Diabetes research and clinical practice · 2026
Association of peripheral neuropathy severity and cardiac autonomic dysfunction in individuals with neuropathic diabetic foot versus those with diabetic peripheral neuropathy alone.
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Ma Chunjie, Lin Shuang, Bai Mingxin, Feng Ruixue, Wan Guorui, Xiong Daizhen, Ran Xingwu, Wang Chun, Chen Dawei, Chen Lihong, He Sen, Yan Donge, Luo Bo, Liu Yan, Gao Yun
Аннотация
AIMS: To investigate whether cardiac autonomic dysfunction severity is associated with diabetic peripheral neuropathy (DPN) severity, and whether this association differs between individuals with neuropathic foot ulceration (DFU) and those with DPN alone.
METHODS: Among 794 participants with DPN (268 with neuropathic DFU and 526 without DFU), cardiac autonomic dysfunction was assessed using heart rate variability and DPN severity using nerve conduction studies. Multivariate logistic regression evaluated the association between DPN severity and cardiac autonomic dysfunction. Subgroup and interaction analyses assessed whether the association differed by DFU status.
RESULTS: As the standard deviation of the normal sinus interval (SDNN) decreased, conduction velocities and amplitudes of all tested nerves declined. In both groups, greater reductions in sural or common peroneal nerve conduction parameters were independently associated with lower SDNN (all P < 0.01). In neuropathic DFU group, 29.6 %-31.1 % of those with both conduction velocity and amplitude abnormalities had SDNN < 50 ms. No significant interactions between DFU and lower extremity nerve conduction parameters were observed (all P for interaction > 0.05).
CONCLUSION: Cardiac autonomic dysfunction was associated with greater DPN severity. Although neuropathic DFUs exhibited more severe cardiac autonomic dysfunction and DPN, the association between their severities did not differ by DFU status.
METHODS: Among 794 participants with DPN (268 with neuropathic DFU and 526 without DFU), cardiac autonomic dysfunction was assessed using heart rate variability and DPN severity using nerve conduction studies. Multivariate logistic regression evaluated the association between DPN severity and cardiac autonomic dysfunction. Subgroup and interaction analyses assessed whether the association differed by DFU status.
RESULTS: As the standard deviation of the normal sinus interval (SDNN) decreased, conduction velocities and amplitudes of all tested nerves declined. In both groups, greater reductions in sural or common peroneal nerve conduction parameters were independently associated with lower SDNN (all P < 0.01). In neuropathic DFU group, 29.6 %-31.1 % of those with both conduction velocity and amplitude abnormalities had SDNN < 50 ms. No significant interactions between DFU and lower extremity nerve conduction parameters were observed (all P for interaction > 0.05).
CONCLUSION: Cardiac autonomic dysfunction was associated with greater DPN severity. Although neuropathic DFUs exhibited more severe cardiac autonomic dysfunction and DPN, the association between their severities did not differ by DFU status.