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

F. Cerutti, F. Rabbia, I. Rabbonei, A. Bobbioi, M. G. Ignaccolo, G. Greco, M. C. Bertello, P. Mulatero, F. Veglio, G. Pacini

Research output: Contribution to journalArticlepeer-review

Abstract

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 non-obese control adolescents age matched were studied. In all subjects we performed oral glucose tolerance test (OGTT) with insulin and glucose determination, 24-h electrocardiogram Holier, blood pressure monitoring, echo-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 high-er 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.

Original languageEnglish
Pages (from-to)539-543
Number of pages5
JournalJournal of Endocrinological Investigation
Volume33
Issue number8
DOIs
Publication statusPublished - Sept 2010
Externally publishedYes

Keywords

  • Adolescents
  • Autonomic dysfunction
  • Insulin sensitivity
  • Obesity
  • Type 2 diabetes

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