Endocrine Abstracts

Objectives: We aimed to stratify the possible risk factors for diabetic cardiac autonomic neuropathy (CAN).

Methods: We did a metaanalysis of risk factors of CAN. We did a web based search for literature in MEDLINE/PubMed, SCOPUS database, and CENTRAL database up to August 2015. We included clinical trials or cohort studies that provide data about relationship between CAN and variables of interest. Our risk factors of interest were age, sex, duration of diabetes, BMI, systolic (sBP) and diastolic blood pressure [dBP], HbA1c, HDL, LDL, triglycerides, retinopathy and nephropathy. We generated Forest plots, chi squared test and (I2) as tests for heterogeneity, risk ratio (RR), mean difference (MD), confidence intervals, and P values by Revman5.3 software.

Results: We found a total of 882 related item. We excluded 873 studies from the title and abstract and four studies after review of full reports. Four studies were included. Our meta-analysis showed significant association between CAN and age (MD=4.94 [3.46, 6.42]), duration of diabetes (MD=4.51 [2.51, 6.52]), HbA1c (MD=0.48 [0.28, 0.67]), BMI (MD=0.55 [0.08, 1.01]), serum triglycerides (MD=0.09 [0.01, 0.17]), proliferative retinopathy (RR=3.69 [1.20, 11.34]), microalbuminuria (RR=2.47 [1.43, 4.29]), hypertension (RR=4.18 [2.52, 6.91]), and sBP (MD=4.10 [2.20, 6.00]). We discovered absence of significant association between development of CAN and male sex (RR=1.57 [0.45, 5.39]), dBP (MD=0.89 [−0.36, 2.14]), cholesterol level (MD=1.19 [−0.99, 3.36]), LDL (MD=0.12 [−0.15,0.39]), nor HDL level (MD=−0.28 [−0.58,0.03]).

Conclusion: Age, duration of diabetes, HbA1c, BMI, serum triglycerides, proliferative retinopathy, microalbuminuria, hypertension, and systolic blood pressure are directly related to the risk of development of diabetic CAN.