Close relationship between cardiovagal function and sural sensory nerve action potential in type 2 diabetes

Yun Ru Lai; Chih Cheng Huang; Wen Chan Chiu; Rue Tsuan Liu; Nai Wen Tsai; Hung Chen Wang; Wei Che Lin; Ben Chung Cheng; Yu Jih Su; Chih Min Su; Sheng Yuan Hsiao; Pei Wen Wang; Jung Fu Chen; Jih Yang Ko; Cheng Hsien Lu

doi:10.1016/j.clinph.2019.03.036

Close relationship between cardiovagal function and sural sensory nerve action potential in type 2 diabetes

Yun Ru Lai, Chih Cheng Huang, Wen Chan Chiu, Rue Tsuan Liu, Nai Wen Tsai, Hung Chen Wang, Wei Che Lin, Ben Chung Cheng, Yu Jih Su, Chih Min Su, Sheng Yuan Hsiao, Pei Wen Wang, Jung Fu Chen, Jih Yang Ko, Cheng Hsien Lu^*

^*Corresponding author for this work

Research output: Contribution to journal › Journal Article › peer-review

3 Scopus citations

Abstract

Objective: Both diabetic distal symmetrical polyneuropathy (DSPN) and cardiac autonomic neuropathy (CAN) indicate the length-dependent pattern of disease. Decreased parasympathetic activity has been found in the early phase of CAN and sural sensory nerve action potential (SNAP) imply axonal loss in DSPN. Method: All patients with type 2 diabetes underwent cardiovascular autonomic function and nerve conduction studies (NCS). We constructed modified composite autonomic scoring scale (CASS) and composite score of NCS to measure the severity of CAN and DSPN, respectively. Results: Patients with a longer duration of diabetes had a lower heart rate response to deep breathing (HR_DB), Valsalva ratio (VR), and baroreflex sensitivity (BRS), higher CASS, a higher percentage of CAN, lower sural SNAP, higher composite score of NCS, and a higher percentage of DSPN. Multiple linear regression analysis showed that only sural SNAPs were independently associated with mean HR_DB. Conclusion: Sural SNAP was closely correlated with parameters of cardiovagal functions in patients with different durations of diabetes. The percentage and severity of CAN and DSPN increase with longer duration of diabetes. Significance: The independent association of sural sensory nerve action potential amplitude and heart rate response to deep breathing with type 2 diabetes is important because combined testing increases diagnostic sensitivity and specificity.

Original language	English
Pages (from-to)	1160-1165
Number of pages	6
Journal	Clinical Neurophysiology
Volume	130
Issue number	7
DOIs	https://doi.org/10.1016/j.clinph.2019.03.036
State	Published - 07 2019
Externally published	Yes

Bibliographical note

Publisher Copyright:
© 2019 International Federation of Clinical Neurophysiology

Keywords

Cardiac autonomic neuropathy (CAN)
Diabetic distal symmetrical polyneuropathy (DSPN)
Heart rate response to deep breathing (HR_DB)
Sensory nerve action potentials (SNAPs)
Valsalva ratio (VR)

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

Access to Document

10.1016/j.clinph.2019.03.036

Cite this

Lai, Y. R., Huang, C. C., Chiu, W. C., Liu, R. T., Tsai, N. W., Wang, H. C., Lin, W. C., Cheng, B. C., Su, Y. J., Su, C. M., Hsiao, S. Y., Wang, P. W., Chen, J. F., Ko, J. Y., & Lu, C. H. (2019). Close relationship between cardiovagal function and sural sensory nerve action potential in type 2 diabetes. Clinical Neurophysiology, 130(7), 1160-1165. https://doi.org/10.1016/j.clinph.2019.03.036

@article{d50d950f51bc41fbbfa08fa94a474b13,

title = "Close relationship between cardiovagal function and sural sensory nerve action potential in type 2 diabetes",

abstract = "Objective: Both diabetic distal symmetrical polyneuropathy (DSPN) and cardiac autonomic neuropathy (CAN) indicate the length-dependent pattern of disease. Decreased parasympathetic activity has been found in the early phase of CAN and sural sensory nerve action potential (SNAP) imply axonal loss in DSPN. Method: All patients with type 2 diabetes underwent cardiovascular autonomic function and nerve conduction studies (NCS). We constructed modified composite autonomic scoring scale (CASS) and composite score of NCS to measure the severity of CAN and DSPN, respectively. Results: Patients with a longer duration of diabetes had a lower heart rate response to deep breathing (HR_DB), Valsalva ratio (VR), and baroreflex sensitivity (BRS), higher CASS, a higher percentage of CAN, lower sural SNAP, higher composite score of NCS, and a higher percentage of DSPN. Multiple linear regression analysis showed that only sural SNAPs were independently associated with mean HR_DB. Conclusion: Sural SNAP was closely correlated with parameters of cardiovagal functions in patients with different durations of diabetes. The percentage and severity of CAN and DSPN increase with longer duration of diabetes. Significance: The independent association of sural sensory nerve action potential amplitude and heart rate response to deep breathing with type 2 diabetes is important because combined testing increases diagnostic sensitivity and specificity.",

keywords = "Cardiac autonomic neuropathy (CAN), Diabetic distal symmetrical polyneuropathy (DSPN), Heart rate response to deep breathing (HR_DB), Sensory nerve action potentials (SNAPs), Valsalva ratio (VR)",

author = "Lai, {Yun Ru} and Huang, {Chih Cheng} and Chiu, {Wen Chan} and Liu, {Rue Tsuan} and Tsai, {Nai Wen} and Wang, {Hung Chen} and Lin, {Wei Che} and Cheng, {Ben Chung} and Su, {Yu Jih} and Su, {Chih Min} and Hsiao, {Sheng Yuan} and Wang, {Pei Wen} and Chen, {Jung Fu} and Ko, {Jih Yang} and Lu, {Cheng Hsien}",

note = "Publisher Copyright: {\textcopyright} 2019 International Federation of Clinical Neurophysiology",

year = "2019",

month = jul,

doi = "10.1016/j.clinph.2019.03.036",

language = "英语",

volume = "130",

pages = "1160--1165",

journal = "Clinical Neurophysiology",

issn = "1388-2457",

publisher = "Elsevier Ireland Ltd",

number = "7",

}

TY - JOUR

T1 - Close relationship between cardiovagal function and sural sensory nerve action potential in type 2 diabetes

AU - Lai, Yun Ru

AU - Huang, Chih Cheng

AU - Chiu, Wen Chan

AU - Liu, Rue Tsuan

AU - Tsai, Nai Wen

AU - Wang, Hung Chen

AU - Lin, Wei Che

AU - Cheng, Ben Chung

AU - Su, Yu Jih

AU - Su, Chih Min

AU - Hsiao, Sheng Yuan

AU - Wang, Pei Wen

AU - Chen, Jung Fu

AU - Ko, Jih Yang

AU - Lu, Cheng Hsien

PY - 2019/7

Y1 - 2019/7

N2 - Objective: Both diabetic distal symmetrical polyneuropathy (DSPN) and cardiac autonomic neuropathy (CAN) indicate the length-dependent pattern of disease. Decreased parasympathetic activity has been found in the early phase of CAN and sural sensory nerve action potential (SNAP) imply axonal loss in DSPN. Method: All patients with type 2 diabetes underwent cardiovascular autonomic function and nerve conduction studies (NCS). We constructed modified composite autonomic scoring scale (CASS) and composite score of NCS to measure the severity of CAN and DSPN, respectively. Results: Patients with a longer duration of diabetes had a lower heart rate response to deep breathing (HR_DB), Valsalva ratio (VR), and baroreflex sensitivity (BRS), higher CASS, a higher percentage of CAN, lower sural SNAP, higher composite score of NCS, and a higher percentage of DSPN. Multiple linear regression analysis showed that only sural SNAPs were independently associated with mean HR_DB. Conclusion: Sural SNAP was closely correlated with parameters of cardiovagal functions in patients with different durations of diabetes. The percentage and severity of CAN and DSPN increase with longer duration of diabetes. Significance: The independent association of sural sensory nerve action potential amplitude and heart rate response to deep breathing with type 2 diabetes is important because combined testing increases diagnostic sensitivity and specificity.

AB - Objective: Both diabetic distal symmetrical polyneuropathy (DSPN) and cardiac autonomic neuropathy (CAN) indicate the length-dependent pattern of disease. Decreased parasympathetic activity has been found in the early phase of CAN and sural sensory nerve action potential (SNAP) imply axonal loss in DSPN. Method: All patients with type 2 diabetes underwent cardiovascular autonomic function and nerve conduction studies (NCS). We constructed modified composite autonomic scoring scale (CASS) and composite score of NCS to measure the severity of CAN and DSPN, respectively. Results: Patients with a longer duration of diabetes had a lower heart rate response to deep breathing (HR_DB), Valsalva ratio (VR), and baroreflex sensitivity (BRS), higher CASS, a higher percentage of CAN, lower sural SNAP, higher composite score of NCS, and a higher percentage of DSPN. Multiple linear regression analysis showed that only sural SNAPs were independently associated with mean HR_DB. Conclusion: Sural SNAP was closely correlated with parameters of cardiovagal functions in patients with different durations of diabetes. The percentage and severity of CAN and DSPN increase with longer duration of diabetes. Significance: The independent association of sural sensory nerve action potential amplitude and heart rate response to deep breathing with type 2 diabetes is important because combined testing increases diagnostic sensitivity and specificity.

KW - Cardiac autonomic neuropathy (CAN)

KW - Diabetic distal symmetrical polyneuropathy (DSPN)

KW - Heart rate response to deep breathing (HR_DB)

KW - Sensory nerve action potentials (SNAPs)

KW - Valsalva ratio (VR)

UR - http://www.scopus.com/inward/record.url?scp=85065580686&partnerID=8YFLogxK

U2 - 10.1016/j.clinph.2019.03.036

DO - 10.1016/j.clinph.2019.03.036

M3 - 文章

C2 - 31102989

AN - SCOPUS:85065580686

SN - 1388-2457

VL - 130

SP - 1160

EP - 1165

JO - Clinical Neurophysiology

JF - Clinical Neurophysiology

IS - 7

ER -

Close relationship between cardiovagal function and sural sensory nerve action potential in type 2 diabetes

Abstract

Bibliographical note

Keywords

UN SDGs

Access to Document

Other files and links

Fingerprint

Cite this