Cardiovascular autonomic neuropathy is associated with microalbuminuria in older patients with type 2 diabetes.

Full Abstract

OBJECTIVE: Cardiovascular autonomic neuropathy is associated with microalbuminuria in young and middle-aged patients with type 2 diabetes. We examined this relationship and the potential mediating role of blood pressure in older patients. RESEARCH DESIGN AND METHODS: At least two of three components of cardiovascular autonomic testing were completed by 132 patients (mean age 70 +/- 5.6 years). Relative rankings on each of the components were averaged to create a summary heart rate variability (HRV) measure. The urine microalbumin-to-creatinine ratio (milligrams albumin/grams creatinine) was calculated. Blood pressure was measured at rest and by 24-h ambulatory recording. RESULTS: Urine microalbumin-to-creatinine ratio was higher in those with lower HRV (mean urine microalbumin-to-creatinine ratio 28, 56, and 191 mg/g from the highest to lowest tertile of HRV; P < 0.0001). Resting and ambulatory blood pressure levels were negatively correlated with HRV and positively correlated with urine microalbumin-to-creatinine ratio. In multivariate analysis adjusting for age, duration of diabetes, HbA(1c), and HDL cholesterol, HRV and blood pressure were both independently associated with urine microalbumin-to-creatinine ratio, with no evidence that either mediates the effect of the other. CONCLUSIONS: Cardiovascular autonomic neuropathy and blood pressure are independently associated with microalbuminuria in older patients with type 2 diabetes.

Author information

Author/s: Moran, Andrew (A); Palmas, Walter (W); Field, Lesley (L); Bhattarai, Jyoti (J); Schwartz, Joseph E (JE); Weinstock, Ruth S (RS); Shea, Steven (S);

Affiliation: Division of General Medicine, Department of Medicine, Columbia University College of Physicians & Surgeons, New York, New York 10032. USA.

Grants: 95-C-90998/2-01 (Agency:PHS HHS)

Journal and publication information

Publication Type: Journal Article; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S.

Journal: Diabetes care (Diabetes Care), published in United States. (Language: eng)

Reference: 2004-Apr; vol 27 (issue 4) : pp 972-7

Dates: Created 2004/03/29; Completed 2004/10/14; Revised 2007/11/14;

PMID: 15047658, status: MEDLINE (last retrieval date: 2/18/2009, IMS Date: )

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