Cardiac Autonomic Neuropathy and Two Insulin Resistance Indices

Background and objectives Cardiac autonomic neuropathy (CAN) is a common and poor prognosis complication of diabetes. There are documents regarding the causative role of autonomic nervous system in the pathogenesis of insulin resistance (IR). As a predisposing factor for diabetes and metabolic syndrome, the IR by itself is also associated with increased risk of cardiovascular disease. Very limited studies concern the relation of IR with CAN. Therefore the values of the homeostasis model assessment of insulin resistance (HOMA-IR) and the triglyceride-glucose (TyG) indices were studied in diabetic patients with CAN. Methods This descriptive cross sectional study was carried on 70 volunteer diabetic’s participants in endocrine clinic of Fifth AZARE hospital in Gorgan that full fit the inclusion criteria. The following tests were used for diagnosis of CAN: resting heart rate, orthostatic challenge tests and corrected QT interval. Two IR indices were calculated for patients based on fasting levels of glucose, insulin and triglyceride. Results The mean±SD for age and weight were 55.19±9.79 years and 76.1±10.22 kilograms. The CAN was diagnosed in 54 cases (85.3%). The mean±SD for TyG and HOMA-IR were 10.11±0.69 and 1.6±0.98 respectively. The TyG but not the HOMA-IR index was more than the considered cutoff in all cases including CAN negatives. The difference of HOMA-IR index in CAN positive and CAN negative subjects was not significant (P value = 0.059). Conclusion The changes of TyG index seem to be much more than HOMA-IR in diabetics with CAN and may be considered to have screening potential for CAN.