Insulin resistance is independently associated with cardiovascular autonomic neuropathy in type 2 diabetes.

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

Original Publication: Tokyo : Asian Association for the Study of Diabetes and Blackwell Pub. Asia

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

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.
(© 2021 The Authors. Journal of Diabetes Investigation published by Asian Association for the Study of Diabetes (AASD) and John Wiley & Sons Australia, Ltd.)

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2016A030313521 Natural Science Foundation of Guangdong Province; CNGZRJJPY202001 Cultivating Plan Program for National Natural Science Foundation of Shenzhen Hospital, Southern Medical University

Keywords: Autonomic nervous system diseases; Insulin resistance; Type 2 diabetes

0 (Biomarkers)
0 (Blood Glucose)
0 (Glycated Hemoglobin A)
0 (hemoglobin A1c protein, human)

Date Created: 20210118 Date Completed: 20220124 Latest Revision: 20231107

20231107

PMC8409868

10.1111/jdi.13507

33460512