Residual sympathetic tone is associated with reduced insulin sensitivity in patients with autonomic failure.
Residual sympathetic tone is associated with reduced insulin sensitivity in patients with autonomic failure.
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DOI：
10.1007/s10286-015-0307-9
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发表时间：
2015-10
期刊：
影响因子：
--
通讯作者：
Shibao CA
中科院分区：
文献类型：
--
作者：
Celedonio JE;Arnold AC;Dupont WD;Ramirez CE;Diedrich A;Okamoto LE;Raj SR;Robertson D;Peltier AC;Biaggioni I;Shibao CA
PurposeParkinson disease, an α-synucleinopathy, is associated with reduced insulin sensitivity, impaired glucose tolerance, and diabetes mellitus. Importantly, these metabolic alterations have been shown to contribute to disease progression. The purpose of this study was to determine if reduced insulin sensitivity is also present in other α-synucleinopathies associated with autonomic failure.MethodsWe studied 19 patients with multiple system atrophy and 26 patients with pure autonomic failure. For comparison, we studied 8 healthy controls matched for body mass index. Insulin sensitivity and beta cell function were calculated using fasting glucose and insulin levels according to the homeostatic model assessment 2. A multiple linear regression model was performed to determine factors that predict insulin sensitivity in autonomic failure.ResultsThere was a significant difference in insulin sensitivity among groups (P= 0.048). This difference was due to lower insulin sensitivity in multiple system atrophy patients: 64 % [interquartile range (IQR), 43 to 117] compared to healthy controls 139 % (IQR, 83 to 212),P= 0.032. The main factor that contributed to the reduced insulin sensitivity was the presence of supine hypertension and residual sympathetic tone.ConclusionsMultiple system atrophy patients have reduced insulin sensitivity that is associated with residual sympathetic activation and supine hypertension. These patients may therefore be at high risk for development of impaired glucose tolerance and diabetes mellitus.
