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Insulin resistance is independently associated with cardiovascular autonomic neuropathy in type 2 diabetes.
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- Author(s): Liu Y;Liu Y;Liu Y; Peng Y; Peng Y; Jin J; Jin J; Jin J; Chen Y; Chen Y; Chen Y; Chen C; Chen C; Chen C; Chen Z; Chen Z; Chen Z; Huang H; Huang H; Huang H; Xu L; Xu L; Xu L
- Source:
Journal of diabetes investigation [J Diabetes Investig] 2021 Sep; Vol. 12 (9), pp. 1651-1662. Date of Electronic Publication: 2021 Feb 15.- Publication Type:
Journal Article- Language:
English - Source:
- Additional Information
- Source: Publisher: Asian Association for the Study of Diabetes and Blackwell Pub. Asia Country of Publication: Japan NLM ID: 101520702 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 2040-1124 (Electronic) Linking ISSN: 20401116 NLM ISO Abbreviation: J Diabetes Investig Subsets: MEDLINE
- Publication Information: Original Publication: Tokyo : Asian Association for the Study of Diabetes and Blackwell Pub. Asia
- Subject Terms: Insulin Resistance* ; Quality of Life*; Biomarkers/*blood ; Blood Glucose/*analysis ; Cardiovascular Diseases/*pathology ; Diabetes Mellitus, Type 2/*complications ; Diabetic Neuropathies/*pathology; Aged ; Cardiovascular Diseases/etiology ; Cardiovascular Diseases/metabolism ; Cross-Sectional Studies ; Diabetic Neuropathies/etiology ; Diabetic Neuropathies/metabolism ; Female ; Follow-Up Studies ; Glycated Hemoglobin/analysis ; Humans ; Male ; Middle Aged ; Prognosis ; Risk Factors
- Abstract: Aims/introduction: Diabetic cardiovascular autonomic neuropathy (DCAN) seriously threatens the prognosis and quality of life of patients with type 2 diabetes mellitus, associated with increased mortality. The present study aimed to investigate the relevant risk factors of DCAN.
Materials and Methods: The present study enrolled a total of 109 patients with type 2 diabetes mellitus. DCAN was defined as a score of at least 2 points in Ewing tests. The updated homeostasis model assessment of insulin resistance (HOMA2-IR) based on fasting C-peptide was calculated to reflect insulin resistance. Logistic regression analysis, interaction and stratified analyses were used to investigate the relationship between HOMA2-IR or other indicators and DCAN. Receiver operating characteristic analysis was carried out to estimate the discriminative value of the variables independently associated with DCAN and to determine the optimal cut-off point of these models to screen DCAN.
Results: The HOMA2-IR levels were significantly higher in patients with DCAN, and tended to be worsened with the progression of the DCAN. Logistic regression analysis showed an independent association between HOMA2-IR (odds ratio 39.30, 95% confidence interval 7.17-215.47) and DCAN. HOMA2-IR (area under the curve 0.878, 95% confidence interval 0.810-0.946; cut-off value 1.735) individually predicted DCAN significantly higher than the other independent risk factors individually used, whereas models combining HOMA2-IR and other risk factors did not significantly boost the diagnostic power.
Conclusions: Insulin resistance is independently associated with DCAN. HOMA2-IR presents to be a highly accurate and parsimonious indicator for DCAN screening. Patients with HOMA2-IR >1.735 are at a high risk of DCAN; thus, priority diagnostic tests should be carried out for these patients for timely integrated intervention.
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- Contributed Indexing: Keywords: Autonomic nervous system diseases; Insulin resistance; Type 2 diabetes
- Accession Number: 0 (Biomarkers)
0 (Blood Glucose)
0 (Glycated Hemoglobin A)
0 (hemoglobin A1c protein, human) - Publication Date: Date Created: 20210118 Date Completed: 20220124 Latest Revision: 20231107
- Publication Date: 20231107
- Accession Number: PMC8409868
- Accession Number: 10.1111/jdi.13507
- Accession Number: 33460512
- Source:
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