Sex differences and sex steroids influence on the presentation and severity of cardiovascular autonomic neuropathy of patients with type 1 diabetes

Background: Sex differences characterize cardiovascular outcomes in patients with type 1 diabetes. Cardioauto‑ nomic neuropathy is a common complication of type 1 diabetes that associates increased morbi-mortality. Data regarding the interplay between sex and cardiovascular autonomic neuropathy are...

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Autores: Nattero Chávez, María Lia, Insenser Nieto, María Rosa, Quintero Tobar, Alejandra, Fernández Durán, Elena, Dorado Avendaño, Beatriz, Fiers, Tom, Kaufman, Jean Marc, Luque Ramírez, Manuel, Escobar Morreale, Héctor Francisco|||0000-0002-6890-1644
Tipo de documento: artigo
Data de publicação:2023
País:España
Recursos:Universidad de Alcalá (UAH)
Repositório:e_Buah Biblioteca Digital Universidad de Alcalá
Idioma:inglês
OAI Identifier:oai:ebuah.uah.es:10017/66794
Acesso em linha:http://hdl.handle.net/10017/66794
https://dx.doi.org/10.1186/s12933-023-01766-y
Access Level:Acceso aberto
Palavra-chave:Autonomic nervous system
Cardioautonomic neuropathy
Cardiovascular disease
Sex differences
Sex hormones
Sex steroids
Sexual dimorphism
Type 1 diabetes mellitus
Medicina
Medicine
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spelling Sex differences and sex steroids influence on the presentation and severity of cardiovascular autonomic neuropathy of patients with type 1 diabetesNattero Chávez, María LiaInsenser Nieto, María RosaQuintero Tobar, AlejandraFernández Durán, ElenaDorado Avendaño, BeatrizFiers, TomKaufman, Jean MarcLuque Ramírez, ManuelEscobar Morreale, Héctor Francisco|||0000-0002-6890-1644Autonomic nervous systemCardioautonomic neuropathyCardiovascular diseaseSex differencesSex hormonesSex steroidsSexual dimorphismType 1 diabetes mellitusMedicinaMedicineBackground: Sex differences characterize cardiovascular outcomes in patients with type 1 diabetes. Cardioauto‑ nomic neuropathy is a common complication of type 1 diabetes that associates increased morbi-mortality. Data regarding the interplay between sex and cardiovascular autonomic neuropathy are scarce and controversial in these patients. We aimed to address sex-related differences in the prevalence of seemingly asymptomatic cardioautonomic neuropathy in type 1 diabetes, and their associations with sex steroids. Methods We conducted a cross-sectional study including 322 consecutively recruited patients with type 1 diabetes. Cardioautonomic neuropathy was diagnosed using Ewing’s score and power spectral heart rate data. We assessed sex hormones by liquid chromatography/tandem mass spectrometry. Results When considering all subjects as a whole, asymptomatic cardioautonomic neuropathy prevalence was not significantly different between women and men. When age was taken into account, the prevalence of cardioauto‑ nomic neuropathy was similar among young men and those>50 years. However, in women>50 years, the preva‑ lence of cardioautonomic neuropathy doubled that of young women [45.8% (32.6; 59.7) vs. 20.4% (13.7; 29.2), respec‑ tively]. The OR of having cardioautonomic neuropathy was 3.3 higher in women>50 years than in their younger counterparts. Furthermore, women presented more severe cardioautonomic neuropathy than men. These differences were even more marked when women were classified according their menopausal status instead of age. Peri- and menopausal women had an OR 3.5 (1.7; 7.2) of having CAN compared with their reproductive-aged counterparts [CAN prevalence: 51% (37; 65) vs. 23% (16; 32), respectively]. A binary logistic regression model (R2 : 0.161; P=0.001) displayed age>50 years as a significant determinant of cardioautonomic neuropathy only in women. Androgens were positively associated with heart rate variability in men, and negatively in women. Accordingly, cardioautonomic neuropathy was associated with increased testosterone/estradiol ratio in women but to decreased testosterone con‑ centrations in men.Society of Endocrinology, Nutrition and Diabetes of the Community of Madrid (SENDIMAD)Instituto de Salud Carlos III20232023-01-01journal articlehttp://purl.org/coar/resource_type/c_6501NAhttp://purl.org/coar/version/c_be7fb7dd8ff6fe43info:eu-repo/semantics/articleapplication/pdfhttp://hdl.handle.net/10017/66794https://dx.doi.org/10.1186/s12933-023-01766-y36793089reponame:e_Buah Biblioteca Digital Universidad de Alcaláinstname:Universidad de Alcalá (UAH)InglésengISCIII Not available PI1400649 Efecto de la disminución de los depósitos tisulares de hierro sobre factores de riesgo cardiovascular en mujeres con síndrome del ovario poliquístico. Un estudio prueba de conceptoISCIII AES. 2015. Proyectos de Investigación en Salud PI15%2F01686 SEXMETAB. Influencia del sexo y de las hormonas sexuales en la disfunción del tejido adiposo y los trastornos metabólicos crónicos de etiologia compleja multifactorialISCIII AES. 2016. Proyectos Integrados de Excelencia (PIE) PI16%2F00050 SEXCOMPLEX. Influence of sex and sex hormones on human chronic disorders of complex etiologyCIBERDEM Not available DEM21‑PIM02open accesshttp://purl.org/coar/access_right/c_abf2Attribution 4.0 Internationalhttp://creativecommons.org/licenses/by/4.0/info:eu-repo/semantics/openAccessoai:ebuah.uah.es:10017/667942026-06-18T11:13:07Z
dc.title.none.fl_str_mv Sex differences and sex steroids influence on the presentation and severity of cardiovascular autonomic neuropathy of patients with type 1 diabetes
title Sex differences and sex steroids influence on the presentation and severity of cardiovascular autonomic neuropathy of patients with type 1 diabetes
spellingShingle Sex differences and sex steroids influence on the presentation and severity of cardiovascular autonomic neuropathy of patients with type 1 diabetes
Nattero Chávez, María Lia
Autonomic nervous system
Cardioautonomic neuropathy
Cardiovascular disease
Sex differences
Sex hormones
Sex steroids
Sexual dimorphism
Type 1 diabetes mellitus
Medicina
Medicine
title_short Sex differences and sex steroids influence on the presentation and severity of cardiovascular autonomic neuropathy of patients with type 1 diabetes
title_full Sex differences and sex steroids influence on the presentation and severity of cardiovascular autonomic neuropathy of patients with type 1 diabetes
title_fullStr Sex differences and sex steroids influence on the presentation and severity of cardiovascular autonomic neuropathy of patients with type 1 diabetes
title_full_unstemmed Sex differences and sex steroids influence on the presentation and severity of cardiovascular autonomic neuropathy of patients with type 1 diabetes
title_sort Sex differences and sex steroids influence on the presentation and severity of cardiovascular autonomic neuropathy of patients with type 1 diabetes
dc.creator.none.fl_str_mv Nattero Chávez, María Lia
Insenser Nieto, María Rosa
Quintero Tobar, Alejandra
Fernández Durán, Elena
Dorado Avendaño, Beatriz
Fiers, Tom
Kaufman, Jean Marc
Luque Ramírez, Manuel
Escobar Morreale, Héctor Francisco|||0000-0002-6890-1644
author Nattero Chávez, María Lia
author_facet Nattero Chávez, María Lia
Insenser Nieto, María Rosa
Quintero Tobar, Alejandra
Fernández Durán, Elena
Dorado Avendaño, Beatriz
Fiers, Tom
Kaufman, Jean Marc
Luque Ramírez, Manuel
Escobar Morreale, Héctor Francisco|||0000-0002-6890-1644
author_role author
author2 Insenser Nieto, María Rosa
Quintero Tobar, Alejandra
Fernández Durán, Elena
Dorado Avendaño, Beatriz
Fiers, Tom
Kaufman, Jean Marc
Luque Ramírez, Manuel
Escobar Morreale, Héctor Francisco|||0000-0002-6890-1644
author2_role author
author
author
author
author
author
author
author
dc.subject.none.fl_str_mv Autonomic nervous system
Cardioautonomic neuropathy
Cardiovascular disease
Sex differences
Sex hormones
Sex steroids
Sexual dimorphism
Type 1 diabetes mellitus
Medicina
Medicine
topic Autonomic nervous system
Cardioautonomic neuropathy
Cardiovascular disease
Sex differences
Sex hormones
Sex steroids
Sexual dimorphism
Type 1 diabetes mellitus
Medicina
Medicine
description Background: Sex differences characterize cardiovascular outcomes in patients with type 1 diabetes. Cardioauto‑ nomic neuropathy is a common complication of type 1 diabetes that associates increased morbi-mortality. Data regarding the interplay between sex and cardiovascular autonomic neuropathy are scarce and controversial in these patients. We aimed to address sex-related differences in the prevalence of seemingly asymptomatic cardioautonomic neuropathy in type 1 diabetes, and their associations with sex steroids. Methods We conducted a cross-sectional study including 322 consecutively recruited patients with type 1 diabetes. Cardioautonomic neuropathy was diagnosed using Ewing’s score and power spectral heart rate data. We assessed sex hormones by liquid chromatography/tandem mass spectrometry. Results When considering all subjects as a whole, asymptomatic cardioautonomic neuropathy prevalence was not significantly different between women and men. When age was taken into account, the prevalence of cardioauto‑ nomic neuropathy was similar among young men and those>50 years. However, in women>50 years, the preva‑ lence of cardioautonomic neuropathy doubled that of young women [45.8% (32.6; 59.7) vs. 20.4% (13.7; 29.2), respec‑ tively]. The OR of having cardioautonomic neuropathy was 3.3 higher in women>50 years than in their younger counterparts. Furthermore, women presented more severe cardioautonomic neuropathy than men. These differences were even more marked when women were classified according their menopausal status instead of age. Peri- and menopausal women had an OR 3.5 (1.7; 7.2) of having CAN compared with their reproductive-aged counterparts [CAN prevalence: 51% (37; 65) vs. 23% (16; 32), respectively]. A binary logistic regression model (R2 : 0.161; P=0.001) displayed age>50 years as a significant determinant of cardioautonomic neuropathy only in women. Androgens were positively associated with heart rate variability in men, and negatively in women. Accordingly, cardioautonomic neuropathy was associated with increased testosterone/estradiol ratio in women but to decreased testosterone con‑ centrations in men.
publishDate 2023
dc.date.none.fl_str_mv 2023
2023-01-01
dc.type.none.fl_str_mv journal article
http://purl.org/coar/resource_type/c_6501
NA
http://purl.org/coar/version/c_be7fb7dd8ff6fe43
dc.type.openaire.fl_str_mv info:eu-repo/semantics/article
format article
dc.identifier.none.fl_str_mv http://hdl.handle.net/10017/66794
https://dx.doi.org/10.1186/s12933-023-01766-y
36793089
url http://hdl.handle.net/10017/66794
https://dx.doi.org/10.1186/s12933-023-01766-y
identifier_str_mv 36793089
dc.language.none.fl_str_mv Inglés
eng
language_invalid_str_mv Inglés
language eng
dc.relation.none.fl_str_mv ISCIII Not available PI1400649 Efecto de la disminución de los depósitos tisulares de hierro sobre factores de riesgo cardiovascular en mujeres con síndrome del ovario poliquístico. Un estudio prueba de concepto
ISCIII AES. 2015. Proyectos de Investigación en Salud PI15%2F01686 SEXMETAB. Influencia del sexo y de las hormonas sexuales en la disfunción del tejido adiposo y los trastornos metabólicos crónicos de etiologia compleja multifactorial
ISCIII AES. 2016. Proyectos Integrados de Excelencia (PIE) PI16%2F00050 SEXCOMPLEX. Influence of sex and sex hormones on human chronic disorders of complex etiology
CIBERDEM Not available DEM21‑PIM02
dc.rights.none.fl_str_mv open access
http://purl.org/coar/access_right/c_abf2
Attribution 4.0 International
http://creativecommons.org/licenses/by/4.0/
dc.rights.openaire.fl_str_mv info:eu-repo/semantics/openAccess
rights_invalid_str_mv open access
http://purl.org/coar/access_right/c_abf2
Attribution 4.0 International
http://creativecommons.org/licenses/by/4.0/
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
dc.source.none.fl_str_mv reponame:e_Buah Biblioteca Digital Universidad de Alcalá
instname:Universidad de Alcalá (UAH)
instname_str Universidad de Alcalá (UAH)
reponame_str e_Buah Biblioteca Digital Universidad de Alcalá
collection e_Buah Biblioteca Digital Universidad de Alcalá
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