Key result
Diabetic retinopathy is linked to a ~4-fold higher rate of cardiac autonomic neuropathy in T2D.
Why the study?
Cardiac autonomic neuropathy is a serious complication of diabetes mellitus strongly associated with increased cardiovascular mortality risk, leading researchers to evaluate its association with diabetic retinopathy in patients with type 2 diabetes.
Is diabetic retinopathy associated with cardiac autonomic neuropathy in patients with type 2 diabetes?
Observational (n=60)
Is diabetic retinopathy associated with cardiac autonomic neuropathy in patients with type 2 diabetes?
Absolute Event Rate: 43.33% vs 10%
p-value: p=0.004
Diabetic retinopathy is strongly associated with cardiac autonomic neuropathy in patients with type 2 diabetes, suggesting fundus evaluation could help identify patients at risk for CAN.
Diabetic retinopathy was associated with cardiac autonomic neuropathy in type 2 diabetes; hypothesis-generating and requires prospective validation before clinical adoption.
Background: Cardiac autonomic neuropathy (CAN) is a serious complication of diabetes mellitus that strongly associated with increased risk of cardiovascular mortality. Aim: The aim of this study was to evaluate the association between diabetic retinopathy (DR) and early CAN in patients with type 2 diabetes (T2D). Materials and Methods: The study was conducted on 60 patients with T2D, divided into two groups; group I included 30 patients with T2D complicated with DR and group II included 30 patients with T2D not complicated with DR. All participants underwent a detailed medical history, examination and laboratory measurements including, hemoglobin A1c (HbA1c) and urinary albumin/creatinine ratio (UACR). CAN was determined based on the results of tilt-table test which was done to all study participants. Results: On comparing tilt table test positive results of group I and group II, the results showed a significant difference between both groups (P = 0.004), being higher in group I (43.33% of group I were tilt table test positive) than in group II (only 10% of the group were positive). In group I, on comparing patients with positive tilt table test (CAN) and those with negative tilt table test (without CAN) regarding fundus findings, the results showed that 69.23% of patients with positive tilt table test had proliferative diabetic retinopathy (PDR), and 30.77% had non-proliferative diabetic retinopathy (NPDR), while in patients with negative tilt table test, 17.65% had PDR, and 82.35% had NPDR, the odd‘s ratio was 10.5 (P = 0.007). Regression of determinants for the presence of cardiac autonomic neuropathy in patients with T2D showed that, the increased duration of diabetes (P = 0.010) and the increased level of UACR (P = 0.001) were significantly associated with CAN in type 2 diabetic patients. Conclusion: DR is a strong predictor for CAN. So, fundus photography may be an alternative to autonomic function testing where facilities for the latter test are unavailable.
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Mohammad et al. (2022) conducted an observational in Type 2 diabetes (n=60). Diabetic retinopathy vs. Type 2 diabetes without diabetic retinopathy was evaluated on Positive tilt-table test (cardiac autonomic neuropathy) (p=0.004). Diabetic retinopathy in patients with type 2 diabetes was significantly associated with a higher rate of cardiac autonomic neuropathy compared to those without retinopathy (43.33% vs 10%; P=0.004).
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