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. 2009 Dec 7;14 Suppl 4(Suppl 4):45-8.
doi: 10.1186/2047-783x-14-s4-45.

Cough reflex sensitivity in adolescents with diabetic autonomic neuropathy

M Ciljakova  1 , J Vojtkova, P Durdik, T Turcan, M Petrikova, Z Michnova, P Banovcin
Affiliations

Cough reflex sensitivity in adolescents with diabetic autonomic neuropathy

M Ciljakova et al. Eur J Med Res. .

Abstract

Objective: Diabetic autonomic neuropathy (DAN) is one of the chronic complications of diabetes mellitus which can involve one or more organ systems. DAN without apparent symptoms is more often in childhood and adolescence. While heart rate variability (HRV) and Ewing's battery of cardiovascular tests are regarded as a gold standard for the diagnosis of DAN, the examination of cough reflex sensitivity (CRS) is another possibility. The aim of this study was to compare HRV and CRS in children with diabetes mellitus.

Material and methods: Sixty one patients (37 girls, 24 boys) aged 15-19 suffering from diabetes mellitus type 1 completed the study. Based on HRV, patients were divided into 2 groups - with DAN (n=25) and without DAN (n=32), 4 patients were excluded because of ambiguous results. CRS was studied in each patient by inhalation of gradually increasing concentration of capsaicin.

Results: Subjects with DAN required a significantly higher concentration of capsaicin needed to evoke 2 coughs (median 625 micromol/l, IQR 68.4-625.0 micromol/l vs. median 29.3 micromol/l, IQR 9.8-156.3 micromol/l, P<0.001) and 5 coughs (median 2500.0 micromol/l, IQR 1250.0-2500.0 micromol/l vs. median 312.5 micromol/l, IQR 117.2-625.0 micromol/l, P<0.001) compared with those without DAN. Moreover, a strong negative correlation between HRV and CRS was established.

Conclusion: Diabetes mellitus lowers the cough response. Cough reflex sensitivity appears to be another sensitive method for the evaluation of DAN in diabetes.

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Figures

Figure 1
Figure 1
Comparison of the C2 and C5 parameters describing cough reflex sensitivity between the patients with and without diabetic autonomic neuropathy (DAN+ and DAN-) (P < 0.001).
Figure 2
Figure 2
Correlations between the CVrr and I/E parameters of deep breathing test, describing heart rate variability, and C2, describing cough reflex sensitivity.
Figure 3
Figure 3
Correlations between the CVrr and I/E parameters of deep breathing test, describing heart rate variability, and C5, describing cough reflex sensitivity.
See this image and copyright information in PMC

References

    1. Verrotti A, Loiacono G, Mohn A, Chiarelli F. New insights in diabetic autonomic neuropathy in children and adolescents. Eur J Endocrinol. 2009. in press . - PubMed
    1. Javorka M, Javorková J, Tonhajzerova I, Calkovská A, Javorka K. Heart rate variability in young patients with diabetes mellitus and healthy subjects explored by Poincaré and sequence plots. Clin Physiol Funct Imaging. 2005;25(2):119–27. doi: 10.1111/j.1475-097X.2004.00601.x. - DOI - PubMed
    1. Benbassat CA, Stern E, Kramer M, Lebzelter J, Blum I. Pulmonary function in patients with diabetes mellitus. Am J Med Sci. 2001;322:127–32. doi: 10.1097/00000441-200109000-00003. - DOI - PubMed
    1. Tonhajzerová I, Javorka K, Javorka M, Petrácková M. Cardiovascular autonomic nervous system tests: reference values in young people (15-19 years) and influence of age and gender. Clin Physiol Funct Imaging. 2002;22(6):398–403. doi: 10.1046/j.1475-097X.2002.00449.x. - DOI - PubMed
    1. Chang AB, Phelan PD, Roberts RGD, Robdertson CF. Capsaicin cough receptor sensitivity test in children. Eur Respir J. 1996;9:2220–23. doi: 10.1183/09031936.96.09112220. - DOI - PubMed

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