Diabetic retinopathy is associated with early autonomic dysfunction assessed by exercise-related heart rate changes

dc.creatorKramer, Caroline Kaercher
dc.creatorLeitão, Cristiane Bauermann
dc.creatorAzevedo, Mirela Jobim de
dc.creatorValiatti, Fabiana Borba
dc.creatorRodrigues, Ticiana da Costa
dc.creatorCanani, Luis Henrique Santos
dc.creatorGross, Jorge Luiz
dc.date2010-04-24T04:15:54Z
dc.date2008
dc.identifier0100-879X
dc.identifierhttp://hdl.handle.net/10183/21234
dc.identifier000708040
dc.descriptionDiabetic retinopathy has been associated with cardiac autonomic dysfunction in both type 1 and type 2 diabetes mellitus (DM) patients. Heart rate (HR) changes during exercise testing indicate early alterations in autonomous tonus. The aim of the present study was to investigate the association of diabetic retinopathy with exercise-related HR changes. A cross-sectional study was performed on 72 type 2 and 40 type 1 DM patients. Autonomic dysfunction was assessed by exercise-related HR changes (Bruce protocol). The maximum HR increase, defined as the difference between the peak exercise rate and the resting rate at baseline, and HR recovery, defined as the reduction in HR from the peak exercise to the HR at 1, 2, and 4 min after the cessation of the exercise, were determined. In type 2 DM patients, lower maximum HR increase (OR = 1.62, 95%CI = 1.03-2.54; P = 0.036), lower HR recovery at 2 (OR = 2.04, 95%CI = 1.16-3.57; P = 0.012) and 4 min (OR = 2.67, 95%CI = 1.37-5.20; P = 0.004) were associated with diabetic retinopathy, adjusted for confounding factors. In type 1 DM, the absence of an increase in HR at intervals of 10 bpm each during exercise added 100% to the odds for diabetic retinopathy (OR = 2.01, 95%CI = 1.1-3.69; P = 0.02) when adjusted for DM duration, A1c test and diastolic blood pressure. In conclusion, early autonomic dysfunction was associated with diabetic retinopathy. The recognition of HR changes during exercise can be used to identify a high-risk group for diabetic retinopathy.
dc.formatapplication/pdf
dc.languageeng
dc.relationBrazilian journal of medical and biological research = Revista brasileira de pesquisas médicas e biológicas. Ribeirão Preto. Vol. 41, n. 12 (dez. 2008), p. 1110-1115
dc.rightsOpen Access
dc.subjectDiabetes mellitus tipo 2
dc.subjectDiabetes mellitus tipo 1
dc.subjectFrequência cardíaca
dc.subjectRetinopatia diabética
dc.subjectType 2 diabetes mellitus
dc.subjectType 1 diabetes mellitus
dc.subjectHeart rate changes
dc.subjectDiabetic retinopathy
dc.titleDiabetic retinopathy is associated with early autonomic dysfunction assessed by exercise-related heart rate changes
dc.typeArtigo de periódico
dc.typeNacional


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