Endocrine Abstracts (2018) 56 EP63 | DOI: 10.1530/endoabs.56.EP63

Sympathetic hyperactivity and sleep disorders: is Type 2 diabetes the link between these two situations?

Carolina López-Cano1,2, Liliana P Gutierrez-Carrasquilla1, Enric Sánchez2, Anna M Gaeta3, Raquel Marti2, Marta Hernández1, Gonzalo Cao4, Merce Ribelles4, Xavier Gómez5, Marta Sánchez1, Chadia Mizab1, Ferran Barbe2,3 & Albert Lecube1,2


1Endocrinology Service, Hospital Universitari Arnau Vilanova, Lleida, Spain; 2Institut de Recerca Biomedica, Lleida, Spain; 3Pneumology Service, Hospital Universitari Arnau Vilanova, Lleida, Spain; 4Hospital Universitari Arnau Vilanova, Lleida, Spain; 5Medicine Department, Universitat de Lleida, Lleida, Spain.


Results: Main clinical, analytical and polygraphic data: 58.1±6.4 years, body mass index 32.4±5.4 kg/m2, 70.4% female, HbA1c 8.0±1.9%, AIH 27.4 events/hour (in the range of severe sleep apnea and hypoapnea index), and CT90% 32.9%. Nocturnal concentration of urine total metanephrines were higher than diurnal levels (226±12 vs 98±13 μg/l; P=0.085). In addition, its nocturnal concentration was significantly associated, in a positive way, with both the AIH and the CT90; however, this association disappeared when the diurnal concentration was evaluated. Furthermore, nocturnal concentration was also associated with a decrease in resting parasympathetic tone. In the multivariate analysis, the concentration of urine metanephrines at night independently predicted CT90 (P=0.016).

Conclusion: We suggest that the increased sympathetic activity previously described in patients with T2D is mediated through the deleterious effect of diabetes in nocturnal breathing. In addition, sympathetic activity is associated with disorders of autonomic tone at resting, suggesting a new pathological pathway between T2D and cardiovascular risk.