Early autonomic dysfunction in patients with diabetes mellitus assessed by spectral analysis of heart rate and blood pressure variability
Identifieur interne : 001994 ( Istex/Corpus ); précédent : 001993; suivant : 001995Early autonomic dysfunction in patients with diabetes mellitus assessed by spectral analysis of heart rate and blood pressure variability
Auteurs : H. Laederach-Hofmann ; H. Mussgay ; H. Winter ; H. Klinkenberg ; H. RüddelSource :
- Clinical Physiology [ 0144-5979 ] ; 1999-02.
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Abstract
Patients with diabetes mellitus (DM) often have alterations of the autonomic nervous system (ANS), even early in their disease course. Previous research has not evaluated whether these changes may have consequences on adaptation mechanisms in DM, e.g. to mental stress. We therefore evaluated whether patients with DM who already had early alterations of the ANS reacted with an abnormal regulatory pattern to mental stress. We used the spectral analysis technique, known to be valuable and reliable in the investigation of disturbances of the ANS. We investigated 34 patients with DM without clinical evidence of ANS dysfunction (e.g. orthostatic hypotension) and 44 normal control subjects (NC group). No patients on medication known to alter ANS responses were accepted. The investigation consisted of a resting state evaluation and a mental stress task (BonnDet). In basal values, only the 21 patients with type 2 DM were different in respect to body mass index and systolic blood pressure. In the study parameters we found significantly lower values in resting and mental stress spectral power of mid‐frequency band (known to represent predominantly sympathetic influences) and of high‐frequency and respiration bands (known to represent parasympathetic influences) in patients with DM (types 1 and 2) compared with NC group (5·3 ± 1·2 ms2 vs. 6·1 ± 1·3 ms2, and 5·5 ± 1·6 ms2 vs. 6·2 ± 1·5 ms2, and 4·6 ± 1·7 ms2 vs. 6·2 ± 1·5 ms2, for resting values respectively; 4·7 ± 1·4 ms2 vs. 5·9 ± 1·2 ms2, and 4·6 ± 1·9 ms2 vs. 5·6 ± 1·7 ms2, and 3·7 ± 2·1 ms2 vs. 5·6 ± 1·7 ms2, for stress values respectively; M/F ratio 6/26 vs. 30/14). These differences remained significant even when controlled for age, sex, and body weight. However, patients with DM type 2 (and significantly higher body weight) showed only significant values in mental stress modulus values. There were no specific group effects in the patients with DM in adaptation mechanisms to mental stress compared with the NC group. These findings demonstrate that power spectral examinations at rest are sufficiently reliable to diagnose early alterations in ANS in patients with DM. The spectral analysis technique is sensitive and reliable in investigation of ANS in patients with DM without clinically symptomatic autonomic dysfunction.
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DOI: 10.1046/j.1365-2281.1999.00150.x
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ISTEX:B1FAC7CB46D1927CFA77FCB49046B7DCC88DA760Le document en format XML
<record><TEI wicri:istexFullTextTei="biblStruct"><teiHeader><fileDesc><titleStmt><title xml:lang="en">Early autonomic dysfunction in patients with diabetes mellitus assessed by spectral analysis of heart rate and blood pressure variability</title><author><name sortKey="Laederach Ofmann, H" sort="Laederach Ofmann, H" uniqKey="Laederach Ofmann H" first="H." last="Laederach-Hofmann">H. Laederach-Hofmann</name><affiliation><mods:affiliation>Unit of Psychosomatic and Psychosocial Medicine, University of Berne, Switzerland, Fellowship at the Centre for Psychobiological and Psychosomatic Research, University of Trier, Germany,</mods:affiliation></affiliation></author><author><name sortKey="Mussgay, H" sort="Mussgay, H" uniqKey="Mussgay H" first="H." last="Mussgay">H. Mussgay</name><affiliation><mods:affiliation>University of Trier, Centre for Psychobiological and Psychosomatic Research, Department of Behavioral Medicine, St. Franziska Stift, D‐Bad Kreuznach, Germany</mods:affiliation></affiliation></author><author><name sortKey="Winter, H" sort="Winter, H" uniqKey="Winter H" first="H." last="Winter">H. Winter</name><affiliation><mods:affiliation>University of Trier, Centre for Psychobiological and Psychosomatic Research, Department of Behavioral Medicine, St. Franziska Stift, D‐Bad Kreuznach, Germany</mods:affiliation></affiliation></author><author><name sortKey="Klinkenberg, H" sort="Klinkenberg, H" uniqKey="Klinkenberg H" first="H." last="Klinkenberg">H. 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Rüddel</name><affiliation><mods:affiliation>University of Trier, Centre for Psychobiological and Psychosomatic Research, Department of Behavioral Medicine, St. Franziska Stift, D‐Bad Kreuznach, Germany</mods:affiliation></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">ISTEX</idno><idno type="RBID">ISTEX:B1FAC7CB46D1927CFA77FCB49046B7DCC88DA760</idno><date when="1999" year="1999">1999</date><idno type="doi">10.1046/j.1365-2281.1999.00150.x</idno><idno type="url">https://api.istex.fr/document/B1FAC7CB46D1927CFA77FCB49046B7DCC88DA760/fulltext/pdf</idno><idno type="wicri:Area/Istex/Corpus">001994</idno><idno type="wicri:explorRef" wicri:stream="Istex" wicri:step="Corpus" wicri:corpus="ISTEX">001994</idno></publicationStmt><sourceDesc><biblStruct><analytic><title level="a" type="main" xml:lang="en">Early autonomic dysfunction in patients with diabetes mellitus assessed by spectral analysis of heart rate and blood pressure variability</title><author><name sortKey="Laederach Ofmann, H" sort="Laederach Ofmann, H" uniqKey="Laederach Ofmann H" first="H." last="Laederach-Hofmann">H. Laederach-Hofmann</name><affiliation><mods:affiliation>Unit of Psychosomatic and Psychosocial Medicine, University of Berne, Switzerland, Fellowship at the Centre for Psychobiological and Psychosomatic Research, University of Trier, Germany,</mods:affiliation></affiliation></author><author><name sortKey="Mussgay, H" sort="Mussgay, H" uniqKey="Mussgay H" first="H." last="Mussgay">H. Mussgay</name><affiliation><mods:affiliation>University of Trier, Centre for Psychobiological and Psychosomatic Research, Department of Behavioral Medicine, St. Franziska Stift, D‐Bad Kreuznach, Germany</mods:affiliation></affiliation></author><author><name sortKey="Winter, H" sort="Winter, H" uniqKey="Winter H" first="H." last="Winter">H. Winter</name><affiliation><mods:affiliation>University of Trier, Centre for Psychobiological and Psychosomatic Research, Department of Behavioral Medicine, St. Franziska Stift, D‐Bad Kreuznach, Germany</mods:affiliation></affiliation></author><author><name sortKey="Klinkenberg, H" sort="Klinkenberg, H" uniqKey="Klinkenberg H" first="H." last="Klinkenberg">H. Klinkenberg</name><affiliation><mods:affiliation>University of Trier, Centre for Psychobiological and Psychosomatic Research, Department of Behavioral Medicine, St. Franziska Stift, D‐Bad Kreuznach, Germany</mods:affiliation></affiliation></author><author><name sortKey="Ruddel, H" sort="Ruddel, H" uniqKey="Ruddel H" first="H." last="Rüddel">H. Rüddel</name><affiliation><mods:affiliation>University of Trier, Centre for Psychobiological and Psychosomatic Research, Department of Behavioral Medicine, St. Franziska Stift, D‐Bad Kreuznach, Germany</mods:affiliation></affiliation></author></analytic><monogr></monogr><series><title level="j">Clinical Physiology</title><idno type="ISSN">0144-5979</idno><idno type="eISSN">1365-2281</idno><imprint><publisher>Blackwell Science Ltd</publisher><pubPlace>Oxford UK</pubPlace><date type="published" when="1999-02">1999-02</date><biblScope unit="volume">19</biblScope><biblScope unit="issue">2</biblScope><biblScope unit="page" from="97">97</biblScope><biblScope unit="page" to="106">106</biblScope></imprint><idno type="ISSN">0144-5979</idno></series><idno type="istex">B1FAC7CB46D1927CFA77FCB49046B7DCC88DA760</idno><idno type="DOI">10.1046/j.1365-2281.1999.00150.x</idno><idno type="ArticleID">CPF150</idno></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">0144-5979</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Fourier's transformation</term><term>autonomic nervous system</term><term>diabetes mellitus</term><term>spectral analysis technique</term></keywords></textClass><langUsage><language ident="en">en</language></langUsage></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Patients with diabetes mellitus (DM) often have alterations of the autonomic nervous system (ANS), even early in their disease course. Previous research has not evaluated whether these changes may have consequences on adaptation mechanisms in DM, e.g. to mental stress. We therefore evaluated whether patients with DM who already had early alterations of the ANS reacted with an abnormal regulatory pattern to mental stress. We used the spectral analysis technique, known to be valuable and reliable in the investigation of disturbances of the ANS. We investigated 34 patients with DM without clinical evidence of ANS dysfunction (e.g. orthostatic hypotension) and 44 normal control subjects (NC group). No patients on medication known to alter ANS responses were accepted. The investigation consisted of a resting state evaluation and a mental stress task (BonnDet). In basal values, only the 21 patients with type 2 DM were different in respect to body mass index and systolic blood pressure. In the study parameters we found significantly lower values in resting and mental stress spectral power of mid‐frequency band (known to represent predominantly sympathetic influences) and of high‐frequency and respiration bands (known to represent parasympathetic influences) in patients with DM (types 1 and 2) compared with NC group (5·3 ± 1·2 ms2 vs. 6·1 ± 1·3 ms2, and 5·5 ± 1·6 ms2 vs. 6·2 ± 1·5 ms2, and 4·6 ± 1·7 ms2 vs. 6·2 ± 1·5 ms2, for resting values respectively; 4·7 ± 1·4 ms2 vs. 5·9 ± 1·2 ms2, and 4·6 ± 1·9 ms2 vs. 5·6 ± 1·7 ms2, and 3·7 ± 2·1 ms2 vs. 5·6 ± 1·7 ms2, for stress values respectively; M/F ratio 6/26 vs. 30/14). These differences remained significant even when controlled for age, sex, and body weight. However, patients with DM type 2 (and significantly higher body weight) showed only significant values in mental stress modulus values. There were no specific group effects in the patients with DM in adaptation mechanisms to mental stress compared with the NC group. These findings demonstrate that power spectral examinations at rest are sufficiently reliable to diagnose early alterations in ANS in patients with DM. The spectral analysis technique is sensitive and reliable in investigation of ANS in patients with DM without clinically symptomatic autonomic dysfunction.</div></front></TEI><istex><corpusName>wiley</corpusName><author><json:item><name>Laederach‐Hofmann Laederach‐Hofmann</name><affiliations><json:string>Unit of Psychosomatic and Psychosocial Medicine, University of Berne, Switzerland, Fellowship at the Centre for Psychobiological and Psychosomatic Research, University of Trier, Germany,</json:string></affiliations></json:item><json:item><name>Mussgay Mussgay</name><affiliations><json:string>University of Trier, Centre for Psychobiological and Psychosomatic Research, Department of Behavioral Medicine, St. Franziska Stift, D‐Bad Kreuznach, Germany</json:string></affiliations></json:item><json:item><name>Winter Winter</name><affiliations><json:string>University of Trier, Centre for Psychobiological and Psychosomatic Research, Department of Behavioral Medicine, St. Franziska Stift, D‐Bad Kreuznach, Germany</json:string></affiliations></json:item><json:item><name>Klinkenberg Klinkenberg</name><affiliations><json:string>University of Trier, Centre for Psychobiological and Psychosomatic Research, Department of Behavioral Medicine, St. Franziska Stift, D‐Bad Kreuznach, Germany</json:string></affiliations></json:item><json:item><name>Rüddel Rüddel</name><affiliations><json:string>University of Trier, Centre for Psychobiological and Psychosomatic Research, Department of Behavioral Medicine, St. Franziska Stift, D‐Bad Kreuznach, Germany</json:string></affiliations></json:item></author><subject><json:item><lang><json:string>eng</json:string></lang><value>autonomic nervous system</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>diabetes mellitus</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>Fourier's transformation</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>spectral analysis technique</value></json:item></subject><articleId><json:string>CPF150</json:string></articleId><language><json:string>eng</json:string></language><originalGenre><json:string>article</json:string></originalGenre><abstract>Patients with diabetes mellitus (DM) often have alterations of the autonomic nervous system (ANS), even early in their disease course. Previous research has not evaluated whether these changes may have consequences on adaptation mechanisms in DM, e.g. to mental stress. We therefore evaluated whether patients with DM who already had early alterations of the ANS reacted with an abnormal regulatory pattern to mental stress. We used the spectral analysis technique, known to be valuable and reliable in the investigation of disturbances of the ANS. We investigated 34 patients with DM without clinical evidence of ANS dysfunction (e.g. orthostatic hypotension) and 44 normal control subjects (NC group). No patients on medication known to alter ANS responses were accepted. The investigation consisted of a resting state evaluation and a mental stress task (BonnDet). In basal values, only the 21 patients with type 2 DM were different in respect to body mass index and systolic blood pressure. In the study parameters we found significantly lower values in resting and mental stress spectral power of mid‐frequency band (known to represent predominantly sympathetic influences) and of high‐frequency and respiration bands (known to represent parasympathetic influences) in patients with DM (types 1 and 2) compared with NC group (5·3 ± 1·2 ms2 vs. 6·1 ± 1·3 ms2, and 5·5 ± 1·6 ms2 vs. 6·2 ± 1·5 ms2, and 4·6 ± 1·7 ms2 vs. 6·2 ± 1·5 ms2, for resting values respectively; 4·7 ± 1·4 ms2 vs. 5·9 ± 1·2 ms2, and 4·6 ± 1·9 ms2 vs. 5·6 ± 1·7 ms2, and 3·7 ± 2·1 ms2 vs. 5·6 ± 1·7 ms2, for stress values respectively; M/F ratio 6/26 vs. 30/14). These differences remained significant even when controlled for age, sex, and body weight. However, patients with DM type 2 (and significantly higher body weight) showed only significant values in mental stress modulus values. There were no specific group effects in the patients with DM in adaptation mechanisms to mental stress compared with the NC group. These findings demonstrate that power spectral examinations at rest are sufficiently reliable to diagnose early alterations in ANS in patients with DM. The spectral analysis technique is sensitive and reliable in investigation of ANS in patients with DM without clinically symptomatic autonomic dysfunction.</abstract><qualityIndicators><score>8</score><pdfVersion>1.2</pdfVersion><pdfPageSize>595 x 782 pts</pdfPageSize><refBibsNative>true</refBibsNative><abstractCharCount>2302</abstractCharCount><pdfWordCount>5779</pdfWordCount><pdfCharCount>40122</pdfCharCount><pdfPageCount>10</pdfPageCount><abstractWordCount>334</abstractWordCount></qualityIndicators><title>Early autonomic dysfunction in patients with diabetes mellitus assessed by spectral analysis of heart rate and blood pressure variability</title><refBibs><json:item><author><json:item><name>F. BELLAVERE</name></json:item><json:item><name>I. BALZANI</name></json:item><json:item><name>G. 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Previous research has not evaluated whether these changes may have consequences on adaptation mechanisms in DM, e.g. to mental stress. We therefore evaluated whether patients with DM who already had early alterations of the ANS reacted with an abnormal regulatory pattern to mental stress. We used the spectral analysis technique, known to be valuable and reliable in the investigation of disturbances of the ANS. We investigated 34 patients with DM without clinical evidence of ANS dysfunction (e.g. orthostatic hypotension) and 44 normal control subjects (NC group). No patients on medication known to alter ANS responses were accepted. The investigation consisted of a resting state evaluation and a mental stress task (BonnDet). In basal values, only the 21 patients with type 2 DM were different in respect to body mass index and systolic blood pressure. In the study parameters we found significantly lower values in resting and mental stress spectral power of mid‐frequency band (known to represent predominantly sympathetic influences) and of high‐frequency and respiration bands (known to represent parasympathetic influences) in patients with DM (types 1 and 2) compared with NC group (5·3 ± 1·2 ms2 vs. 6·1 ± 1·3 ms2, and 5·5 ± 1·6 ms2 vs. 6·2 ± 1·5 ms2, and 4·6 ± 1·7 ms2 vs. 6·2 ± 1·5 ms2, for resting values respectively; 4·7 ± 1·4 ms2 vs. 5·9 ± 1·2 ms2, and 4·6 ± 1·9 ms2 vs. 5·6 ± 1·7 ms2, and 3·7 ± 2·1 ms2 vs. 5·6 ± 1·7 ms2, for stress values respectively; M/F ratio 6/26 vs. 30/14). These differences remained significant even when controlled for age, sex, and body weight. However, patients with DM type 2 (and significantly higher body weight) showed only significant values in mental stress modulus values. There were no specific group effects in the patients with DM in adaptation mechanisms to mental stress compared with the NC group. These findings demonstrate that power spectral examinations at rest are sufficiently reliable to diagnose early alterations in ANS in patients with DM. The spectral analysis technique is sensitive and reliable in investigation of ANS in patients with DM without clinically symptomatic autonomic dysfunction.</p></abstract><textClass xml:lang="en"><keywords scheme="keyword"><list><head>keywords</head><item><term>autonomic nervous system</term></item><item><term>diabetes mellitus</term></item><item><term>Fourier's transformation</term></item><item><term>spectral analysis technique</term></item></list></keywords></textClass></profileDesc><revisionDesc><change when="1999-02">Published</change></revisionDesc></teiHeader></istex:fulltextTEI><json:item><extension>txt</extension><original>false</original><mimetype>text/plain</mimetype><uri>https://api.istex.fr/document/B1FAC7CB46D1927CFA77FCB49046B7DCC88DA760/fulltext/txt</uri></json:item></fulltext><metadata><istex:metadataXml wicri:clean="Wiley, elements deleted: body"><istex:xmlDeclaration>version="1.0" encoding="UTF-8" standalone="yes"</istex:xmlDeclaration><istex:document><component version="2.0" type="serialArticle" xml:lang="en"><header><publicationMeta level="product"><publisherInfo><publisherName>Blackwell Science Ltd</publisherName><publisherLoc>Oxford UK</publisherLoc></publisherInfo><doi origin="wiley" registered="yes">10.1111/(ISSN)1365-2281</doi><issn type="print">0144-5979</issn><issn type="electronic">1365-2281</issn><idGroup><id type="product" value="CPF"></id><id type="publisherDivision" value="ST"></id></idGroup><titleGroup><title type="main" sort="CLINICAL PHYSIOLOGY">Clinical Physiology</title></titleGroup></publicationMeta><publicationMeta level="part" position="02002"><doi origin="wiley">10.1111/cpf.1999.19.issue-2</doi><numberingGroup><numbering type="journalVolume" number="19">19</numbering><numbering type="journalIssue" number="2">2</numbering></numberingGroup><coverDate startDate="1999-02">February 1999</coverDate></publicationMeta><publicationMeta level="unit" type="article" position="0009700" status="forIssue"><doi origin="wiley">10.1046/j.1365-2281.1999.00150.x</doi><idGroup><id type="unit" value="CPF150"></id></idGroup><countGroup><count type="pageTotal" number="10"></count></countGroup><titleGroup><title type="tocHeading1">Original Article</title></titleGroup><eventGroup><event type="firstOnline" date="2008-06-28"></event><event type="publishedOnlineFinalForm" date="2008-06-28"></event><event type="xmlConverted" agent="Converter:BPG_TO_WML3G version:2.3.2 mode:FullText source:Header result:Header" date="2010-03-08"></event><event type="xmlConverted" agent="Converter:WILEY_ML3G_TO_WILEY_ML3GV2 version:3.8.8" date="2014-01-16"></event><event type="xmlConverted" agent="Converter:WML3G_To_WML3G version:4.1.7 mode:FullText,remove_FC" date="2014-10-16"></event></eventGroup><numberingGroup><numbering type="pageFirst" number="97">97</numbering><numbering type="pageLast" number="106">106</numbering></numberingGroup><correspondenceTo>Laederach‐Hofmann Unit of Psychosomatic and Psychosocial Medicine MUP, University of Berne, 3010 Berne/Switzerland</correspondenceTo><linkGroup><link type="toTypesetVersion" href="file:CPF.CPF150.pdf"></link></linkGroup></publicationMeta><contentMeta><countGroup><count type="figureTotal" number="1"></count><count type="tableTotal" number="0"></count><count type="referenceTotal" number="59"></count><count type="linksPubMed" number="0"></count><count type="linksCrossRef" number="0"></count></countGroup><titleGroup><title type="main">Early autonomic dysfunction in patients with diabetes mellitus assessed by spectral analysis of heart rate and blood pressure variability</title><title type="shortAuthors">K. Laederach‐Hofmann et al.</title><title type="short">Autonomic dysfunction in diabetes mellitus</title></titleGroup><creators><creator creatorRole="author" xml:id="cr1" affiliationRef="#a1"><personName><familyName>Laederach‐Hofmann</familyName></personName></creator><creator creatorRole="author" xml:id="cr2" affiliationRef="#a2"><personName><familyName>Mussgay</familyName></personName></creator><creator creatorRole="author" xml:id="cr3" affiliationRef="#a2"><personName><familyName>Winter</familyName></personName></creator><creator creatorRole="author" xml:id="cr4" affiliationRef="#a2"><personName><familyName>Klinkenberg</familyName></personName></creator><creator creatorRole="author" xml:id="cr5" affiliationRef="#a2"><personName><familyName>Rüddel</familyName></personName></creator></creators><affiliationGroup><affiliation xml:id="a1"><unparsedAffiliation>Unit of Psychosomatic and Psychosocial Medicine, University of Berne, Switzerland, Fellowship at the Centre for Psychobiological and Psychosomatic Research, University of Trier, Germany,</unparsedAffiliation></affiliation><affiliation xml:id="a2" countryCode="DE"><unparsedAffiliation>University of Trier, Centre for Psychobiological and Psychosomatic Research, Department of Behavioral Medicine, St. Franziska Stift, D‐Bad Kreuznach, Germany</unparsedAffiliation></affiliation></affiliationGroup><keywordGroup xml:lang="en"><keyword xml:id="k1">autonomic nervous system</keyword><keyword xml:id="k2">diabetes mellitus</keyword><keyword xml:id="k3">Fourier's transformation</keyword><keyword xml:id="k4">spectral analysis technique</keyword></keywordGroup><abstractGroup><abstract type="main" xml:lang="en"><p>Patients with diabetes mellitus (DM) often have alterations of the autonomic nervous system (ANS), even early in their disease course. Previous research has not evaluated whether these changes may have consequences on adaptation mechanisms in DM, e.g. to mental stress. We therefore evaluated whether patients with DM who already had early alterations of the ANS reacted with an abnormal regulatory pattern to mental stress. We used the spectral analysis technique, known to be valuable and reliable in the investigation of disturbances of the ANS. We investigated 34 patients with DM without clinical evidence of ANS dysfunction (e.g. orthostatic hypotension) and 44 normal control subjects (NC group). No patients on medication known to alter ANS responses were accepted. The investigation consisted of a resting state evaluation and a mental stress task (BonnDet). In basal values, only the 21 patients with type 2 DM were different in respect to body mass index and systolic blood pressure. In the study parameters we found significantly lower values in resting and mental stress spectral power of mid‐frequency band (known to represent predominantly sympathetic influences) and of high‐frequency and respiration bands (known to represent parasympathetic influences) in patients with DM (types 1 and 2) compared with NC group (5·3 ± 1·2 ms<sup>2 </sup>vs. 6·1 ± 1·3 ms<sup>2</sup>, and 5·5 ± 1·6 ms<sup>2</sup> vs. 6·2 ± 1·5 ms<sup>2</sup>, and 4·6 ± 1·7 ms<sup>2</sup> vs. 6·2 ± 1·5 ms<sup>2</sup>, for resting values respectively; 4·7 ± 1·4 ms<sup>2</sup> vs. 5·9 ± 1·2 ms<sup>2</sup>, and 4·6 ± 1·9 ms<sup>2</sup> vs. 5·6 ± 1·7 ms<sup>2</sup>, and 3·7 ± 2·1 ms<sup>2</sup> vs. 5·6 ± 1·7 ms<sup>2</sup>, for stress values respectively; M/F ratio 6/26 vs. 30/14). These differences remained significant even when controlled for age, sex, and body weight. However, patients with DM type 2 (and significantly higher body weight) showed only significant values in mental stress modulus values. There were no specific group effects in the patients with DM in adaptation mechanisms to mental stress compared with the NC group. These findings demonstrate that power spectral examinations at rest are sufficiently reliable to diagnose early alterations in ANS in patients with DM. The spectral analysis technique is sensitive and reliable in investigation of ANS in patients with DM without clinically symptomatic autonomic dysfunction.</p></abstract></abstractGroup></contentMeta></header></component></istex:document></istex:metadataXml><mods version="3.6"><titleInfo lang="en"><title>Early autonomic dysfunction in patients with diabetes mellitus assessed by spectral analysis of heart rate and blood pressure variability</title></titleInfo><titleInfo type="abbreviated" lang="en"><title>Autonomic dysfunction in diabetes mellitus</title></titleInfo><titleInfo type="alternative" contentType="CDATA" lang="en"><title>Early autonomic dysfunction in patients with diabetes mellitus assessed by spectral analysis of heart rate and blood pressure variability</title></titleInfo><name type="personal"><namePart>Laederach‐Hofmann</namePart><namePart type="family">Laederach‐Hofmann</namePart><affiliation>Unit of Psychosomatic and Psychosocial Medicine, University of Berne, Switzerland, Fellowship at the Centre for Psychobiological and Psychosomatic Research, University of Trier, Germany,</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart>Mussgay</namePart><namePart type="family">Mussgay</namePart><affiliation>University of Trier, Centre for Psychobiological and Psychosomatic Research, Department of Behavioral Medicine, St. Franziska Stift, D‐Bad Kreuznach, Germany</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart>Winter</namePart><namePart type="family">Winter</namePart><affiliation>University of Trier, Centre for Psychobiological and Psychosomatic Research, Department of Behavioral Medicine, St. Franziska Stift, D‐Bad Kreuznach, Germany</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart>Klinkenberg</namePart><namePart type="family">Klinkenberg</namePart><affiliation>University of Trier, Centre for Psychobiological and Psychosomatic Research, Department of Behavioral Medicine, St. Franziska Stift, D‐Bad Kreuznach, Germany</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart>Rüddel</namePart><namePart type="family">Rüddel</namePart><affiliation>University of Trier, Centre for Psychobiological and Psychosomatic Research, Department of Behavioral Medicine, St. Franziska Stift, D‐Bad Kreuznach, Germany</affiliation><role><roleTerm type="text">author</roleTerm></role></name><typeOfResource>text</typeOfResource><genre type="article" displayLabel="article"></genre><originInfo><publisher>Blackwell Science Ltd</publisher><place><placeTerm type="text">Oxford UK</placeTerm></place><dateIssued encoding="w3cdtf">1999-02</dateIssued><copyrightDate encoding="w3cdtf">1999</copyrightDate></originInfo><language><languageTerm type="code" authority="rfc3066">en</languageTerm><languageTerm type="code" authority="iso639-2b">eng</languageTerm></language><physicalDescription><internetMediaType>text/html</internetMediaType><extent unit="figures">1</extent><extent unit="references">59</extent></physicalDescription><abstract lang="en">Patients with diabetes mellitus (DM) often have alterations of the autonomic nervous system (ANS), even early in their disease course. Previous research has not evaluated whether these changes may have consequences on adaptation mechanisms in DM, e.g. to mental stress. We therefore evaluated whether patients with DM who already had early alterations of the ANS reacted with an abnormal regulatory pattern to mental stress. We used the spectral analysis technique, known to be valuable and reliable in the investigation of disturbances of the ANS. We investigated 34 patients with DM without clinical evidence of ANS dysfunction (e.g. orthostatic hypotension) and 44 normal control subjects (NC group). No patients on medication known to alter ANS responses were accepted. The investigation consisted of a resting state evaluation and a mental stress task (BonnDet). In basal values, only the 21 patients with type 2 DM were different in respect to body mass index and systolic blood pressure. In the study parameters we found significantly lower values in resting and mental stress spectral power of mid‐frequency band (known to represent predominantly sympathetic influences) and of high‐frequency and respiration bands (known to represent parasympathetic influences) in patients with DM (types 1 and 2) compared with NC group (5·3 ± 1·2 ms2 vs. 6·1 ± 1·3 ms2, and 5·5 ± 1·6 ms2 vs. 6·2 ± 1·5 ms2, and 4·6 ± 1·7 ms2 vs. 6·2 ± 1·5 ms2, for resting values respectively; 4·7 ± 1·4 ms2 vs. 5·9 ± 1·2 ms2, and 4·6 ± 1·9 ms2 vs. 5·6 ± 1·7 ms2, and 3·7 ± 2·1 ms2 vs. 5·6 ± 1·7 ms2, for stress values respectively; M/F ratio 6/26 vs. 30/14). These differences remained significant even when controlled for age, sex, and body weight. However, patients with DM type 2 (and significantly higher body weight) showed only significant values in mental stress modulus values. There were no specific group effects in the patients with DM in adaptation mechanisms to mental stress compared with the NC group. These findings demonstrate that power spectral examinations at rest are sufficiently reliable to diagnose early alterations in ANS in patients with DM. The spectral analysis technique is sensitive and reliable in investigation of ANS in patients with DM without clinically symptomatic autonomic dysfunction.</abstract><subject lang="en"><genre>keywords</genre><topic>autonomic nervous system</topic><topic>diabetes mellitus</topic><topic>Fourier's transformation</topic><topic>spectral analysis technique</topic></subject><relatedItem type="host"><titleInfo><title>Clinical Physiology</title></titleInfo><genre type="journal">journal</genre><identifier type="ISSN">0144-5979</identifier><identifier type="eISSN">1365-2281</identifier><identifier type="DOI">10.1111/(ISSN)1365-2281</identifier><identifier type="PublisherID">CPF</identifier><part><date>1999</date><detail type="volume"><caption>vol.</caption><number>19</number></detail><detail type="issue"><caption>no.</caption><number>2</number></detail><extent unit="pages"><start>97</start><end>106</end><total>10</total></extent></part></relatedItem><identifier type="istex">B1FAC7CB46D1927CFA77FCB49046B7DCC88DA760</identifier><identifier type="DOI">10.1046/j.1365-2281.1999.00150.x</identifier><identifier type="ArticleID">CPF150</identifier><recordInfo><recordContentSource>WILEY</recordContentSource><recordOrigin>Blackwell Science Ltd</recordOrigin></recordInfo></mods></metadata><serie></serie></istex></record>Pour manipuler ce document sous Unix (Dilib)
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