Higher frequency of cardiovascular autonomic neuropathy in youth with type 2 compared to type 1 diabetes : Role of cardiometabolic risk factors

Journal article


Varley, Benjamin J., Gow, Megan L., Cho, Yoon Hi, Benitez-Aguirre, Paul, Cusumano, Janine, Pryke, Alison, Chan, Albert, Velayutham, Vallimayil, Donaghue, Kim C. and Craig, Maria E.. (2022). Higher frequency of cardiovascular autonomic neuropathy in youth with type 2 compared to type 1 diabetes : Role of cardiometabolic risk factors. Pediatric Diabetes. 23(7), pp. 1073-1079. https://doi.org/10.1111/pedi.13393
AuthorsVarley, Benjamin J., Gow, Megan L., Cho, Yoon Hi, Benitez-Aguirre, Paul, Cusumano, Janine, Pryke, Alison, Chan, Albert, Velayutham, Vallimayil, Donaghue, Kim C. and Craig, Maria E.
Abstract

Objective
Cardiovascular autonomic neuropathy (CAN) is an overlooked but common and serious diabetes complication. We examined CAN in youth with diabetes and associations with cardiovascular risk factors.

Research Design and Methods
This was a prospective cohort of youth aged <20 years with type 2 or type 1 diabetes (n = 66/1153, median age 15.4/16.5 years, duration 1.7/8.0 years), assessed between 2009 and 2020. CAN was defined as ≥2 abnormal heart rate variability measures across time, geometric, and frequency domains. Obesity was defined as BMI ≥ 95th percentile and severe obesity as ≥120% of 95th percentile. Multivariable generalized estimating equations (GEE) were used to examine putative risk factors for CAN, including diabetes type, obesity, and HbA1c.

Results
At most recent assessment, youth with type 2 versus type 1 diabetes had median: HbA1c 7.1% (54 mmol/mol) versus 8.7% (72 mmol/mol) and BMI SDS (2.0 vs. 0.7); frequency of CAN (47% vs. 27%), peripheral nerve abnormality (47% vs. 25%), hypertension (29% vs. 12%), albuminuria (21% vs. 3%), and severe obesity (35% vs. 2%). In multivariable GEE, CAN was associated with type 2 diabetes: Odds Ratio 2.53, 95% CI 1.46, 4.38, p = 0.001, higher BMI SDS: 1.49, 95% CI 1.29, 1.73, p < 0.0001, and obesity: 2.09, 95% CI 1.57, 2.78, p < 0.0001.

Conclusions
Youth with type 2 diabetes have a higher frequency of CAN, peripheral nerve abnormality, hypertension, albuminuria and severe obesity despite shorter diabetes duration and younger age. Our findings highlight the importance of targeting modifiable risk factors to prevent cardiovascular disease in youth with diabetes.

Keywordscardiovascular autonomic neuropathy; cardiovascular disease; heart rate variability; obesity; youth
Year2022
JournalPediatric Diabetes
Journal citation23 (7), pp. 1073-1079
PublisherJohn Wiley & Sons Ltd
ISSN1399-543X
Digital Object Identifier (DOI)https://doi.org/10.1111/pedi.13393
PubMed ID35856852
Scopus EID2-s2.0-85135561366
PubMed Central IDPMC9805172
Open accessPublished as ‘gold’ (paid) open access
Page range1073-1079
FunderResearch Training Program Scholarship (RTP), Australian Government
National Health and Medical Research Council (NHMRC)
Publisher's version
License
File Access Level
Open
Output statusPublished
Publication dates
Online09 Aug 2022
Publication process dates
Accepted12 Jul 2022
Deposited10 Aug 2023
Grant ID1158876
1136735
Permalink -

https://acuresearchbank.acu.edu.au/item/8z7xq/higher-frequency-of-cardiovascular-autonomic-neuropathy-in-youth-with-type-2-compared-to-type-1-diabetes-role-of-cardiometabolic-risk-factors

Download files


Publisher's version
  • 37
    total views
  • 32
    total downloads
  • 1
    views this month
  • 0
    downloads this month
These values are for the period from 19th October 2020, when this repository was created.

Export as

Related outputs

Early life determinants of vascular structure in fetuses, infants, children, and adolescents : A systematic review and meta-analysis
Varley, Benjamin J., Nasir, Reeja F., Skilton, Michael R., Craig, Maria E. and Gow, Megan L.. (2023). Early life determinants of vascular structure in fetuses, infants, children, and adolescents : A systematic review and meta-analysis. Journal of Pediatrics. 252, pp. 101-110. https://doi.org/10.1016/j.jpeds.2022.08.033
Aortic intima media thickness in children and adolescents with type 1 diabetes : A systematic review
Gow, Megan L., Varley, Benjamin J., Nasir, Reeja F., Skilton, Michael R. and Craig, Maria E.. (2022). Aortic intima media thickness in children and adolescents with type 1 diabetes : A systematic review. Pediatric Diabetes. 23(4), pp. 489-498. https://doi.org/10.1111/pedi.13322
Intrauterine exposure to preeclampsia does not impair vascular health in children
Varley, Benjamin, Henry, Amanda, Roberts, Lynne, Davis, Gregory, Skilton, Michael, Craig, Maria and Gow, Megan. (2022). Intrauterine exposure to preeclampsia does not impair vascular health in children. Frontiers in Public Health. 10, p. Article 1071304. https://doi.org/10.3389/fpubh.2022.1071304
Current perspectives on the role of very-low-energy diets in the treatment of obesity and type 2 diabetes in youth
Gow, Megan L., Pham-Short, Anna, Jebeile, Hiba, Varley, Benjamin and Craig, Maria E.. (2021). Current perspectives on the role of very-low-energy diets in the treatment of obesity and type 2 diabetes in youth. Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy. 14, pp. 215-225. https://doi.org/10.2147/DMSO.S238419
Revisiting poststroke upper limb stratification : Resilience in a larger cohort
Varley, Benjamin J., Shiner, Christine T., Johnson, Liam, McNulty, Penelope A. and Thompson Butel, A.. (2021). Revisiting poststroke upper limb stratification : Resilience in a larger cohort. Neurorehabilitation and Neural Repair. 35(3), pp. 280-289. https://doi.org/10.1177/1545968321992048
A low-carbohydrate ketogenic diet reduces body mass without compromising performance in powerlifting and Olympic weightlifting athletes
Greene, David A., Varley, Benjamin J., Hartwig, Timothy B., Chapman, Phillip and Rigney, Michael. (2018). A low-carbohydrate ketogenic diet reduces body mass without compromising performance in powerlifting and Olympic weightlifting athletes. Journal of Strength and Conditioning Research. 32(12), pp. 3373 - 3382. https://doi.org/10.1519/JSC.0000000000002904
Assessment of body composition in junior representative and first grade rugby league players using dual x-ray absorptiometry
David Greene, Benjamin Varley, Craig Duncan and Tim Gabbett. (2017). Assessment of body composition in junior representative and first grade rugby league players using dual x-ray absorptiometry. Science and Medicine in Football. 1(3), pp. 197-202. https://doi.org/10.1080/24733938.2017.1331043