Impairment of cardiovascular autonomic pattern in obese adolescents with Type 2 diabetes mellitus

• Published in: Journal of endocrinological investigation Vol. 33; no. 8; pp. 539 - 543
• Main Authors: Cerutti, F., Rabbia, F., Rabbone, I., Bobbio, A., Ignaccolo, M. G., Greco, G., Bertello, M. C., Mulatero, P., Veglio, F., Pacini, G.
• Format: Journal Article
• Language: English
• Published: Cham Springer International Publishing 01.09.2010
• Subjects: Adolescent; Autonomic Nervous System - physiopathology; Blood Pressure; Cardiovascular System - physiopathology; Child; Diabetes Mellitus, Type 2 - physiopathology; Echocardiography; Electrocardiography, Ambulatory; Endocrinology; Female; Glucose Tolerance Test; Humans; Insulin Resistance - physiology; Insulin-Secreting Cells - physiology; Lipids - blood; Medicine; Medicine & Public Health; Metabolic Diseases; Obesity - complications; Obesity - physiopathology; Original Articles; Type 2 diabetes; insulin sensitivity; Adolescents; autonomic dysfunction; obesity
• ISSN: 0391-4097; 1720-8386
• DOI: 10.1007/BF03346644

The aim of this study was to assess the behaviour of insulin sensitivity and insulin resistance (IR) indexes in a group of obese adolescents with Type 2 diabetes mellitus (T2DM) in comparison to obese adolescents without diabetes and normal controls, moreover to compare these parameters with the cardiac autonomic pattern. Seven T2DM obese (12.7±0.5 yr), 18 obese without T2DM, and 10 nonobese control adolescents age matched were studied. In all subjects we performed oral glucose tolerance test (OGTT) with insulin and glucose determination, 24-h electrocardiogram Holter, blood pressure monitoring, ecoho-cardiogram. Results : serum lipids were significantly higher in obese and T2DM. Insulin sensitivity was significantly reduced in T2DM and obese vs controls; T2DM showed a more pronounced oral glucose insulin sensitivity (OGIS) reduction vs obese. Both obese and T2DM presented an higher IR. T2DM showed an impaired β-cell function, with insulin areas under the curve and disposition index significantly reduced in comparison to controls and obese who showed similar values. A progressive reduction of vagal indexes and an increase of sympathetic indexes were found in obese adolescents and were more pronounced in T2DM. These parameters were correlated with OGIS and β-cell function parameters in both obese and T2DM adolescents. T2DM showed a significant relative wall thickness increase suggesting a trend toward concentric remodeling. In conclusion, T2DM adolescents are characterized by a more marked IR reduced β-cell function in comparison to non-diabetic obese. These modifications may lead to an early impairment of the autonomic pattern.