Association of cardiac autonomic neuropathy and microalbuminuria in non-insulin-dependent diabetes mellitus

To evaluate the relationship between microalbuminuria and autonomic neuropathy in diabetes mellitus. A consecutive series of 151 patients with non-insulin-dependent diabetes mellitus underwent assessment in a single medical practice during a 3 1/2-year period for the presence of microalbuminuria and cardiac autonomic neuropathy. On the basis of microalbuminuria, the patients were categorized into two groups for comparison. Of the overall group of 151 patients, 91 had increased urinary albumin (50 mg/L or more), and 60 had normal albumin excretion (20 mg/L or less). Cardiac autonomic neuropathy was detected in 54% of the former group and 35% of the latter group. Thus, the presence of microalbuminuria was highly associated with cardiac autonomic neuropathy (results of chi2 analysis were significant at 2.3%). Other factors--duration of diabetes, blood pressure, and serum cholesterol and creatinine levels--did not differ between the two study groups. Results of this study indicate that the incidence of cardiac autonomic neuropathy is higher in those patients with increased urinary albumin levels than in those with normal excretion of albumin.