Association of Different Types of Diabetic Autonomic Neuropathy With Left Ventricular Diastolic Dysfunction in Patients With Type 2 Diabetes: A Cross‐Sectional Study

ABSTRACT Background To investigate the association between different categories of diabetic autonomic neuropathy (DAN) and left ventricular diastolic dysfunction (LVDD) in patients with type 2 diabetes mellitus (T2DM). Methods We conducted a cross‐sectional study of 3440 participants with T2DM recru...

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Main Authors: Ruixue Feng, Donge Yan, Mingxin Bai, Xingwu Ran, Dawei Chen, Chun Wang, Lihong Chen, Shuang Lin, Sen He, Yan Liu, Murong Wu, Zhiyi Lei, Yun Gao
Format: Article
Language:English
Published: Wiley 2025-07-01
Series:Journal of Diabetes
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Online Access:https://doi.org/10.1111/1753-0407.70124
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author Ruixue Feng
Donge Yan
Mingxin Bai
Xingwu Ran
Dawei Chen
Chun Wang
Lihong Chen
Shuang Lin
Sen He
Yan Liu
Murong Wu
Zhiyi Lei
Yun Gao
author_facet Ruixue Feng
Donge Yan
Mingxin Bai
Xingwu Ran
Dawei Chen
Chun Wang
Lihong Chen
Shuang Lin
Sen He
Yan Liu
Murong Wu
Zhiyi Lei
Yun Gao
author_sort Ruixue Feng
collection DOAJ
description ABSTRACT Background To investigate the association between different categories of diabetic autonomic neuropathy (DAN) and left ventricular diastolic dysfunction (LVDD) in patients with type 2 diabetes mellitus (T2DM). Methods We conducted a cross‐sectional study of 3440 participants with T2DM recruited in Diabetic Foot Care Center of West China Hospital, Sichuan University from January 2016 to February 2024. LVDD was assessed via echocardiography, defined as an average E/e′ ratio > 14. Twenty‐four hour Holter ECG, postvoid residual volume (PVR) examinations, and gastric emptying scintigraphy were employed to evaluate cardiac autonomic dysfunction, diabetic neurogenic bladder (DNB), and diabetic gastrointestinal autonomic neuropathy (DGAN), respectively. Logistic regression and propensity score matching (PSM) analyses were employed to examine the associations. Results Severe cardiac autonomic dysfunction (SDNN < 50 ms) was independently associated with LVDD, with odds ratios (OR) 1.731 (95% CI: 1.103–2.719, p = 0,018) after adjustment for potential confounding factors. LVDD tended to be independently associated with DNB (OR 1.356; 95% CI [0.992, 1.856]; p = 0.056). PSM analysis further validated the independent associations of SDNN < 50 ms (OR 1.587, 95% CI 1.028, 2.450, p = 0.037) and DNB (OR 1.454, 95% CI 1.011, 2.090, p = 0.043). However, DGAN was not independently associated with LVDD. Additionally, women had a higher risk of LVDD compared to men (OR 1.995, 95% CI 1.379, 2.885, p < 0.001). Conclusions Severe (SDNN < 50 ms), rather than mild–moderate, cardiac autonomic dysfunction, and DNB are independently associated with LVDD in individuals with T2DM. Additionally, women have a higher risk of LVDD than men.
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spelling doaj-art-7cf084ae19e14c8eaf68b0ab6639cc872025-08-20T03:35:16ZengWileyJournal of Diabetes1753-03931753-04072025-07-01177n/an/a10.1111/1753-0407.70124Association of Different Types of Diabetic Autonomic Neuropathy With Left Ventricular Diastolic Dysfunction in Patients With Type 2 Diabetes: A Cross‐Sectional StudyRuixue Feng0Donge Yan1Mingxin Bai2Xingwu Ran3Dawei Chen4Chun Wang5Lihong Chen6Shuang Lin7Sen He8Yan Liu9Murong Wu10Zhiyi Lei11Yun Gao12Diabetic Foot Care Center, Department of Endocrinology and Metabolism West China Hospital, Sichuan University Chengdu ChinaDepartment of Cardiology West China Hospital, Sichuan University Chengdu ChinaDiabetic Foot Care Center, Department of Endocrinology and Metabolism West China Hospital, Sichuan University Chengdu ChinaDiabetic Foot Care Center, Department of Endocrinology and Metabolism West China Hospital, Sichuan University Chengdu ChinaDiabetic Foot Care Center, Department of Endocrinology and Metabolism West China Hospital, Sichuan University Chengdu ChinaDiabetic Foot Care Center, Department of Endocrinology and Metabolism West China Hospital, Sichuan University Chengdu ChinaDiabetic Foot Care Center, Department of Endocrinology and Metabolism West China Hospital, Sichuan University Chengdu ChinaDiabetic Foot Care Center, Department of Endocrinology and Metabolism West China Hospital, Sichuan University Chengdu ChinaDepartment of Cardiology West China Hospital, Sichuan University Chengdu ChinaDepartment of Endocrinology Chengdu Eighth People's Hospital Chengdu ChinaDiabetic Foot Care Center, Department of Endocrinology and Metabolism West China Hospital, Sichuan University Chengdu ChinaWest China Medical School Sichuan University Chengdu ChinaDiabetic Foot Care Center, Department of Endocrinology and Metabolism West China Hospital, Sichuan University Chengdu ChinaABSTRACT Background To investigate the association between different categories of diabetic autonomic neuropathy (DAN) and left ventricular diastolic dysfunction (LVDD) in patients with type 2 diabetes mellitus (T2DM). Methods We conducted a cross‐sectional study of 3440 participants with T2DM recruited in Diabetic Foot Care Center of West China Hospital, Sichuan University from January 2016 to February 2024. LVDD was assessed via echocardiography, defined as an average E/e′ ratio > 14. Twenty‐four hour Holter ECG, postvoid residual volume (PVR) examinations, and gastric emptying scintigraphy were employed to evaluate cardiac autonomic dysfunction, diabetic neurogenic bladder (DNB), and diabetic gastrointestinal autonomic neuropathy (DGAN), respectively. Logistic regression and propensity score matching (PSM) analyses were employed to examine the associations. Results Severe cardiac autonomic dysfunction (SDNN < 50 ms) was independently associated with LVDD, with odds ratios (OR) 1.731 (95% CI: 1.103–2.719, p = 0,018) after adjustment for potential confounding factors. LVDD tended to be independently associated with DNB (OR 1.356; 95% CI [0.992, 1.856]; p = 0.056). PSM analysis further validated the independent associations of SDNN < 50 ms (OR 1.587, 95% CI 1.028, 2.450, p = 0.037) and DNB (OR 1.454, 95% CI 1.011, 2.090, p = 0.043). However, DGAN was not independently associated with LVDD. Additionally, women had a higher risk of LVDD compared to men (OR 1.995, 95% CI 1.379, 2.885, p < 0.001). Conclusions Severe (SDNN < 50 ms), rather than mild–moderate, cardiac autonomic dysfunction, and DNB are independently associated with LVDD in individuals with T2DM. Additionally, women have a higher risk of LVDD than men.https://doi.org/10.1111/1753-0407.70124cardiac autonomic dysfunctiondiabetic neurogenic bladdergastrointestinal autonomic neuropathyleft ventricular diastolic dysfunctiontype 2 diabetes mellitus
spellingShingle Ruixue Feng
Donge Yan
Mingxin Bai
Xingwu Ran
Dawei Chen
Chun Wang
Lihong Chen
Shuang Lin
Sen He
Yan Liu
Murong Wu
Zhiyi Lei
Yun Gao
Association of Different Types of Diabetic Autonomic Neuropathy With Left Ventricular Diastolic Dysfunction in Patients With Type 2 Diabetes: A Cross‐Sectional Study
Journal of Diabetes
cardiac autonomic dysfunction
diabetic neurogenic bladder
gastrointestinal autonomic neuropathy
left ventricular diastolic dysfunction
type 2 diabetes mellitus
title Association of Different Types of Diabetic Autonomic Neuropathy With Left Ventricular Diastolic Dysfunction in Patients With Type 2 Diabetes: A Cross‐Sectional Study
title_full Association of Different Types of Diabetic Autonomic Neuropathy With Left Ventricular Diastolic Dysfunction in Patients With Type 2 Diabetes: A Cross‐Sectional Study
title_fullStr Association of Different Types of Diabetic Autonomic Neuropathy With Left Ventricular Diastolic Dysfunction in Patients With Type 2 Diabetes: A Cross‐Sectional Study
title_full_unstemmed Association of Different Types of Diabetic Autonomic Neuropathy With Left Ventricular Diastolic Dysfunction in Patients With Type 2 Diabetes: A Cross‐Sectional Study
title_short Association of Different Types of Diabetic Autonomic Neuropathy With Left Ventricular Diastolic Dysfunction in Patients With Type 2 Diabetes: A Cross‐Sectional Study
title_sort association of different types of diabetic autonomic neuropathy with left ventricular diastolic dysfunction in patients with type 2 diabetes a cross sectional study
topic cardiac autonomic dysfunction
diabetic neurogenic bladder
gastrointestinal autonomic neuropathy
left ventricular diastolic dysfunction
type 2 diabetes mellitus
url https://doi.org/10.1111/1753-0407.70124
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