Key result
Diabetes mellitus was associated with significantly greater muscle sympathetic nerve activity compared to healthy controls (MD 8.1; 95% CI 1.21-15.08; P<0.05), driven entirely by type 2 diabetes.
Why the study?
Comorbidities and metabolic abnormalities associated with T1DM and T2DM affect MSNA, confounding whether diabetes mellitus itself is associated with sympathetic activation.
Does diabetes mellitus increase muscle sympathetic nerve activity compared to healthy controls?
Meta-Analysis (n=314)
Does diabetes mellitus increase muscle sympathetic nerve activity compared to healthy controls?
Type 2 diabetes, but not type 1 diabetes, is associated with increased sympathetic activation as measured by MSNA, which correlates with plasma insulin levels.
Answers are grounded in this paper and cite their sources.
Supports sympathetic overdrive in T2DM; leaves open whether targeting MSNA improves outcomes.
BACKGROUND: Microneurographic recordings of muscle sympathetic nerve activity (MSNA) have shown that sympathetic activation may characterize diabetes mellitus. However, it is recognized that comorbidities and metabolic abnormalities frequently associated with both type 1 diabetes mellitus (T1DM) and type 2 diabetes mellitus (T2DM) diabetes affect MSNA, generating potential confounding effects and making the association between sympathetic activation and diabetes mellitus still a controversial matter. METHODS: The present meta-analysis evaluated 11 microneurographic studies enrolling 314 diabetes mellitus patients and healthy controls, and MSNA was chosen as the main variable of interest. Collection of the data included indirect adrenergic markers such as heart rate and venous plasma noradrenaline, together with hemodynamic, anthropometric and metabolic variables. RESULTS: A total of 11 microneurographic studies were evaluated including 314 diabetes mellitus patients and controls. Diabetes mellitus displayed MSNA significantly greater than controls (mean difference amounting to 8.1, 95% confidence interval 1.21-15.08, P < 0.05). This difference was ascribed to T2DM, since T1DM patients displayed MSNA values superimposable to controls. In T2DM MSNA was directly related to age (r = 0.83, β = 0.82, P < 0.04) and plasma insulin (r = 1.00, β = 2.25, P < 0.01) but not to other variables. CONCLUSION: T2DM-related sympathetic activation is detectable even when obesity, hypertension and metabolic syndrome are excluded; not found in T1DM; not associated with anthropometric and hemodynamic variables; and related to plasma insulin.
No takes yet. Share an insight, caveat, or question.
Grassı et al. (2020) conducted a meta-analysis in Diabetes mellitus (Type 1 and Type 2) (n=314). Diabetes mellitus vs. Healthy controls was evaluated on Muscle sympathetic nerve activity (MSNA) (MD 8.1, 95% CI 1.21-15.08, p=<0.05). Diabetes mellitus was associated with significantly greater muscle sympathetic nerve activity compared to healthy controls (MD 8.1; 95% CI 1.21-15.08; P<0.05), driven entirely by type 2 diabetes.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: