1. Risk of cardiac autonomic neuropathy in latent autoimmune diabetes in adults is similar to type 1 diabetes and lower compared to type 2 diabetes: A cross-sectional study.
- Author
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Maddaloni E, Moretti C, Del Toro R, Sterpetti S, Ievolella MV, Arnesano G, Strollo R, Briganti SI, D'Onofrio L, Pozzilli P, and Buzzetti R
- Subjects
- Adult, Autonomic Nervous System Diseases etiology, Autonomic Nervous System Diseases physiopathology, Cholesterol, HDL metabolism, Cross-Sectional Studies, Diabetes Mellitus, Type 1 complications, Diabetes Mellitus, Type 1 metabolism, Diabetes Mellitus, Type 2 complications, Diabetes Mellitus, Type 2 metabolism, Diabetic Neuropathies etiology, Diabetic Neuropathies physiopathology, Female, Humans, Hypertension epidemiology, Hypotension, Orthostatic etiology, Hypotension, Orthostatic physiopathology, Latent Autoimmune Diabetes in Adults complications, Latent Autoimmune Diabetes in Adults metabolism, Logistic Models, Male, Middle Aged, Odds Ratio, Risk Factors, Smoking epidemiology, Autonomic Nervous System Diseases epidemiology, Diabetes Mellitus, Type 1 epidemiology, Diabetes Mellitus, Type 2 epidemiology, Diabetic Neuropathies epidemiology, Heart Rate physiology, Latent Autoimmune Diabetes in Adults epidemiology
- Abstract
Aims: Microvascular complications' risk differs between people with latent autoimmune diabetes in adults (LADA) and people with type 2 diabetes. We aimed to investigate whether the prevalence of cardiac autonomic neuropathy, a life-threatening complication of diabetes, also varies depending on diabetes type., Methods: In this cross-sectional study, 43 adults with LADA, 80 with type 1 diabetes and 61 with type 2 diabetes were screened for cardiac autonomic neuropathy with recommended tests. Logistic regression models were used to test differences between diabetes types adjusting for confounders., Results: Cardiac autonomic neuropathy was diagnosed in 17 (40%) participants with LADA, 21 (26%) participants with type 1 diabetes and 39 (64%) participants with type 2 diabetes (p < 0.001). The odds ratio (OR) for cardiac autonomic neuropathy in type 1 diabetes and in type 2 diabetes compared to LADA were 0.54 (95% CI: 0.25-1.20, p-value: 0.13) and 2.71 (95% CI: 1.21-6.06, p-value 0.015) respectively. Smoking (
adj OR 3.09, 95% CI: 1.40-6.82, p-value: 0.005), HDL cholesterol (adj OR 0.29, 95% CI: 0.09-0.93, p-value: 0.037) and hypertension (adj OR 2.11, 95% CI: 1.05-4.24, p-value: 0.037) were independent modifiable risk factors for cardiac autonomic neuropathy. Differences among diabetes types did not change after correction for confounders., Conclusions: This is the first study offering a comparative evaluation of cardiac autonomic neuropathy among LADA, type 1 and type 2 diabetes, showing a lower risk of cardiac autonomic neuropathy in LADA compared to type 2 diabetes and similar compared to type 1 diabetes. This disparity was not due to differences in age, metabolic control or cardiovascular risk factors., (© 2020 Diabetes UK.)- Published
- 2021
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