Chest
Clinical InvestigationsCholinergic Bronchomotor Tone and Airway Caliber in Insulin-Dependent Diabetes Mellitus
Section snippets
Subjects
We studied 34 insulin-dependent diabetic patients aged 18 to 45 y and a control group of 32 healthy individuals aged 23 to 35 y. The diabetic patients were divided into two groups on the basis of clinical manifestations of AN and the responses to the two tests of autonomic cardiovascular activity, ie, the tilting test and the magnitude of RSA (see procedures for details). The first group of diabetic patients (group D-1) consisted of 19 subjects with no AN symptoms and with circulatory autonomic
Autonomic Cardiovascular Activity
The results obtained during the study of the autonomic cardiovascular activity are given in Table 2. In the resting supine position the patients of group D-2, as compared with the other two groups, had significantly higher values of HR (p<0.001). The increase in HR at 5 s of tilting test was significantly lower in group D-2 than in group C (p<0.001) and group D-1 (p<0.001). Similar HR results were observed at 10 s of the tilting period, with smaller variation in group D-2 than in group C
DISCUSSION
On the basis of clinical and functional criteria used in the present study, the diabetic patients were divided into two groups in terms of ANS involvement. Patients of group D-1, with no clinical manifestation of AN, behaved like group C in terms of circulatory responses to the tilting test and RSA magnitude. On the other hand, group D-2 of patients with AN symptoms showed intense depression of the parasympathetic autonomic control of the heart, as judged by the higher HR observed under basal
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2002, ChestCitation Excerpt :However, cholinergic bronchomotor tone did not distinguish diabetic patients with and without AN. The last finding is at variance with previous studies252627 showing depressed parasympathetic bronchomotor tone in patients with type I diabetes mellitus complicated by AN. However, Fonseca et al25 studied diabetic patients with lower baseline FEV1, expressed as percentage of predicted, than control normal subjects, whereas no information on the alveolar-capillary permeability was provided by either Bertherat et al26 or Douglas et al.27 This limits comparability of previous and present data.
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Manuscript received May 10; revision accepted August 5.