Key result
Greater diabetic peripheral neuropathy severity is independently associated with reduced heart rate variability.
Why the study?
The relationship between cardiac autonomic dysfunction severity and diabetic peripheral neuropathy severity, and its variation by neuropathic diabetic foot ulceration status, was unclear.
Cross-Sectional (n=794)
p-value: p=<0.01
Greater severity of diabetic peripheral neuropathy is independently associated with more severe cardiac autonomic dysfunction, regardless of the presence of a diabetic foot ulcer.
Supports broader neuropathy assessment in diabetes; extends evidence across foot ulcer status yet leaves open clinical adoption.
AIMS: To investigate whether cardiac autonomic dysfunction severity is associated with diabetic peripheral neuropathy (DPN) severity, and whether this association differs between individuals with neuropathic foot ulceration (DFU) and those with DPN alone. METHODS: Among 794 participants with DPN (268 with neuropathic DFU and 526 without DFU), cardiac autonomic dysfunction was assessed using heart rate variability and DPN severity using nerve conduction studies. Multivariate logistic regression evaluated the association between DPN severity and cardiac autonomic dysfunction. Subgroup and interaction analyses assessed whether the association differed by DFU status. RESULTS: As the standard deviation of the normal sinus interval (SDNN) decreased, conduction velocities and amplitudes of all tested nerves declined. In both groups, greater reductions in sural or common peroneal nerve conduction parameters were independently associated with lower SDNN (all P < 0.01). In neuropathic DFU group, 29.6 %-31.1 % of those with both conduction velocity and amplitude abnormalities had SDNN < 50 ms. No significant interactions between DFU and lower extremity nerve conduction parameters were observed (all P for interaction > 0.05). CONCLUSION: Cardiac autonomic dysfunction was associated with greater DPN severity. Although neuropathic DFUs exhibited more severe cardiac autonomic dysfunction and DPN, the association between their severities did not differ by DFU status.
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Ma et al. (2026) conducted a cross-sectional in Diabetic peripheral neuropathy (n=794). Diabetic peripheral neuropathy severity vs. Less severe diabetic peripheral neuropathy was evaluated on Association between nerve conduction parameters (DPN severity) and standard deviation of normal sinus interval (SDNN) (p=<0.01). Greater diabetic peripheral neuropathy severity was independently associated with lower SDNN (P<0.01), and this association did not differ by the presence of neuropathic diabetic foot ulceration.
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