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Relationship between metabolism, autonomic neuropathy and vascular disease in patients with type 1 and 2 diabetes mellitus
Malá, Šárka ; Keil, Radan (advisor) ; Lhotská, Lenka (referee) ; Krčma, Michal (referee)
The study aims to evaluate the relationship between cardiac autonomic neuropathy (CAN) and intima-media thickness (IMT) of carotid arteries in patients with diabetes mellitus. Individuals with type 1 and type 2 diabetes mellitus were included, with non-diabetic controls. Medical history, anthropometric and biochemical data, IMT measurements and heart-rate- variability (HRV) analysis in all probands were evaluated. A model of semiparametric logistic regression from the class of generalized additive models was used for statistical analysis. CAN demonstrated significant increasing effects on IMT values in type 1 diabetes patients. The model showed greater IMT values in type 2 diabetes mellitus patients suffering from CAN, but the effect of CAN was not significant. The interaction of CAN and diabetes mellitus effects on IMT values was proven. The interactions of CAN and age, CAN and BMI were also demonstrated. In CAN positive groups, IMT values increased more quickly with greater age and BMI. The results suggest that CAN may play a role in the pathogenesis of atherosclerosis in patients with diabetes mellitus. The secondary objective was to evaluate the usage of the recurrence quantification analysis of HRV in CAN diagnostics. Between the group of healthy individuals and patients with vasovagal...
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