Cardiac Autonomic Neuropathy and Two Insulin Resistance Indices

2014 ◽  
Vol 01 (03) ◽  
Author(s):  
Hosseini S. Mehran ◽  
Maleki Alireza ◽  
S. Mohsen Hosseininejad
Keyword(s):  
Insulin Resistance ◽  
Autonomic Neuropathy ◽  
Cardiac Autonomic Neuropathy

scholarly journals Diabetic Cardiovascular Autonomic Neuropathy: Insulin Resistance, Lipids and Simvastatin

2020 ◽  
pp. 1-5
Author(s):  
Victoria Serhiyenko ◽  
Victoria Serhiyenko ◽  
Samir Ajmi ◽  
Alexandr Serhiyenko
Keyword(s):  
Insulin Resistance ◽  
Autonomic Neuropathy ◽  
Lifestyle Modification ◽  
Density Lipoprotein ◽  
Lipoprotein Cholesterol ◽  
Cardiac Autonomic Neuropathy ◽  
Control Group ◽  
Immunoreactive Insulin ◽  
Type 2 Dm

Background: Treatment of diabetic cardiac autonomic neuropathy (CAN) is a complex process, that includes: lifestyle modification; reducing of insulin resistance (IR); optimal glycemic control; management of diabetic dyslipidemia; antioxidants; vitamins; treatment of myocardial metabolic abnormalities; thrombosis and others. The aim of study was to investigate the effects of simvastatin on insulin resistance and blood lipid profile parameters in patients with type 2 diabetes mellitus (DM) and the definite stage of cardiac autonomic neuropathy. Methods: The study involved 107 patients with type 2 DM among them 16 patients without CAN, 19 with subclinical stage of CAN and 72 with definite CAN. Median age of patients was 53.6±0.41 years, disease duration - 4.12±0.24 years and median glycated hemoglobin (HbA1c) - 7.01%±0.09%. The control group included 14 almost healthy people without DM. Patients with definite CAN were allocated into two treatment groups: 1st group - 22 patients received standard hypoglycemic therapy and simvastatin 20 mg/day; 2nd group - control (n = 15). The duration of the study was 3 mos. The concentrations of glucose, HbA1c, immunoreactive insulin (IRI) in the blood were determined. Lipid metabolism was assessed by the concentration of total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), triglycerides (TG) measurements. The IR index (HOMA-IR), atherogenic coefficient (AC), TG/HDL-C parameters, and TG-glucose (TyG) index were calculated. Result: It was established that in patients with type 2 DM with subclinical stage of CAN there was statistically significant increase in the parameters of HbA1c, IRI, TC, TG and HOMA-IR, AC, TyG indices and decrease of TG/HDL-C and HDL-C compared to control; increase of IRI, TG, TG/HDL-C and TyG indices compared to patients with type 2 DM without CAN. The definite stage of CAN is characterized by an increase of HbA1c, IRI, TC, LDL-C levels and HOMA-IR, AC indices and a significant decrease in the concentration of HDL-C (compared to patients with subclinical CAN). As a result of our study, we found out that prescription of simvastatin to patients with definite stage of CAN was accompanied by a statistically significant decrease in the concentration of TC, LDL-C, TG and an increase in the content of HDL-C (compared to 2nd, control group). Conclusion: Obtained results justify the appropriateness of statins prescription to patients with type 2 DM and the definite stage of CAN.

Mechanism Underlying the Formation of a Cluster of Metabolic Syndrome

2020 ◽  
Vol 20 (4) ◽  
pp. 564-569 ◽  
Author(s):  
Svetlana Igorevna Kseneva ◽  
Elena Valentinovna Borodulina ◽  
Vladimir Vasilievich Udut ◽  
Vladimir Petrovich Fisenko
Keyword(s):  
Insulin Resistance ◽  
Metabolic Syndrome ◽  
Gastroesophageal Reflux Disease ◽  
Gastroesophageal Reflux ◽  
Autonomic Neuropathy ◽  
Autonomic Dysfunction ◽  
Reflux Disease ◽  
Prostate Gland ◽  
Clinical Manifestations ◽  
Cardiac Autonomic Neuropathy

Background: The concept of metabolic syndrome (MetS) as a cluster of risk factors of type 2 diabetes and cardiovascular diseases has undergone some evolutionary transformations over the past years. Integrating the autonomic dysfunction into the pathogenesis of MetS creates the possibility of including a range of nosologies affecting treatment and clinical manifestations of pathologies belonging to MetS into the MetS cluster. The purpose of this work is to determine the involvement of autonomic dysfunction in the pathogenesis of associated pathological conditions in patients and MetS. Methods: A cross-sectional study was conducted. The sample consisted of 158 patients with metabolic syndrome. The patients underwent a physical examination, including BMI; a blood chemistry test with the determination of the hormonal status (insulin, testosterone, dihydrotestosterone); a 24-hour monitoring of blood pressure (BP); an assessment of heart rate variability; studies showing the presence of gastric reflux (рН-measurement) or its damaging impact (endoscopy); men were tested with the IPSSQOL questionnaire and underwent transrectal ultrasound of the prostate and ultrasound of the bladder. Results: It is revealed that because of MetS, the occurrence of cardiac autonomic neuropathy reaches 37.5%. Some features of gastroesophageal reflux disease in patients with MetS are shown. Regurgitation prevails in the structure of complaints. In case of fibrogastroduodenoscopy, an endoscopynegative form of the disease occurs in 38%. According to the data of daily pH-measurement, when DeMeester score is high, in the supine position, 25% of the time accounts for alkaline reflux (рН > 7). It is found out that young men experience the enlargement of prostate volume and size; according to the IPSS questionnaire, the scores correspond to the initial manifestations of hyperplastic diseases of the prostate gland due to insulin resistance and normal level of androgens. Conclusions: The paper demonstrates that the autonomic dysfunction of the nervous system (on a par with insulin resistance) is the main link in the development of MetS. This provides the basis for including the mentioned states – cardiac autonomic neuropathy, lower urinary tract symptoms, and gastroesophageal reflux disease – into the MetS cluster..

scholarly journals Increased Leukotriene B4 Plasma Concentration in Type 2 Diabetes Individuals with Cardiovascular Autonomic Neuropathy

2020 ◽  
Author(s):  
JOSE ANTONIO JANUARIO NEVES ◽  
MOZÂNIA REIS DE MATOS ◽  
THERESA RAMALHO ◽  
DANIELE PEREIRA SANTOS-BEZERRA ◽  
CRISTIANE DAS GRAÇAS DIAS CAVALCANTE ◽  
...  
Keyword(s):  
Insulin Resistance ◽  
Plasma Concentration ◽  
Glycemic Control ◽  
Autonomic Neuropathy ◽  
Inflammatory Mediators ◽  
Plasma Concentrations ◽  
Surrogate Marker ◽  
Leukotriene B4 ◽  
Cardiac Autonomic Neuropathy ◽  
Low Grade

Abstract Background and Aim: A low-grade inflammation is associated with cardiac autonomic neuropathy (CAN) and increased concentration of leukotriene B4 (LTB4) was found in individuals with type 1 diabetes and definitive CAN. This study evaluated plasma concentration of LTB4 and of other inflammatory mediators, namely, tumor necrosis factor (TNF), interleukin (IL)1B, and IL10 in individuals with T2D and different degrees of CAN, and correlated these inflammatory mediators with the degree of glycemic control and with a surrogate marker of insulin resistance. Methods: TNF, IL1B, IL10 and LTB4 plasma concentrations were measured in 129 T2D subjects (62% women with [median] age of 63 years, disease duration of 8 years and HbA1c of 7.3%) with or without CAN. The Lipid accumulation product (LAP) index was used as a surrogate marker of insulin resistance. Results TNF and LTB4 concentrations were higher in the group with definitive CAN while IL10 concentration was lower in this group versus those without definitive CAN. After adjustment for confounding variables, only LTB4 concentration remained significantly different. Plasma concentration of LTB4 did not correlate with the degree of glycemic control. After sorting the participants by sex, a borderline weak correlation was found between LTB4 and LAP in women. Conclusion: In the T2D setting, circulating LTB4 concentration seems to be associated with cardiovascular dysautonomia.

548-P: Early Liver Dysfunction Predicts Cardiac Autonomic Neuropathy in Adolescents with Type 1 Diabetes

Diabetes ◽  
2020 ◽  
Vol 69 (Supplement 1) ◽  
pp. 548-P
Author(s):  
VALLIMAYIL VELAYUTHAM ◽  
PAUL Z. BENITEZ-AGUIRRE ◽  
MARIA E. CRAIG ◽  
JANINE CUSUMANO ◽  
GERALD LIEW ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Autonomic Neuropathy ◽  
Liver Dysfunction ◽  
Cardiac Autonomic Neuropathy
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