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<h5 class="section-title" id="d1016812e215">Aims</h5>
<p id="P1">Cardiovascular autonomic neuropathy (CAN) predicts clinical diabetic nephropathy
(DN).
We investigated the relationship between DN structural lesions and CAN.
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<h5 class="section-title" id="d1016812e220">Methods</h5>
<p id="P2">Sixty three Pima Indians with type 2 diabetes underwent kidney biopsies
following
a 6-year clinical trial testing the renoprotective efficacy of losartan
<i>vs</i>. placebo. CAN was assessed a median 9.2 years later. CAN variables included
expiration/inspiration
ratio (E/I), standard deviation of the normal RR interval (sdNN), and low and high
frequency signal power and their ratio (LF, HF, LF/HF); lower values reflect more
severe neuropathy. Associations of CAN with renal structural variables were assessed
by linear regression adjusted for age, sex, diabetes duration, blood pressure, HbA1c,
glomerular filtration rate, and treatment assignment during the trial.
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<h5 class="section-title" id="d1016812e228">Results</h5>
<p id="P3">Global glomerular sclerosis was negatively associated with sdNN (partial
r = −0.35,
p = 0.01) and LF (r = −0.32, p = 0.02); glomerular basement membrane width was negatively
associated with all measures of CAN except for LF/HF (r = −0.28 to −0.42, p<0.05);
filtration surface density was positively associated with sdNN, LF, and HF (r = 0.31
to 0.38, p<0.05); and cortical interstitial fractional volume was negatively associated
with HF (r = −0.27, p = 0.04).
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<h5 class="section-title" id="d1016812e233">Conclusions</h5>
<p id="P4">CAN associates with DN lesions.</p>
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