Anti-autonomic receptors, IGG presence and cardiac rhythm disorders in Type 2 Diabetes Mellitus

pp 384-390

Abstract

Introduction 
Type 2 diabetes mellitus (DM2) is frequently associated with potentially severe cardiovas­cular disorders. These manifestations are not only related to myocardial ischemia, but also to functional myocardial compromise and rhythm alterations. 

Objectives 
To study the association between DM2 and a) anti-autonomic receptors (anti-RA) IgG ; b) heart rate variability alterations (VFC); c) se­vere ventricular arrhythmias (A V) and microalbuminuria (MAU).

Material and methods 
Seventy-three patients were included (with no sex or age differences), 25 of them were re­cruited as a control group, and 48 with DM2 (age: 46.6±5.1 vs 44.5±3.4 y.o., p > 0.05). Anti-RA lgG presence was determined by ELISA essay while VFC and ventricular arrhythmias (AV) were detected by a 24-hour Holter study, microalbuminuria (MAU) by RIA essay; total cholesterol, triglycerides, and HDL cholesterol were measured; and routine analysis were also included. All data were submitted to statisti­cal analysis: chi², Student's t test, Spearman's rank correlation coefficient, multiple logisti­cal regression analysis. 

Results 

The presence of anti-RA lgG was more frequent in diabetic patients (56.3% vs 8.0%, p > 0.001). Moreover, VFC alterations and ventricular arrhythmias were also more frequent in DM2 patients (54.2% vs 4.0%, p > 0.001; and 43.7% vs 4.0%, p > 0.001 respectively). lgG antibodies against RA were associated to DM2 (rS = 0.48, p > 0.001), with ventricular arrhythmias (rS = 0.26, p > 0.03) and positive MAU (rS = 0.38, p > 0.001). AV were also associated with MAU (rS = 0.44, p > 0.001). According to the multivari­ate test anti-RA lgG presence was associated with DM2 (OR = 11.7, p = 0.03) and there was a borderline association to positive MAU (OR = 5.3, p = 0.02). 

Conclusions 

Anti-RAigGs presence, VFC alterations and AV seem to be more frequent in DM2 patients. The clinical consequences of these findings should be explored in future prospective studies, be­cause they could contribute to cardiovascular morbimortality in DM2.