Journal
JOURNAL OF DIABETES AND ITS COMPLICATIONS
Volume 30, Issue 5, Pages 873-879Publisher
ELSEVIER SCIENCE INC
DOI: 10.1016/j.jdiacomp.2016.03.008
Keywords
Type 2 diabetes; Cardiovascular autonomic neuropathy; Diabetic nephropathy; American Indians; Kidney biopsy
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Funding
- Intramural Research Program of the National Institute of Diabetes and Digestive and Kidney Diseases
- American Diabetes Association [1-08-CR-42, 1-14-MN-02]
- [R01-HL-102334]
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Aims: Cardiovascular autonomic neuropathy (CAN) predicts clinical diabetic nephropathy (DN). We investigated the relationship between DN structural lesions and CAN. Methods: Sixty three Pima Indians with type 2 diabetes underwent kidney biopsies following a 6-year clinical trial testing the renoprotective efficacy of losartan vs. placebo. CAN was assessed a median 9.2 years later. CAN variables included expiration/inspiration ratio (E/I), standard deviation of the normal R-R interval (sdNN), and low and high frequency signal power and their ratio (LF, HF, LF/HF); lower values reflect more severe neuropathy. Associations of CAN with renal structural variables were assessed by linear regression adjusted for age, sex, diabetes duration, blood pressure, HbA1c, glomerular filtration rate, and treatment assignment during the trial. Results: Global glomerular sclerosis was negatively associated with sdNN (partial r = -0.35, p = 0.01) and LF (r = -032, p = 0.02); glomerular basement membrane width was negatively associated with all measures of CAN except for LF/HF (r = -0.28 to -0.42, p < 0.05); filtration surface density was positively associated with sdNN, LF, and HF (r = 0.31 to 0.38, p < 0.05); and cortical interstitial fractional volume was negatively associated with HF (r = -0.27, p = 0.04). Conclusions: CAN associates with DN lesions. Published by Elsevier Inc.
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