Medial arterial calcification (MAC) is one of the complications of diabetes mellitus and recently, a relationship between cardiac autonomic neuropathy and MAC has been pointed out. By means of this relationship, we evaluated whether MAC may be important in the detection of cardiac morbidity. A total of 100 diabetic patients (33 Type 1 and 67 Type 2) and 50 healthy subjects were included in this study. We aimed to show a correlation between autonomic nepopathy, cardiac morbidity and MAC, and also investigated whether MAC is a predictor of cardiac mortality or not. Orthostatic systolic blood pressure change, respiratory cardiac rate change and conduction velocity (by calculating the QTc duration of each subject according to Bazzet formula) were all calculated. Of the diabetic patients, 28% had cardiac autonomic neuropathy. In 70% of diabetic patients with MAC, the orthostatic blood pressure change was significantly greater, the cardiac rate change with deep inspiration was lower, and the QTc duration was longer in comparison with diabetic patients without MAC. The relationship between MAC and diabetic cardiovascular autonomic neuropathy was statistically significant (p<0.05). There was also a significant correlation between diabetic cardiovascular autonomic neuropathy (QTc duration) and the duration of diabetes. The mean duration of diabetes in patients with long and normal QTc was 13 ± 5.4 and 5 ± 5.2 years, respectively. In conclusion, we recommend that MAC can be an predictor for cardiac autonomic neuropathy and play a role in the prevention of diabetic cardiac mortality. If more extensive studies confirm our data, then clinical practice can be altered.
Keywords: Diabetes mellitus, medial arterial calcification, autonomic neuropathy