Reach further, in an Open Access Journal Endocrinology, Diabetes & Metabolism Case Reports

ISSN 1470-3947 (print)
ISSN 1479-6848 (online)

Searchable abstracts of presentations at key conferences in endocrinology

Published by BioScientifica
Endocrine Abstracts (2012) 29 P641 

The relationship between daytime, nighttime and total heart rate with albumin and protein excretion in newly diagnosed type 2 diabetic patients

B Afsar

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Introduction: Autonomic nervous system dysfunction has been widely observed in patients with type 2 diabetes. Twenty-four hour ambulatory heart rate measurements (AHRM) have been found to associate with autonomic dysfunction in patient with type 2 diabetes. Since albumin excretion is also related with autonomic dysfunction; in the current study, we analyzed whether 24-h AHRM were related with 24 h urinary albumin excretion (UAE) and urinary protein excretion (UPE) in newly diagnosed patients with type 2 diabetes.

Methods: All patients underwent following procedures: history taking, physical examination, blood pressure measurement, 12 lead electocardiographic evaluation, routine urine analysis, biochemical analysis, 24-h urine collection to measure urinary sodium and protein excretion and creatinine clearance calculation. Twenty-four hour ambulatory blood pressure and heart rate monitoring were performed for all patients. Diagnosis of diabetes was based on at least two fasting blood glucose.

Results: In total 80 patients (34 male, 46 female aged 50.4±9.2 years) with newly diagnosed type 2 diabetic patients were included. Stepwise linear regression of factors including age, gender, body mass index, smoking status, presence of coronary artery disease, dipping status, averaged fasting blood glucose, 24-h creatinine clearance, 24-h average ambulatory systolic blood pressure (AASBP), 24-h average ambulatory diastolic blood pressure (AADBP), daytime AHRM, nighttime AHRM and 24-h AHRM revealed that logarithmically converted 24-h UAE were independently related with 24-h AASBP (b: 0.02, CI: 0.09–0.031, P: 0.001) and nighttime AHRM (b: 0.05, CI: 0.03–0.069, P<0.0001). Using the same independent variables logarithmically converted 24-h UPE were independently related with age (b: −0.014, CI: −0.027 (to) −0.001, P: 0.032), with averaged fasting blood glucose (b: 0.011, CI: 0.002–0.021, P 0.023), 24-h AASBP (b: 0.013, CI: 0.005–0.020, P 0.002), nighttime AHRM (b 0.021, CI: 0.009–0.033, P 0.001).

Conclusion: Nighttime AHRM but not daytime and 24-h AHRM were related with both 24-h UAE and UPE in patients with type 2 diabetes. Whether augmentation of autonomic dysfunction specifically during nighttime should be evaluated in patients with type 2 diabetes.

Declaration of interest: The authors declare that there is no conflict of interest that could be perceived as prejudicing the impartiality of the research project.

Funding: This research did not receive any specific grant from any funding agency in the public, commercial or not-for-profit sector.

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