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Impairment of cardiovascular autonomic pattern in obese adolescents with Type 2 diabetes mellitus

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Abstract

The aim of this study was to assess the behaviour of insulin sensitivity and insulin resistance (IR) indexes in a group of obese adolescents with Type 2 diabetes mellitus (T2DM) in comparison to obese adolescents without diabetes and normal controls, moreover to compare these parameters with the cardiac autonomic pattern. Seven T2DM obese (12.7±0.5 yr), 18 obese without T2DM, and 10 nonobese control adolescents age matched were studied. In all subjects we performed oral glucose tolerance test (OGTT) with insulin and glucose determination, 24-h electrocardiogram Holter, blood pressure monitoring, ecoho-cardiogram. Results: serum lipids were significantly higher in obese and T2DM. Insulin sensitivity was significantly reduced in T2DM and obese vs controls; T2DM showed a more pronounced oral glucose insulin sensitivity (OGIS) reduction vs obese. Both obese and T2DM presented an higher IR. T2DM showed an impaired β-cell function, with insulin areas under the curve and disposition index significantly reduced in comparison to controls and obese who showed similar values. A progressive reduction of vagal indexes and an increase of sympathetic indexes were found in obese adolescents and were more pronounced in T2DM. These parameters were correlated with OGIS and β-cell function parameters in both obese and T2DM adolescents. T2DM showed a significant relative wall thickness increase suggesting a trend toward concentric remodeling. In conclusion, T2DM adolescents are characterized by a more marked IR reduced β-cell function in comparison to non-diabetic obese. These modifications may lead to an early impairment of the autonomic pattern.

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Authors and Affiliations

  1. Department of Pediatrics, University of Torino, Piazza Polonia 96, 10126, Torino, Italy

    F. Cerutti MD, I. Rabbone, A. Bobbio, M. G. Ignaccolo, G. Greco & M. C. Bertello

  2. Department of Internal Medicine, University of Turin, Turin

    F. Rabbia, P. Mulatero & F. Veglio

  3. Metabolic Unit, Institute of Biomedical Engineering, National Research Council, Padua, Italy

    G. Pacini

Authors
  1. F. Cerutti MD
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  2. F. Rabbia
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  3. I. Rabbone
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  4. A. Bobbio
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  5. M. G. Ignaccolo
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  6. G. Greco
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  7. M. C. Bertello
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  8. P. Mulatero
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  9. F. Veglio
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  10. G. Pacini
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Correspondence to F. Cerutti MD.

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Cerutti, F., Rabbia, F., Rabbone, I. et al. Impairment of cardiovascular autonomic pattern in obese adolescents with Type 2 diabetes mellitus. J Endocrinol Invest 33, 539–543 (2010). https://doi.org/10.1007/BF03346644

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