In patients with diabetes, cardiovascular disease risk was significantly associated with diabetes-related variables such as glycaemic control, proteinuria, and retinopathy, alongside classic risk factors like blood pressure and dyslipidaemia.
Cohort (n=4,743)
Yes
Does cardiac autonomic neuropathy or diabetic retinopathy associate with carotid atherosclerosis in patients with type 2 diabetes?
Cardiac autonomic neuropathy and diabetic retinopathy are independently associated with subclinical carotid atherosclerosis in patients with type 2 diabetes.
BACKGROUND: It is not clear whether microangiopathies are associated with subclinical atherosclerosis in type 2 diabetes mellitus (T2DM). We investigated the relation of cardiac autonomic neuropathy (CAN) and other microangiopathies with carotid atherosclerosis in T2DM. METHODS: A total of 131 patients with T2DM were stratified by mean carotid intima-media thickness (CIMT) ≥ or <1.0 mm and the number of carotid plaques. CAN was assessed by the five standard cardiovascular reflex tests according to the Ewing's protocol. CAN was defined as the presence of at least two abnormal tests or an autonomic neuropathy points ≥2. Diabetic microangiopathies were assessed. RESULTS: Patients with CAN comprised 77% of the group with mean CIMT ≥1.0 mm, while they were 29% of the group with CIMT <1.0 mm (P=0.016). Patients with diabetic retinopathy (DR) comprised 68% of the group with CIMT ≥1.0 mm, while they were 28% of the group without CIMT thickening (P=0.003). Patients with CAN comprised 51% of the group with ≥2 carotid plaques, while they were 23% of the group with ≤1 carotid plaque (P=0.014). In multivariable adjusted logistic regression analysis, the patients who presented with CAN showed an odds ratio OR of 8.6 (95% confidence interval CI, 1.6 to 44.8) for CIMT thickening and an OR of 2.9 (95% CI, 1.1 to 7.5) for carotid plaques. Furthermore, patients with DR were 3.8 times (95% CI, 1.4 to 10.2) more likely to have CIMT thickening. CONCLUSION: These results suggest that CAN is associated with carotid atherosclerosis, represented as CIMT and plaques, independent of the traditional cardiovascular risk factors in T2DM. CAN or DR may be a determinant of subclinical atherosclerosis in T2DM.
Jung et al. (Tue,) conducted a cohort in Type 1 and Type 2 diabetes mellitus (n=4,743). Cardiovascular and diabetes-specific risk factors (e.g., glycaemic control, proteinuria, retinopathy) vs. Absence or lower levels of risk factors was evaluated on Fatal and non-fatal cardiovascular disease outcomes (CVD mortality, myocardial infarction, and stroke). In patients with diabetes, cardiovascular disease risk was significantly associated with diabetes-related variables such as glycaemic control, proteinuria, and retinopathy, alongside classic risk factors like blood pressure and dyslipidaemia.