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. 2023 Jan 12:16:1107752.
doi: 10.3389/fnins.2022.1107752. eCollection 2022.

Limited evidence for sympathetic neural overactivation in older patients with type 2 diabetes mellitus

Karsten Heusser  1 , Jens Tank  1 , André Diedrich  2   3 , Annelie Fischer  4 , Tim Heise  4 , Jens Jordan  1   5
Affiliations

Limited evidence for sympathetic neural overactivation in older patients with type 2 diabetes mellitus

Karsten Heusser et al. Front Neurosci. .

Abstract

Introduction: Mechanistic studies suggested that excess sympathetic activity promotes arterial hypertension while worsening insulin sensitivity. Older patients with type 2 diabetes are at particularly high cardiovascular and metabolic risk. However, data on sympathetic activity in this population is scarce.

Methods: We studied 61 patients with type 2 diabetes mellitus (22 women, 60.9 ± 1.4 years; 39 men, 60.9 ± 1.4 years). They had to have diabetes for at least 2 years, a hemoglobin A1c of 6.5-10%, a body-mass-index of 20-40 kg/m2, and had to be treated with stable doses of metformin only. We recorded ECG, finger and brachial blood pressure, and muscle sympathetic nerve activity (MSNA).

Results: MSNA was 37.5 ± 2.5 bursts/min in women and 39.0 ± 2.0 bursts/min in men (p = 0.55). MSNA expressed as burst incidence was 52.7 ± 2.0 bursts/100 beats in women and 59.2 ± 3.1 bursts/100 beats in men (p = 0.21). Five out of 39 men (12.8%) and two out of 22 women (9.1%) exhibited resting MSNA measurements above the 95th percentile for sex and age. In the pooled analysis, MSNA was not significantly correlated with systolic blood pressure, diastolic blood pressure, body mass index, waist circumference, body composition, or HbA1c (r 2 < 0.02, p > 0.26 for all).

Discussion: We conclude that relatively few older patients with type 2 diabetes mellitus exhibit increased MSNA. The large interindividual variability in MSNA cannot be explained by gender, blood pressure, body mass index, or glycemic control.

Keywords: autonomic nervous system; blood pressure; microneurography; sympathetic activity; type 2 diabetes mellitus.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

FIGURE 1
FIGURE 1
Muscle sympathetic nerve activity (MSNA) over age in men with type 2 diabetes mellitus. Dots indicate individual patients. The dashed lines indicate the 5th and the 95th percentile of MSNA in different age groups from a previous study in healthy persons (Keir et al., 2020).
FIGURE 2
FIGURE 2
Muscle sympathetic nerve activity (MSNA) over age in women with type 2 diabetes mellitus. Dots indicate individual patients. The dashed lines indicate the 5th and the 95th percentile of MSNA in different age groups from a previous study in healthy persons (Keir et al., 2020).
FIGURE 3
FIGURE 3
Correlation heat map showing the relationship between clinical characteristics and muscle sympathetic nerve activity expressed as burst incidence (MSNA_I). The numbers denote uncorrected p-values for correlations between measurements. R-values are color coded as shown in the scale on the right. WSTCIR, waist circumference; SYSBP, systolic blood pressure; MAP, mean arterial pressure; LBM, lean body mass; HR, heart rate; HBA1C, hemoglobin A1C; DiabDuration, duration of diabetes mellitus; DIABP, diastolic blood pressure; BODYFATM, body fat mass; BMI, body mass index.
See this image and copyright information in PMC

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