Cardiovascular Autonomic Neuropathy in Adolescents and Young Adults with Type 1 and Type 2 Diabetes: The SEARCH for Diabetes in Youth Cohort Study

Details

• Alternative Title:
  Pediatr Diabetes
• Personal Author:
  Jaiswal, Mamta ; Divers, Jasmin ; Urbina, Elaine M. ; Dabelea, Dana ; Bell, Ronny A. ; Pettitt, David J. ; Imperatore, Giuseppina ; Pihoker, Catherine ; Dolan, Lawrence M. ; Liese, Angela D. ; Marcovina, Santica ; Linder, Barbara ; Feldman, Eva L. ; Pop-Busui, Rodica
• Corporate Authors:
  for the SEARCH For Diabetes In Youth Study Group
• Description:
  Aims
  
  To estimate the prevalence of and risk factors for cardiovascular autonomic neuropathy (CAN) in adolescents and young adults with type 1 and type 2 diabetes enrolled in the SEARCH for Diabetes in Youth Study.
  
  Methods
  
  The study included 1646 subjects with type 1 diabetes (age 18 ± 4 years, diabetes duration 8 ± 2 years, HbA1c 9.1 ± 1.9%, 76% Non-Hispanic Whites) and 252 with type 2 diabetes (age 22 ± 4 years, diabetes duration 8 ± 2 years, HbA1c 9.2 ± 3.0%, 45% Non-Hispanic Blacks). Cross-sectional and longitudinal risk factors were assessed at baseline and follow-up visits. Area under the curve (AUC) was used to assess the longitudinal glycemic exposure and cardiovascular risk factors. CAN was assessed by time and frequency domain indices of heart rate variability (HRV). CAN was defined as the presence of ≥3 of 5 abnormal HRV indices.
  
  Results
  
  The prevalence of CAN was 12% in adolescents and young adults with type 1 diabetes and 17% in those with type 2 diabetes. Poor long-term glycemic control (AUC HbA1c), high blood pressure, and elevated triglyceride levels were correlates of CAN in subjects with type 1 diabetes. In those with type 2 diabetes, CAN was associated with elevated triglycerides and increased urinary albumin excretion.
  
  Conclusions
  
  The prevalence of CAN in this multiethnic cohort of adolescents and young adults with type 1 and type 2 diabetes are comparable to those reported in adults with diabetes. Suboptimal glycemic control and elevated triglycerides were the modifiable risk factors associated with CAN.
  
  
• Subjects:
  Adolescent Adult Autonomic Nervous System Diseases Cardiovascular Diseases Cohort Studies Cross-Sectional Studies Diabetes Mellitus, Type 1 Diabetes Mellitus, Type 2 Diabetic Angiopathies Diabetic Neuropathies Female Humans Longitudinal Studies Male Prevalence Risk Factors Young Adult

  More +
• Source:
  Pediatr Diabetes. 19(4):680-689
• Pubmed ID:
  29292558
• Pubmed Central ID:
  PMC5938122
• Document Type:
  Journal Article
• Funding:
  P30 DK057516/DK/NIDDK NIH HHSUnited States/ ; U01 DP000247/DP/NCCDPHP CDC HHSUnited States/ ; U18 DP002710/DP/NCCDPHP CDC HHSUnited States/ ; U18 DP006134/DP/NCCDPHP CDC HHSUnited States/ ; UL1 TR000154/TR/NCATS NIH HHSUnited States/ ; U18 DP002714/DP/NCCDPHP CDC HHSUnited States/ ; U01 DP000248/DP/NCCDPHP CDC HHSUnited States/ ; U01 DP000244/DP/NCCDPHP CDC HHSUnited States/ ; UL1 TR000062/TR/NCATS NIH HHSUnited States/ ; U18 DP002709/DP/NCCDPHP CDC HHSUnited States/ ; UL1 TR000423/TR/NCATS NIH HHSUnited States/ ; U01 DP000250/DP/NCCDPHP CDC HHSUnited States/ ; U18 DP002708/DP/NCCDPHP CDC HHSUnited States/ ; UL1 TR001425/TR/NCATS NIH HHSUnited States/ ; UL1 TR002319/TR/NCATS NIH HHSUnited States/ ; P30 DK020572/DK/NIDDK NIH HHSUnited States/ ; UL1 TR000077/TR/NCATS NIH HHSUnited States/ ; U01 DP000246/DP/NCCDPHP CDC HHSUnited States/ ; U01 DP000254/DP/NCCDPHP CDC HHSUnited States/ ; HIR 10-001/HX/HSRD VAUnited States/ ; P30 DK017047/DK/NIDDK NIH HHSUnited States/
• Volume:
  19
• Issue:
  4
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:0332f7a3de50651ee05dd9a02bb663c8d84fb0eb31c071ccd00e20aa611b5f7d
• Download URL:
  https://stacks.cdc.gov/view/cdc/53829/cdc_53829_DS1.pdf
• File Type:
  [PDF - 543.90 KB ]