TY - JOUR
T1 - Erythropoietin response to anemia and its association with autonomic neuropathy in type 2 diabetic patients without advanced renal failure
AU - Kim, Mee Kyoung
AU - Baek, Ki Hyun
AU - Lim, Dong Jun
AU - Kim, Young Kyu
AU - Kang, Moo Il
AU - Lee, Kwang Woo
AU - Song, Ki Ho
PY - 2010/3
Y1 - 2010/3
N2 - Aim: We aim to investigate erythropoietin (EPO) response to anemia and its association with autonomic neuropathy in type 2 diabetic patients without advanced renal failure. Methods: A cross-sectional study was conducted on 211 type 2 diabetes mellitus patients without advanced renal failure [estimated glomerular filtration rate (eGFR) >40 ml/min/1.73 m2]. The response of EPO to anemia of type 2 diabetic patients without advanced renal failure was compared with those of nondiabetic control subjects. Autonomic nerve function was assessed using three cardiovascular tests (deep breathing, the Valsalva maneuver, and lying-to-standing). The results of each test were scored as 0 if normal, 1 if borderline, and 2 if abnormal. Autonomic neuropathy was diagnosed when a total score of the tests was 2 or more. Results: Fifty-eight patients were anemic; compared with nonanemic patients, they had a longer duration of diabetes (16.69±10.11 vs. 10.67±8.41 years, P<.001), lower eGFR (66.43±16.30 vs. 81.74±19.49 ml/min/1.73 m2, P<.001), and higher cardiovascular autonomic neuropathy score (3.17±1.95 vs. 1.79±1.72, P<.001). Serum EPO level was weakly correlated with hemoglobin (Hb) level (r=-.085, P<.001). However, the slopes of regression lines between EPO and Hb levels differed significantly between type 2 diabetic patients and nondiabetic control subjects (-0.0085 vs. -0.255, P=.008). Multiple linear regression analysis revealed that cardiovascular autonomic neuropathy score was independently related to Hb (P<.001) or EPO level (P=.052). Conclusions: Autonomic neuropathy is associated with a blunted EPO response to anemia in type 2 diabetic patients without advanced renal failure.
AB - Aim: We aim to investigate erythropoietin (EPO) response to anemia and its association with autonomic neuropathy in type 2 diabetic patients without advanced renal failure. Methods: A cross-sectional study was conducted on 211 type 2 diabetes mellitus patients without advanced renal failure [estimated glomerular filtration rate (eGFR) >40 ml/min/1.73 m2]. The response of EPO to anemia of type 2 diabetic patients without advanced renal failure was compared with those of nondiabetic control subjects. Autonomic nerve function was assessed using three cardiovascular tests (deep breathing, the Valsalva maneuver, and lying-to-standing). The results of each test were scored as 0 if normal, 1 if borderline, and 2 if abnormal. Autonomic neuropathy was diagnosed when a total score of the tests was 2 or more. Results: Fifty-eight patients were anemic; compared with nonanemic patients, they had a longer duration of diabetes (16.69±10.11 vs. 10.67±8.41 years, P<.001), lower eGFR (66.43±16.30 vs. 81.74±19.49 ml/min/1.73 m2, P<.001), and higher cardiovascular autonomic neuropathy score (3.17±1.95 vs. 1.79±1.72, P<.001). Serum EPO level was weakly correlated with hemoglobin (Hb) level (r=-.085, P<.001). However, the slopes of regression lines between EPO and Hb levels differed significantly between type 2 diabetic patients and nondiabetic control subjects (-0.0085 vs. -0.255, P=.008). Multiple linear regression analysis revealed that cardiovascular autonomic neuropathy score was independently related to Hb (P<.001) or EPO level (P=.052). Conclusions: Autonomic neuropathy is associated with a blunted EPO response to anemia in type 2 diabetic patients without advanced renal failure.
KW - Anemia: Type 2 diabetes
KW - Autonomic neuropathy
KW - Erythropoietin
UR - https://www.scopus.com/pages/publications/76949095411
U2 - 10.1016/j.jdiacomp.2009.02.002
DO - 10.1016/j.jdiacomp.2009.02.002
M3 - Article
C2 - 19303331
AN - SCOPUS:76949095411
SN - 1056-8727
VL - 24
SP - 90
EP - 95
JO - Journal of Diabetes and its Complications
JF - Journal of Diabetes and its Complications
IS - 2
ER -
