Autoantibodies to Autonomic Nerves Associated With Cardiac and Peripheral Autonomic Neuropathy
| العنوان: | Autoantibodies to Autonomic Nerves Associated With Cardiac and Peripheral Autonomic Neuropathy |
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| المؤلفون: | Göran Sundkvist, Mark Peakman, Niels Ejskjaer, Viktoria Granberg |
| المصدر: | Diabetes Care. 28:1959-1964 |
| بيانات النشر: | American Diabetes Association, 2005. |
| سنة النشر: | 2005 |
| مصطلحات موضوعية: | Adult, medicine.medical_specialty, Time Factors, Adolescent, Endocrinology, Diabetes and Metabolism, Blood Pressure, Diabetic Neuropathies, Heart Conduction System, Internal medicine, Diabetes mellitus, Internal Medicine, medicine, Albuminuria, Humans, Peripheral Nerves, Autoantibodies, Glycated Hemoglobin, Advanced and Specialized Nursing, Diabetic Retinopathy, Autonomic nerve, business.industry, Nervous tissue, medicine.disease, Surgery, Vagus nerve, Autonomic nervous system, Diabetes Mellitus, Type 1, Blood pressure, Peripheral neuropathy, medicine.anatomical_structure, Cardiology, medicine.symptom, business, Vasoconstriction, Follow-Up Studies |
| الوصف: | OBJECTIVE—This study examines whether autonomic nerve autoantibodies (ANabs) are associated with development of autonomic neuropathy using a prospective study design. RESEARCH DESIGN AND METHODS—A group of type 1 diabetic patients were followed prospectively with regard to autonomic nerve function on four occasions. At the third examination, 41 patients were tested for ANabs (complement-fixing autoantibodies to the sympathetic ganglion, vagus nerve, and adrenal medulla), and the results were related to cardiac autonomic nerve function (heart rate variation during deep breathing [expiration/inspiration ratio] and heart-rate reaction to tilt [acceleration and brake index]) and to peripheral sympathetic nerve function (vasoconstriction after indirect cooling [vasoconstriction index]). RESULTS—ANabs were detected in 23 of 41 (56%) patients at the third examination. Compared with patients without ANabs (ANabs−), patients with ANabs (ANabs+) showed significantly higher frequencies of at least one abnormal cardiac autonomic nerve function test at the third examination (17 of 23 [74%] vs. 7 of 18 [39%]; P = 0.03) and fourth examination (15 of 21 [71%] vs. 4 of 16 [25%]; P < 0.01). In contrast, there was no similar difference at the first or second examination. The relative risk for ANabs+ patients to develop cardiac autonomic neuropathy at follow-up was 7.5 (95% CI 1.72–32.80). The vasoconstriction index was more abnormal in ANabs+ than in ANabs− patients at the fourth examination (median 1.40 [interquartile range 1.58] vs. 0.35 [2.05]; P = 0.01). CONCLUSIONS—ANabs were associated with future development of cardiac and peripheral autonomic neuropathy in diabetic patients, implying an etiological relationship between nervous tissue autoimmunity and these diabetes complications. |
| تدمد: | 1935-5548 0149-5992 |
| الوصول الحر: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::f8e90827348fd6394d1ed32c953d2675Test https://doi.org/10.2337/diacare.28.8.1959Test |
| حقوق: | OPEN |
| رقم الانضمام: | edsair.doi.dedup.....f8e90827348fd6394d1ed32c953d2675 |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 19355548 01495992 |
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