Optimization of the diagnosis of cardiovascular autonomic neuropathy in diabetes mellitusand metabolic syndrome

Purpose: to clarify and compare the effectiveness of the method of quantitative autonomic testing on the Case-4 apparatus and cardiovascular functional tests performed by pulse oximetry for the early diagnosis of cardiovascular autonomic neuropathy in patients with type 2 diabetes mellitus and metabolic syndrome. Material and Methods. The study included 30 patients with type 2 diabetes (average age 56.5±13.5 years), 30 patients with metabolic syndrome (average age61±9 years) and 30 healthy subjects (average age 58±10 years), comparable in gender and age with the study groups. The main cardiovascular reflex tests were performed: subjective sensations were assessed using the NSC questionnaire, the severity of deficient neuropathic disorders was assessed by the NIS-LL scale, and neuropathic pain syndrome was assessed by the TSS scale. Results. In the study group of patients with type 2 diabetes, severe cardiac autonomic neuropathy (CAN) was detected in 13.3% of patients, moderate in 40% of patients, and in 46.6% of patients, signs of CAN were not detected. In the group of patients with metabolic syndrome, 10% of patients had severe CAN, 10% had moderate, and 80% of patients had no signs of CAN. In the group of healthy volunteers, no disorders of the autonomic nervous system were identified. Conclusion. The results of pulse oximetry tests with deep breathing were comparable to the results of quantitative autonomic testing with the Case-4 apparatus (p<0.001). The use of pulse oximetry is most expedient in terms of time and consumables in comparison with hardware quantitative vegetative testing.