O. Schnell et al., Autoantibodies against autonomic nervous tissues in Type 2 diabetes mellitus: No association with cardiac autonomic dysfunction, EXP CL E D, 108(3), 2000, pp. 181-186
Citations number
29
Categorie Soggetti
Endocrinology, Nutrition & Metabolism
Journal title
EXPERIMENTAL AND CLINICAL ENDOCRINOLOGY & DIABETES
There is evidence that autoimmune factors contribute to the pathogenesis of
cardiac autonomic dysfunction in Type 1 Diabetes mellitus (DM). To evaluat
e the presence of autoantibodies against autonomic nervous tissues in Type
2 DM, 127 patients were studied for complement-fixing sympathetic and paras
ympathetic ganglia (CF-SG and CF-PSG) autoantibodies with an indirect immun
ofluorescence technique. Five cardiac reflex tests were performed to invest
igate cardiac autonomic neuropathy. QTc interval was assessed in all patien
ts. As a control group, 60 healthy non-diabetic subjects were also tested f
or CF-SG and CF-PSG autoantibodies.
CF-SG autoantibodies were detected in 11 (9%) and CF-PSG autoantibodies wer
e observed in 7 (6%) Type 2 DM patients, whereas in control subjects, the f
requency was 1 (2%) and 0 (0%) respectively (ns vs. Type 2 DM patients). In
Type 2 DM patients with cardiac autonomic neuropathy (n=31, 24%), CF-SG au
toantibodies and CF-PSG autoantibodies were detected in 3 (10%) patients, r
espectively, compared to 8 (8%) and 4 (4%) in Type 2 DM patients without ca
rdiac autonomic neuropathy (n=96, 76%, ns v. Type 2 DM with cardiac autonom
ic neuropathy). Both CF-SG autoantibodies and CF-PSG autoantibodies were ob
served in 2 (7%) Type 2 DM patients with cardiac autonomic neuropathy and 3
(3%) Type 2 DM patients without cardiac autonomic neuropathy. Type 2 DM pa
tients with cardiac autonomic neuropathy demonstrated a longer QTc-interval
(446+/-42ms) than Type 2 DM patients without cardiac autonomic neuropathy
(413+/-45 ms, p= 0.0001). In Type 2 DM patients with a prolonged QTc-interv
al (>440 ms: n=29, 23%), 2 (7%) patients presented with CF-SG and 3 (10%) h
ad CF-PSG autoantibodies.
In Type 2 DM, CF-SG and CF-PSG autoantibodies are not frequently observed.
The results do not give evidence, that immunological factors - like in Type
1 DM - play a role in the pathogenesis of cardiac autonomic dysfunction in
Type 2 DM.