Correlations between hormone levels and cardiovascular autonomic neuropathy in menopausal patients with diabetes mellitus

Objective: To discuss the correlation between hormone levels and cardiovascular autonomic neuropathy (CAN) in menopausal patients with Type-2 diabetes mellitus (T2DM).

Methods: This clinical research study was conducted at Department of Endocrinology, Baoding No. 1 Hospital from January 2016 to December 2017. In this study a total of 386 menopausal female patients with T2DM were selected and classified into two groups according to the CAN function test: the CAN group (80 cases) and the DM group (306 cases). The Kupperman score (KI integral) was calculated for all participants in the study, and the following indexes were measured: body mass index (BMI), blood estrogen (E2), follicle-stimulating hormone (FSH), luteinizing hormone (LH), thyroid-stimulating hormone (TSH), free thyroxine (FT4), free triiodothyronine (FT3), fasting blood-glucose (FBG), glycosylated hemoglobin (HbA1c), serum lipids, uric acid (SUA), hypersensitive c-reactive protein (CRP), etc.

Results: The FBG, HbA1c, TGs, Hs-CRP, SUA, KI score, TSH, FSH and LH of the CAN group were obviously higher than the same parameters in the DM group (P﹤0.01, P﹤0.05), while HDL-C, E2, FT3 and FT4 were significantly lower (P﹤0.01, P﹤0.05). Pearson correlation analysis indicated that CAN presents a positive correlation with HbA1c, TGs, hs-CRP and SUA and a negative correlation with HDL-C and E2, and the difference was statistically significant (P<0.05). The multifactor logistic regression analysis results showed that HbA1c (OR=3.980, 95%CI=1.268~10.319) and E2 (OR=3.075, 95%CI=1.167~7.366) are independent risk factors for CAN.

Conclusion: The CAN morbidity of menopausal female patients with T2DM is high, and HbA1c and E2 should be mainly monitored to identify and treat CAN early.