Cardiovascular autonomic neuropathy, autonomic symptoms and diabetic complications in 674 type 2 diabetes

Aims: To determine the relationships between cardiovascular autonomic neuropathy (CAN) and autonomic symptoms, clinical parameters and diabetic complications in type 2 diabetes (T2DM). Methods: The results of autonomic symptoms, clinical parameters, diabetes complications and cardiovascular reflex (CVR) tests of 674 T2DM were analyzed. Results: Significant correlations were found between CAN risk and age (p = 0.019), duration of diabetes (p = 0.008), HbA1c (p < 0.001), systolic blood pressure (p = 0.006), nephropathy (p < 0.001), retinopathy (p < 0.001), and QTc interval (p < 0.001.), but not BMI and hyperlipidemia. Patients with retinopathy or proteinuria had increase risk of CAN, and proliferative diabetic retinopathy (PDR) was the most significant risk factor (odds ratio: 6.85; 95% Cl: 2.32-20.20) for CAN. Eighty-three percent of patients complained of autonomic symptoms; and the more symptoms complained, the higher the prevalence of CAN. Impotence was the only single symptom associated with CAN risk. Additional CAN risks were also observed when patients with multiple symptoms and/or complications in combinations. Conclusions: Our results implied that patients with multiple symptoms and/or complications in combinations have increased CAN risk, and this may provide additional information for clinicians to identify T2DM at risk of having CAN. (C) 2008 Elsevier Ireland Ltd. All rights reserved.