Endocrinol Metab > Volume 26(1); 2011 > Article
Endocrinology and Metabolism 2011;26(1):44-52.
DOI: https://doi.org/10.3803/EnM.2011.26.1.44    Published online March 1, 2011.
Relationships between Cardiac Autonomic Neuropathy and the Brachial-ankle Pulse Wave Velocity in Patients with Type 2 Diabetes.
Young Pil Bae, Byeong Do Yi, Bong Gun Kim, Jong Hwa Park, Yong Seop Kwon, Ja Young Park, Chang Won Lee, Bo Hyun Kim, Jae Sik Jang
1Department of Internal Medicine, Busan St. Mary's Medical Center, Busan, Korea. koje94@hanmail.net
2Division of Endocrinology and Metabolism, Department of Internal Medicine, Pusan National University School of Medicine Hospital, Busan, Korea.
3Division of Cardiology, Department of Internal Medicine, Pusan-Paik Hospital, Inje University College of Medicine, Busan, Korea.
Cardiovascular disease is the leading cause of death in patients with type 2 diabetes. Clinically, evaluating cardiovascular autonomic neuropathy (CAN) is important to predict cardiovascular mortality because it is correlated with cardiovascular death. The pulse wave velocity (PWV) correlates well with arterial distensibility and stiffness. It is also a useful approach for evaluating the severity of systemic atherosclerosis in adults. So, we evaluated that the relationship between cardiac autonomic neuropathy and the brachial-ankle pulse wave velocity (baPWV) in patients with type 2 diabetes. METHODS: We retrospectively analyzed 465 patients (209 men and 256 women) with type 2 diabetes. We checked the clinical characteristics and the laboratory tests and we assessed the diabetic complications. Standard tests for CAN were performed by DiCAN (Medicore, Seoul, Korea): 1) heart rate variability during deep breathing (the E/I ratio), 2) a Valsalva maneuver, 3) 30:15 ratio of R-R interval the blood pressure response to standing, and 5) the blood pressure response to handgrip. The CAN score was determined according to the results of the test as following: 0 = normal, 0.5 = borderline, 1 = abnormal. We also measured the baPWV by using a VP 1000 (Colin, Japan) and all the analyses were performed with the SPSS version 14.0. P values < 0.05 were considered significant. RESULTS: The CAN score is associated with the maximal baPWV, age, systolic blood pressure, microalbuminuria, the duration of diabetes, angiotensin II receptor blocker treatment, calcium channel blocker treatment, beta-blocker treatment and nephropathy. After adjusting for age, the baPWV is a independent predictor of the risk for CAN (beta = 0.108, P = 0.021). CONCLUSION: The CAN is associated with the baPWV in patient with type 2 diabetes.
Key Words: Brachial-ankle pulse-wave velocity, Cardiovascular atonomic neuropathy, Type 2 diabetes

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