ratio 2.984, 95% CI 1.177–7.561; P = 0.021). CONCLUSIONS—The development of cardiovascular autonomic dysfunction was independently associated with microvascular complications and glycemic control status during this 7.5-year follow-up in patients with type 2 diabetes.
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spelling pubmed-25183542009-09-01 Progression of Cardiovascular Autonomic Dysfunction in Patients With Type 2 Diabetes: A 7-year follow-up study Ko, Seung-Hyun Park, Shin-Ae Cho, Jae-Hyoung Song, Ki-Ho Yoon, Kun-Ho Cha, Bong-Yun Son, Ho-Young Yoo, Ki-Dong Moon, Keon-Woong Park, Yong-Moon Ahn, Yu-Bai Diabetes Care Pathophysiology/Complications OBJECTIVE—We investigated whether cardiovascular autonomic dysfunction was associated with glycemic control status over time in patients with type 2 diabetes. RESEARCH DESIGN AND METHODS—From 1999 to 2000, cardiovascular autonomic nerve function testing (AFT) was performed on patients with type 2 diabetes (n = 1,021) and was followed-up in 2006 and February 2008. Tests for cardiovascular autonomic functions measured heart rate variability parameters (expiration-to-inspiration [E/I] ratio, responses to the Valsalva maneuver, and standing). AFT scores were determined from the results of the each test as follows: 0 for normal and 1 for abnormal. We began with those who had a score of 0 and assessed the changes in total score along with biannual A1C levels. RESULTS—At follow-up, the development of cardiovascular autonomic dysfunction was 34.5% (E/I ratio 21.9%, Valsalva maneuver 77.8%, and posture 58.9%; n = 783). The development of cardiovascular autonomic dysfunction was higher in older patients (P < 0.001); in those with longer duration of diabetes (P < 0.001); of hypertension (P = 0.005), and of diabetic retinopathy (P < 0.001); and in those who had higher levels of microalbuminuria (P = 0.002). Logistic regression analysis revealed that the development of cardiovascular autonomic dysfunction was strongly associated with the mean A1C level during the follow-up period (mean A1C >9.0% vs. ≤7.0%, odds ratio 2.984, 95% CI 1.177–7.561; P = 0.021). CONCLUSIONS—The development of cardiovascular autonomic dysfunction was independently associated with microvascular complications and glycemic control status during this 7.5-year follow-up in patients with type 2 diabetes. American Diabetes Association 2008-09 /pmc/articles/PMC2518354/ /pubmed/18509202 http://dx.doi.org/10.2337/dc08-0682 Text en Copyright © 2008, DIABETES CARE Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered. See http://creativecommons.org/licenses/by-nc-nd/3.0/ for details.
spellingShingle Pathophysiology/Complications
Ko, Seung-Hyun
Park, Shin-Ae
Cho, Jae-Hyoung
Song, Ki-Ho
Yoon, Kun-Ho
Cha, Bong-Yun
Son, Ho-Young
Yoo, Ki-Dong
Moon, Keon-Woong
Park, Yong-Moon
Ahn, Yu-Bai
Progression of Cardiovascular Autonomic Dysfunction in Patients With Type 2 Diabetes: A 7-year follow-up study
title Progression of Cardiovascular Autonomic Dysfunction in Patients With Type 2 Diabetes: A 7-year follow-up study
title_full Progression of Cardiovascular Autonomic Dysfunction in Patients With Type 2 Diabetes: A 7-year follow-up study
title_fullStr Progression of Cardiovascular Autonomic Dysfunction in Patients With Type 2 Diabetes: A 7-year follow-up study
title_full_unstemmed Progression of Cardiovascular Autonomic Dysfunction in Patients With Type 2 Diabetes: A 7-year follow-up study
title_short Progression of Cardiovascular Autonomic Dysfunction in Patients With Type 2 Diabetes: A 7-year follow-up study
title_sort progression of cardiovascular autonomic dysfunction in patients with type 2 diabetes: a 7-year follow-up study
topic Pathophysiology/Complications
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2518354/
https://www.ncbi.nlm.nih.gov/pubmed/18509202
http://dx.doi.org/10.2337/dc08-0682
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