To focus on early cardiac and vascular autonomic dysfunction that might complicate type 1 diabetes mellitus in children, we planned an observational, cross-sectional study in a population of 93 young patients, under insulin treatment, subdivided in 2 age subgroups (children: 11.5 +/- 0.4 years; adolescents: 19.3 +/- 0.2 years). Time and frequency domain analysis of RR interval and systolic arterial pressure variability provided quantitative indices of the sympatho-vagal balance regulating the heart period, of the gain of cardiac baroreflex, and of the sympathetic vasomotor control. Sixty-eight children of comparable age served as a reference group. At rest, systolic arterial pressure and the power of its low-frequency component were greater in patients than in controls, particularly in children (14.0 +/- 2.3 versus 3.1 +/- 0.3 mm Hg(2)). Moreover, baroreflex gain was significantly reduced in both subgroups of patients. Standing induced similar changes in the autonomic profiles of controls and patients. A repeat study after 1 year showed a progression in low- frequency oscillations of arterial pressure and a shift toward low frequency in RR variability. Data in young patients with type 1 diabetes mellitus show a significant increase in arterial pressure, a reduced gain of the baroreflex regulation of the heart period, and an increase of the low- frequency component of systolic arterial pressure variability, suggestive of simultaneous impairment of vagal cardiac control and increases of sympathetic vasomotor regulation. A repeat study after 1 year shows a further increase of sympathetic cardiac and vascular modulation, suggesting early progression of the autonomic dysfunction.
Early progression of the autonomic dysfunction observed in pediatric type 1 diabetes mellitus / D. Lucini, G. Zuccotti, M. Malacarne, A. Scaramuzza, S. Riboni, C. Palombo, M.Pagani. - In: HYPERTENSION. - ISSN 0194-911X. - 54:5(2009 Nov), pp. 987-994.
|Titolo:||Early progression of the autonomic dysfunction observed in pediatric type 1 diabetes mellitus|
LUCINI, DANIELA (Primo)
ZUCCOTTI, GIAN VINCENZO (Secondo)
PAGANI, MASSIMO (Ultimo)
|Parole Chiave:||Autonomic nervous system; Baroreflex; Children; Diabetes mellitus; Sympathetic nervous system; Vasculature|
|Settore Scientifico Disciplinare:||Settore MED/38 - Pediatria Generale e Specialistica|
Settore M-EDF/01 - Metodi e Didattiche delle Attivita' Motorie
Settore MED/09 - Medicina Interna
|Data di pubblicazione:||nov-2009|
|Digital Object Identifier (DOI):||http://dx.doi.org/10.1161/HYPERTENSIONAHA.109.140103|
|Appare nelle tipologie:||01 - Articolo su periodico|