Insulin Resistance, Cardiovascular Autonomic Neuropathy, and Left Ventricular Hypertrophy in Patients with Congenital Generalized Lipodystrophy

Congenital generalized lipodystrophy (CGL) subjects have a high prevalence of cardiovascular autonomic neuropathy (CAN) and cardiac complications, including left ventricular hypertrophy (LVH). This study aimed to analyze insulin resistance (IR), CAN severity and LVH association. A cross sectional st...

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Published inDiabetes (New York, N.Y.) Vol. 67; no. Supplement_1
Main Authors FERNANDES, VIRGINIA O., PONTE, CLARISSE M.M., GURGEL, MARIA HELANE C., MONTENEGRO, ANA PAULA D.R., BATISTA, LIVIA A.A., LIBERATO, CRISTIANE B.R., D'ALVA, CATARINA B., MONTENEGRO, RENAN M.
Format Journal Article
LanguageEnglish
Published New York American Diabetes Association 01.07.2018
Subjects
Autonomic nervous system
Cardiac arrhythmia
Congenital diseases
Diabetic neuropathy
Echocardiography
Heart rate
Hypertrophy
Hypotension
Insulin
Insulin resistance
Lipodystrophy
Neuropathy
Oils & fats
Posture
Reflexes
Ultrasonic imaging
Vagus nerve
Ventricle
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Summary:Congenital generalized lipodystrophy (CGL) subjects have a high prevalence of cardiovascular autonomic neuropathy (CAN) and cardiac complications, including left ventricular hypertrophy (LVH). This study aimed to analyze insulin resistance (IR), CAN severity and LVH association. A cross sectional study with 10 CGL patients and 20 healthy controls. We evaluated clinical and laboratory data, echocardiogram parameters, 3 spectral analysis components - high frequency (HF), low frequency (LF), and very low frequency (VLF) - of heart rate variability (HRV), sympathetic-vagal balance, time domains of HRV, corrected QT interval (cQT), and 4 cardiovascular reflexes tests (postural hypotension test, orthostatic, respiratory, and valsalva coefficients - 2 abnormal tests: clinic CAN, 1 abnormal test: incipient CAN, and postural hypotension: advanced CAN). In CGL group 50% had CAN (40% clinic and 10% incipient) and 40% LVH. There was inverse correlation between LVMI and HF (p=0,007), IVS and HF (p=0,013), and positive correlation between IVS and HOMA-IR (p=0,042), and BP drop (p=0,010). These suggest that IR may be involved in the severity of CAN and cardiac autonomic dysfunction in the pathophysiology of cardiovascular complications in these disease. Disclosure V.O. Fernandes: None. C.M.M. Ponte: None. M.C. Gurgel: None. A.D.R. Montenegro: None. L.A.A. Batista: None. C.B.R. Liberato: None. C.B. D'Alva: None. R.M. Montenegro: None.
ISSN:0012-1797
1939-327X
DOI:10.2337/db18-585-P