Risk factors of cardiovascular autonomic neuropathy in patients with prediabetes and coronary artery disease

Abstract

Introduction: Cardiovascular autonomic neuropathy (CAN) is a serious risk factor for cardiovascular morbidity and mortality in patients with diabetes mellitus (DM) and prediabetes. On the other hand, gene brain-derived neurotrophic factor (BDNF) promotes synthesis of nerve growth factor. Degeneration of autonomic nerves is a common feature of autonomic neuropathy. However, an association between CAN and protein BDNF in newly diagnosed patients with DM type 2 was not fully investigated. Objectives: The aim of this study was to investigate the relationship of CAN and gene encoding BDNF in patients with newly diagnosed type 2 DM. Methods: We examined 52 patients with newly diagnosed type 2 DM, 16 males and 36 females (aged 60,9+1,55 years, HbA1c – 7,77+0,18 %) (data are presented everywhere as mean+SEM). All patients were performed cardiovascular autonomic reflex tests (CARTs) by Ewing and real-time PCR analysis for quantitative evaluation of BDNF gene. The diagnosis of CAN was confirmed in patients with 2 positive tests. The statistical analysis was performed using SPSS statistical package version 23.0 for Windows. Results: CAN was diagnosed in 76,9 % patients. We found negative correlation between levels of BDNF gene and the total score of CARTs, (r= –0,003, p<0,05), and positive correlation with presence CAN and BDNF gene in newly diagnosed type 2 DM (r= 0,01, p<0,05). Conclusion: We found some relationship between the presence of CAN, total score of CARTs and BDNF gene which could suggest the possible role of production of this protein in the development of CAN in patients with newly diagnosed type 2 DM.