Relationship between cardiovascular autonomic neuropathy and coronary artery calcification in patients with type 2 diabetes

Seong-Su Moon; Yeon-Kyung Choi; Hyun-Ae Seo; Jae-Han Jeon; Jung-Eun Lee; Ji-Yun Jeong; Ju-Young Lee; Duk-Hee Lee; Wan-Ju Park; Jung-Guk Kim; Bo-Wan Kim; In-Kyu Lee

doi:10.1507/endocrj.K09E-299

ORIGINALS

Relationship between cardiovascular autonomic neuropathy and coronary artery calcification in patients with type 2 diabetes

Seong-Su Moon ^†, Yeon-Kyung Choi ^†, Hyun-Ae Seo ^†, Jae-Han Jeon ^†, Jung-Eun Lee ^†, Ji-Yun Jeong ^†, Ju-Young Lee ^†, Duk-Hee Lee ^†, Wan-Ju Park ^†, Jung-Guk Kim ^†, Bo-Wan Kim ^†, In-Kyu Lee ^†

Author information

Seong-Su Moon ^†
Department of Endocrinology and Metabolism, Kyungpook National University Hospital, Daegu, Korea
Yeon-Kyung Choi ^†
Department of Endocrinology and Metabolism, Kyungpook National University Hospital, Daegu, Korea
Hyun-Ae Seo ^†
Department of Endocrinology and Metabolism, Kyungpook National University Hospital, Daegu, Korea
Jae-Han Jeon ^†
Department of Endocrinology and Metabolism, Kyungpook National University Hospital, Daegu, Korea
Jung-Eun Lee ^†
Department of Endocrinology and Metabolism, Kyungpook National University Hospital, Daegu, Korea
Ji-Yun Jeong ^†
Department of Endocrinology and Metabolism, Kyungpook National University Hospital, Daegu, Korea
Ju-Young Lee ^†
Department of Endocrinology and Metabolism, Kyungpook National University Hospital, Daegu, Korea
Duk-Hee Lee ^†
Department of Preventive Medicine and Health Promotion Research Center, School of Medicine, Kyungpook National University, Daegu, Korea
Wan-Ju Park ^†
College of Nursing and Research Institute of Nursing Science, Kyungpook National University, Daegu, Korea
Jung-Guk Kim ^†
Department of Endocrinology and Metabolism, Kyungpook National University Hospital, Daegu, Korea
Bo-Wan Kim ^†
Department of Endocrinology and Metabolism, Kyungpook National University Hospital, Daegu, Korea
In-Kyu Lee ^†
Department of Endocrinology and Metabolism, Kyungpook National University Hospital, Daegu, Korea
WCU project “Development for new drug-target in complication of metabolic syndrome”, Kyungpook National University School of Medicine, Daegu, Korea
Research Institure for Aging and Metabolism, Kyungpook National University, Daegu, Korea
Author contributions

†These authors contributed equally: Seong-Su Moon, Yeon-Kyung Choi, Hyun-Ae Seo, Jae-Han Jeon, Jung-Eun Lee, Ji-Yun Jeong, Ju-Young Lee, Duk-Hee Lee, Wan-Ju Park, Jung-Guk Kim, Bo-Wan Kim, In-Kyu Lee

Keywords: Cardiovascular autonomic neuropathy, Coronary calcium score, Type 2 diabetes, Coronary artery calcification

JOURNAL FREE ACCESS

2010 Volume 57 Issue 5 Pages 445-454

DOI https://doi.org/10.1507/endocrj.K09E-299

View "Advance Publication" version (February 26, 2010).

Details

Abstract

To test the hypothesis that cardiovascular autonomic neuropathy (CAN) in Type 2 diabetes is a risk factor of coronary artery calcification (CAC), in this cross-sectional study, 118 patients (60 males, 58 females) with type 2 diabetes mellitus were randomly selected from the diabetes clinic of Kyungpook National University Hospital, Daegu, Korea, between January, 2008 and September, 2008. The subjects, whose mean age was 56.9±1.1 years, were tested for CAN by Ewing’s method which employs five non-invasive tests of autonomic function. The coronary calcium score (CCS) was determined by Multi Detector-row Computed Tomography (MDCT). Statistical analysis was performed by using SPSS 13.0 (SPSS, Inc., Chicago,-Illinois). CAN was found in 31/118 (26.3%) patients. Compared to the patients without CAN, the patients with CAN were significantly older and had significantly higher triglyceride levels, blood pressure, pulse pressure, fasting c-peptide levels, CAN scores, and log-transformed coronary calcium scores [ln(CCS+1)]. The CAN scores correlated positively with ln(CCS+1) values (r = 0.214; P = 0.028). Multiple regression analysis using ln(CCS+1) as a dependent variable showed that CAN score (β coefficient 0.623, 95% CI 0.059~1.188, P = 0.031) associated independently with ln(CCS+1). In conclusion, CAN was associated independently with CAC, which suggests that CAN is a risk factor of coronary atherosclerosis in patients with type 2 diabetes. This may help to explain the excess cardiovascular mortality seen in diabetic patients with CAN.

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