Search

The article presents a study which examined the influence of sexual dimorphism and sex steroids on cardiovascular autonomic neuropathy in patients with type 1 diabetes. Topics discussed include features of study participants, the assessment of cardiovascular autonomic function using Ewing tests, and group of women with more cardiovascular risk factors than the other study subgroups.

Aim: To clarify whether autoantibodies against glutamic acid decarboxylase (GAD-ab) are associated with cardiac autonomic neuropathy (CAN). Methods: 319 consecutive patients with type 1 diabetes (DM1) were included. We assessed CAN by responses of heart rate variability to deep breathing (E/I index), Valsalva maneuver, standing (30:15 ratio), low-frequency activity (LFa), and high-frequency activity (HFa). We assayed GAD-ab by immunoprecipitation radioligand. Results: Mean age was of 40 ± 14 years, with 20 ± 12 years as mean duration of diabetes. Mean A1c was 7.2 ± 1.0%. We confirmed CAN in 66 patients resulting in a 21% (95% CI 17-25) prevalence of asymptomatic CAN. GAD-ab were present in 199 individuals (62%), with no significant differences as a function of the presence of CAN or not [44 (70%) vs. 144 (66%), respectively; P = 0.544]. GAD-ab titles were similar between both groups (431 ± 695 U/mL in CAN subjects vs. 390 ± 662 U/mL in subjects without CAN, P = 0.688). Considering all patients as a whole, GAD-ab titles only correlated with duration of DM1 (r = -0.346, P < 0.001). HFa correlated with age (r = -0.523, P < 0.001), duration of DM1 (r = -0.374, P < 0.001), and A1c (r = -0.261, P < 0.001), but not with GAD-ab. Similarly, LFa correlated with age (r = -0.473, P < 0.001), duration of DM1 (r = -0.223, P < 0.001), and A1c (r = -0.294, P < 0.001). Age, sex, A1c, duration of DM1, GAD-ab, and systolic blood pressure were introduced as independent variables into a binary regression analysis. The stepwise model (R2: 0.106, P < 0.001) retained only age (β: -0.933, 95% CI: 0.933-0.976) as the significant predictor of the presence of CAN. Conclusion: GAD-ab unlikely have a role as a CAN marker in patients with DM1. Disclosure: L. Nattero-chávez: None. E. Lecumberri: None. H. F. Escobar-morreale: Consultant; Self; InsudPharma. M. Luque-ramírez: None. J. Quiñones silva: None. L. Montanez: None. E. Fernández durán: None. B. Dorado avendaño: None. C. Sánchez rodríguez: None. M. Lorenzo: None. M. Fernández argüeso: None. N. Bengoa rojano: None. Funding: Menarini International Foundation [ABSTRACT FROM AUTHOR]

Introduction: Increased prevalence of functional hyperandrogenism/polycystic ovary syndrome (PCOS) has been previously described in type 1 diabetes (T1DM) patients. However, the reported prevalence rates vary depending on different diagnostic criteria. Our study aim was to determine the prevalence of PCOS and hyperandrogenic traits in premeopausal women with T1DM. Methods: A cross-sectional study was conducted at a diabetes outpatient clinic in a tertiary Hospital from Madrid, Spain. We recruited consecutive premenopausal woman with T1DM, and menarche at least 2 years before the study. For this preliminary report, we included 40 patients. History data collection, physical exam, a complete hormonal analysis in follicular phase (including d4-androstenedione, DHEA-S, total testosterone, SHBG, 17-OH-progesterone, FSH, LH, prolactin, and TSH), and ovarian ultrasound were performed. Results: Mean age of patients was of 28 ± 8 yr; mean duration of T1DM was of 13 ± 8 yr-old. Twenty-seven patients were on multiple daily insulin therapy, while 13 of them were on continuous subcutaneous insulin infusion. Mean BMI was of 23.8 ± 3.7 Kg/m2. Mean daily insulin dose was 0.64 ± 0.2 U/kg and mean A1C was 7.5 ± 1.8%. PCOS was diagnosed in 7 patients resulting in a 18% (95% CI: 8; 32) prevalence of PCOS according to NIH-Rotterdam, and in 6 patients resulting in a 15% (95% CI: 7; 29) prevalence of PCOS according to AES-PCOS criteria. Three patients [7% (95% CI: 3; 20)] had isolated polycystic ovarian morphology (PCOM), and 7 patients [18% (95% CI: 8; 32)] presented with oligo-amenorrhea (ovulatory dysfunction-WHO class 2). Conclusion: Our preliminary data show a significant increase in prevalence of PCOS in premenopausal women with T1DM with respect to the general population. Disclosure: A. Bayona: None. L. Nattero-chávez: None. E. Fernández durán: None. B. Dorado avendaño: None. H. F. Escobar-morreale: Consultant; Self; InsudPharma. M. Luque-ramírez: None. [ABSTRACT FROM AUTHOR]

Objective: To investigate the effect of 6m CFTR modulators treatment on insulin secretion in CF patients. Methods: 21 CF patients (17 Phe.508del hom) were included in a prospective, observational study. After 6m of lumacaftor/tezacaftor+ivacaftor, AUC of glucose, insulin and C peptide were evaluated by using 5-point OGTT. GLM repeated measures test performed. Results: 21 patients initially participated, 3 were excluded: 1 had no basal OTTG, and 2 had drug intolerance. Median age 14,7yr (ICR 8,5-26,0); 57% ≥13 yr and 57% male. Initially: 8 had normal glucose metabolism (N), 1 indeterminate (IND), 2 abnormal glucose tolerance (AGT), 2 IND+AGT, and 5 CFRD. After 6m: in the N group: 5 (62,5%; 100% <18yr) worsened their glucose tolerance status and 3 (37,5%) had no group change; in the abnormal glucose group: 2 (20%) worsened their glucose tolerance status (100% <18 yr), 3 (30%) improved (66,6% adults) and 5 (50%) remained similar (60% adults). Significant increase in AUC of glucose, insulin and C-peptide were observed after 6m in the whole group, without differences after adjustment for glucose tolerance status subgroup in AUC of insulin and C-peptide (Table 1). Conclusion: Increase in AUC of insulin and C-peptide were observed after 6m with CFTR modulators, suggesting a potential role in improving insulin secretion. AUC of glucose should be analyzed prospectively. Disclosure: E. Lecumberri: None. R. Y. Yelmo: None. M. Garriga: None. A. F. Lamas: None. S. Vicente: Consultant; Self; Abbott, Fresenius Medical Care, Mead Johnson Nutrition. M. Martin-frias: None. L. Nattero-chávez: None. V. Martínez-vaello: None. L. Maiz: None. C. Sánchez rodríguez: None. M. Lorenzo: None. B. Dorado avendaño: None. [ABSTRACT FROM AUTHOR]