Naslov
Autonomic nervous system function accessed by conventional and spectral analysis might be useful in terms of predicting retinal deterioration in persons with type 1 diabete

Autori
Duvjak, Lea ; Tomić, Martina ; Blaslov, Kristina ; Vučković-Rebrina, Sandra

Izvornik
Diabetes research and clinical practice (0168-8227) 116 (2016); 111-116

Vrsta, podvrsta i kategorija rada
Radovi u časopisima, članak, znanstveni

Ključne riječi
type 1 diabetes mellitus ; cardiac autonomic dysfunction ; hearth rate variability

Sažetak
A risk factor for diabetic retinopathy (DR) development and progression in persons with type 1 diabetes mellitus (T1DM). Methods: The study comprised 154 normoalbuminuric persons with T1DM divided into two groups according to the DR presence: with and without DR. Cardiovascular autonomic functioning was measured at baseline using conventional and spectral analysis. Participants were re- examined for the DR presence 18 months after. Results: The group with DR had longer disease duration compared to the group witout DR (20 vrs 11.5 years, p<0.001), heart rate coefficient of variation (HRV-CV) at rest and during deep breathing were lower in participants with DR (p=0.001 and 0.004), as well did spectral indices of HRV: low frequency (LF) band, high frequency (HF) band (p=0.003 and 0.022) while LF/HF ratio indicating sympathovagal balance was higher (p=0.037). No difference in glycaemic control or blod pressure value were observed. Twenty-one (13.36%) participants developed non proliferative DR or progressed to proliferative DR. Cox proportional regression showed that the 18 months risk from retinal deterioration was reduced by 33.4% by each increase in the HRV-CV of 1%, 12.7% for the same HRV- CV increase during deep breathing while LF band of 1 ms2 results in 8.6% risk reduction. Conclusions: This study provides evidence that DR should not be considered merely a metabolic control manifestation and that HRV-CV as well as spectral indicies of HRV might serve as a practical tool to identify a subgroup of T1DM patients with higher risk of retinal deterioration.

Izvorni jezik
Engleski

Znanstvena područja
Kliničke medicinske znanosti

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