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Cardiac risk factors and prevention
Original research article
Risk factors of diabetic cardiac autonomic neuropathy in patients with type 1 diabetes mellitus: a meta-analysis
  1. Mohamed D Dafaalla1,
  2. Mohammed N Nimir2,
  3. Mosab I Mohammed2,
  4. Omer A Ali2 and
  5. Abbashar Hussein3
  1. 1Soba Center for Audit and Research (SCAR), University of Khartoum, Khartoum, Sudan
  2. 2Daoud Research Group, University of Khartoum, Khartoum, Sudan
  3. 3Faculty of Medicine, Daoud Research Group, University of Khartoum, Khartoum, Sudan
  1. Correspondence to Dr Mohamed D Dafaalla; mdafaallah200{at}gmail.com

Abstract

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

Methods We did a meta-analysis 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, body mass index (BMI), systolic blood pressure (sBP) and diastolic blood pressure (dBP), glycated haemoglobin (HbA1c), high-density lipoprotein and low-density lipoprotein (HDL and LDL), triglycerides, retinopathy and nephropathy. We generated Forest plots, χ2 test and I2 as tests for heterogeneity, risk ratio (RR), mean difference (MD), CIs and p values by ReVMan V.5.3 software.

Results We found a total of 882 related items. We excluded 873 studies from the title and abstract and 4 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 to 6.42)), duration of diabetes (MD=4.51 (2.51 to 6.52)), HbA1c (MD=0.48 (0.28 to 0.67)), BMI (MD=0.55 (0.08 to 1.01)), serum triglycerides (MD=0.09 (0.01 to 0.17)), proliferative retinopathy (RR=3.69 (1.20 to 11.34)), microalbuminuria (RR=2.47 (1.43 to 4.29)), hypertension (RR=4.18 (2.52 to 6.91)) and sBP (MD=4.10 (2.20 to 6.00)). We neither discovered the absence of significant association between the development of CAN and male sex (RR=1.57 (0.45 to 5.39)), dBP (MD=0.89 (−0.36 to 2.14)), cholesterol level (MD=1.19 (−0.99 to 3.36)), LDL (MD=0.12 (−0.15 to 0.39)), nor HDL level (MD=−0.28 (−0.58 to 0.03)).

Conclusions Age, duration of diabetes, HbA1c, BMI, serum triglycerides, proliferative retinopathy, microalbuminuria, hypertension and sBP are directly related to the risk of development of diabetic CAN.

  • ARRHYTHMIAS
  • AUTONOMIC NERVOUS SYSTEM

This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/

https://doi.org/10.1136/openhrt-2015-000336

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    Footnotes

    • Twitter Follow Musab Mohammed at @ganas90

    • Contributors MDD and OAA performed formulation of idea. MDD and MNM conducted data extraction and analysis. MIM and MDD helped in writing the manuscript. AH performed formulation of idea.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Data sharing statement No additional data are available.