Relationship between cardiovascular autonomic neuropathy and coronary artery calcification in patients with type 2 diabetes

Endocr J. 2010;57(5):445-54. doi: 10.1507/endocrj.k09e-299. Epub 2010 Feb 26.


To test the hypothesis that cardiovascular autonomic neuropathy (CAN) in Type 2 diabetes is a risk factor of coronary artery calcification (CAC), in this cross-sectional study, 118 patients (60 males, 58 females) with type 2 diabetes mellitus were randomly selected from the diabetes clinic of Kyungpook National University Hospital, Daegu, Korea, between January, 2008 and September, 2008. The subjects, whose mean age was 56.9+/-1.1 years, were tested for CAN by Ewing's method which employs five non-invasive tests of autonomic function. The coronary calcium score (CCS) was determined by Multi Detector-row Computed Tomography (MDCT). Statistical analysis was performed by using SPSS 13.0 (SPSS, Inc., Chicago,-Illinois). CAN was found in 31/118 (26.3%) patients. Compared to the patients without CAN, the patients with CAN were significantly older and had significantly higher triglyceride levels, blood pressure, pulse pressure, fasting c-peptide levels, CAN scores, and log-transformed coronary calcium scores [ln(CCS+1)]. The CAN scores correlated positively with ln(CCS+1) values (r = 0.214; P = 0.028). Multiple regression analysis using ln(CCS+1) as a dependent variable showed that CAN score (beta coefficient 0.623, 95% CI 0.059 approximately 1.188, P = 0.031) associated independently with ln(CCS+1). In conclusion, CAN was associated independently with CAC, which suggests that CAN is a risk factor of coronary atherosclerosis in patients with type 2 diabetes. This may help to explain the excess cardiovascular mortality seen in diabetic patients with CAN.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Calcinosis / diagnostic imaging
  • Calcinosis / epidemiology
  • Calcinosis / etiology*
  • Cardiomyopathies / diagnostic imaging
  • Cardiomyopathies / epidemiology
  • Cardiomyopathies / etiology*
  • Coronary Vessels / pathology*
  • Cross-Sectional Studies
  • Diabetes Mellitus, Type 2 / complications*
  • Diabetes Mellitus, Type 2 / diagnostic imaging
  • Diabetes Mellitus, Type 2 / epidemiology
  • Diabetic Neuropathies / complications*
  • Diabetic Neuropathies / diagnostic imaging
  • Diabetic Neuropathies / epidemiology
  • Female
  • Heart / diagnostic imaging
  • Heart / innervation*
  • Humans
  • Male
  • Middle Aged
  • Prevalence
  • Regression Analysis
  • Risk Factors
  • Tomography, X-Ray Computed / methods