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Relationship between autonomic neuropathy, 24-hr blood pressure and retinopathy in normoalbuminuric and normotensive Type 1 diabetic patients

To order to investigate factors related to the development of retinopathy in 122 normotensive and normoalbuminuric patients 24 h blood pressure (BP) measurement and autonomic tests based on standard, vector and spectral analysis of heart rate variation (HRV) were performed. Retinopathy was found in 47 patients with significantly higher duration of diabetes and incidence of autonomic neuropathy ( 9, 5&plusmn ; ; ; ; 5, 5 ; 59, 6%) in comparison with 75 patients without retinopathy (5.29&plusmn ; ; ; ; 4.9 ; 16%), (p<0, 05). Patients were matched according to age, gender, HbA1c, 24h urinary albumin excretion (UAE). Maximal night systolic, mean night and day diastolic blood pressure was significantly higher in patients with retinopathy (118, 94&plusmn ; ; ; ; 11 ; 62, 94&plusmn ; ; ; ; 8, 1 ; 74, 3&plusmn ; ; ; ; 7, 2 mmHg) as compared to patients without it(115, 03&plusmn ; ; ; ; 8, 9 ; 59, 65&plusmn ; ; ; ; 7, 1 ; 71, 75&plusmn ; ; ; ; 5, 7) (p=0, 03). Maximal night systolic BP was inversely related to power HF (r=-0, 28, p=0, 05) and CV deep breathing (r= -0, 23, p= 0, 02). Mean night diastolic BP was inversely related to power MF (r= -0, 21, p=0, 03), HF (r=-0, 32, p=0, 005), CV deep breathing (r=-0, 27, p=0, 005) and MCR deep breathing (r=-0, 24, p=0, 003) ; mean day diastolic BP to power HF (r=-0, 22, p=0, 02). In multiple regression analysis retinopathy was associated with the duration of diabetes (b=0.53) and autonomic neuropathy (b=0.28) (p<0.001). Autonomic neuropathy was related to BP elevation and retinopathy in normotensive and normoalbuminuric type 1 diabetic patients.

Autonomic neuropaty; blood pressure; retinopathy; Type 1 diabetes mellitus

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