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Erschienen in: Diabetologia 1/2005

01.01.2005 | Article

Risk factors for cardiac autonomic neuropathy in type 1 diabetes mellitus

verfasst von: D. R. Witte, S. Tesfaye, N. Chaturvedi, S. E. M. Eaton, P. Kempler, J. H. Fuller, EURODIAB Prospective Complications Study Group

Erschienen in: Diabetologia | Ausgabe 1/2005

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Abstract

Aims/hypothesis

Cardiac autonomic neuropathy (CAN) is associated with increased morbidity and mortality in type 1 diabetes. Apart from glycaemic control, risk factors for CAN have not been extensively studied.

Methods

As part of the EURODIAB Prospective Complications Study, CAN—defined as either a loss of heart rate variability or postural hypotension on standing—was assessed at baseline and follow-up (7.3±0.6 years from baseline) in patients with type 1 diabetes.

Results

Follow-up measurements were available for 956 participants without CAN at baseline (age at baseline 31.3±8.9 years, duration of diabetes 13.5±8.3 years). During follow-up, 163 (17%) subjects developed CAN, yielding an incidence of 23.4 per 1,000 person-years. Blood pressure, weight, the presence of cardiovascular disease, albuminuria, distal symmetrical polyneuropathy (DSP) and retinopathy at baseline were associated with the incidence of CAN after adjustment for sex, duration of diabetes and HbA1c. In a multivariate regression model, baseline factors associated with an increased risk of developing CAN were age [odds ratio (OR)=1.3 per decade, 95% CI 1.1–1.7], HbA1c (OR=1.2 per percentage point, 95% CI 1.1–1.4), systolic blood pressure (OR=1.1 per 10 mmHg, 95% CI 1.0–1.3), feeling faint on standing (OR=2.0, 95% CI 1.2–3.2), DSP (OR=1.9, 95% CI 1.2–3.0) and retinopathy (OR=1.7, 95% CI 1.1–2.6).

Conclusion/interpretation

This study confirms the importance of exposure to hyperglycaemia as a risk factor for CAN. A small set of variables, including HbA1c, hypertension, DSP and retinopathy, predict the risk of CAN. Clinical trials are needed to address the impact of intensive antihypertensive treatment on CAN in type 1 diabetes.
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Metadaten
Titel
Risk factors for cardiac autonomic neuropathy in type 1 diabetes mellitus
verfasst von
D. R. Witte
S. Tesfaye
N. Chaturvedi
S. E. M. Eaton
P. Kempler
J. H. Fuller
EURODIAB Prospective Complications Study Group
Publikationsdatum
01.01.2005
Erschienen in
Diabetologia / Ausgabe 1/2005
Print ISSN: 0012-186X
Elektronische ISSN: 1432-0428
DOI
https://doi.org/10.1007/s00125-004-1617-y

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