Links between metabolic syndrome and cardiovascular autonomic dysfunction

Abstract

Background: Type 2 diabetes (T2D) might occur within metabolic syndrome (MbS). One of the complications of T2D is an impaired (imp) cardiovascular autonomic function (CAF).

Aims: In subjects with T2D and age ≤ 55 years, the prevalence of impCAF and its relationship with BMI, waist, HbA(1c) values, MbS, hypertension, and family history of T2D and/or hypertension were analysed.

Methods: 180 subjects consecutively undergoing a day hospital for T2D were studied. The IDF criteria were used to diagnose MbS. To detect impCAF, 5 tests for the evaluation of CAF were performed with Cardionomic (Meteda, Italy). Univariate and multivariate analyses were performed.

Results: The prevalence of impCAF and MbS were 33.9% and 67.8%, respectively. Among diabetics with impCAF, 86.9% had MbS. ImpCAF was significantly associated with MbS, overweight, and HbA(1c) > 7%. Both logistic (P = 0.0009) and Poisson (P = 0.0113) models showed a positive association between impCAF and MbS. The degree of ImpCAF showed a positive linear correlation with BMI and HbA(1c) values.

Conclusions: The study demonstrates that glycaemic control and overweight influence CAF and that T2D + MbS is more strongly associated with impCAF than isolated T2D. We suggest that MbS not only increases the cardiovascular risk of relatively young subjects with T2D but is also associated with impCAF.

Figure 1

Distribution of different scores of impaired CAF in the cohort.

Figure 2

Distribution of BMI classes in the cohort.

Figure 3

Prevalence of metabolic syndrome in the cohort in the presence or in the absence of impaired CAF. Abbreviations: CAF+, presence of impaired CAF; MbS+, presence of Metabolic syndrome; MbS−, absence of metabolic syndrome. Notes. Sixty patients out of 180 had an impaired CAF.

Figure 4

Distribution of different components of the metabolic syndrome in the female cohort in the presence or in the absence of impaired CAF. Abbreviations: CAF+: presence of impaired CAF; CAF−: absence of impaired CAF.

Figure 5

Distribution of different components of the metabolic syndrome in the male cohort in the presence or in the absence of impaired CAF. Abbreviations: CAF+: presence of impaired CAF; CAF−: absence of impaired CAF.