Residual sympathetic tone is associated with reduced insulin sensitivity in patients with autonomic failure

Jorge E. Celedonio, Amy Arnold, William D. Dupont, Claudia E. Ramirez, André Diedrich, Luis E. Okamoto, Satish R. Raj, David Robertson, Amanda C. Peltier, Italo Biaggioni, Cyndya A. Shibao

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Purpose: Parkinson disease, an α-synucleinopathy, is associated with reduced insulin sensitivity, impaired glucose tolerance, and diabetes mellitus. Importantly, these metabolic alterations have been shown to contribute to disease progression. The purpose of this study was to determine if reduced insulin sensitivity is also present in other α-synucleinopathies associated with autonomic failure. Methods: We studied 19 patients with multiple system atrophy and 26 patients with pure autonomic failure. For comparison, we studied 8 healthy controls matched for body mass index. Insulin sensitivity and beta cell function were calculated using fasting glucose and insulin levels according to the homeostatic model assessment 2. A multiple linear regression model was performed to determine factors that predict insulin sensitivity in autonomic failure. Results: There was a significant difference in insulin sensitivity among groups (P = 0.048). This difference was due to lower insulin sensitivity in multiple system atrophy patients: 64 % [interquartile range (IQR), 43 to 117] compared to healthy controls 139 % (IQR, 83 to 212), P = 0.032. The main factor that contributed to the reduced insulin sensitivity was the presence of supine hypertension and residual sympathetic tone. Conclusions: Multiple system atrophy patients have reduced insulin sensitivity that is associated with residual sympathetic activation and supine hypertension. These patients may therefore be at high risk for development of impaired glucose tolerance and diabetes mellitus.

Original languageEnglish (US)
Pages (from-to)309-315
Number of pages7
JournalClinical Autonomic Research
Volume25
Issue number5
DOIs
StatePublished - Oct 1 2015

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Insulin Resistance
Multiple System Atrophy
Glucose Intolerance
Linear Models
Diabetes Mellitus
Pure Autonomic Failure
Hypertension
Parkinson Disease
Disease Progression
Fasting
Body Mass Index
Insulin
Glucose

All Science Journal Classification (ASJC) codes

  • Endocrine and Autonomic Systems
  • Clinical Neurology

Cite this

Celedonio, J. E., Arnold, A., Dupont, W. D., Ramirez, C. E., Diedrich, A., Okamoto, L. E., ... Shibao, C. A. (2015). Residual sympathetic tone is associated with reduced insulin sensitivity in patients with autonomic failure. Clinical Autonomic Research, 25(5), 309-315. https://doi.org/10.1007/s10286-015-0307-9
Celedonio, Jorge E. ; Arnold, Amy ; Dupont, William D. ; Ramirez, Claudia E. ; Diedrich, André ; Okamoto, Luis E. ; Raj, Satish R. ; Robertson, David ; Peltier, Amanda C. ; Biaggioni, Italo ; Shibao, Cyndya A. / Residual sympathetic tone is associated with reduced insulin sensitivity in patients with autonomic failure. In: Clinical Autonomic Research. 2015 ; Vol. 25, No. 5. pp. 309-315.
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Celedonio, JE, Arnold, A, Dupont, WD, Ramirez, CE, Diedrich, A, Okamoto, LE, Raj, SR, Robertson, D, Peltier, AC, Biaggioni, I & Shibao, CA 2015, 'Residual sympathetic tone is associated with reduced insulin sensitivity in patients with autonomic failure', Clinical Autonomic Research, vol. 25, no. 5, pp. 309-315. https://doi.org/10.1007/s10286-015-0307-9

Residual sympathetic tone is associated with reduced insulin sensitivity in patients with autonomic failure. / Celedonio, Jorge E.; Arnold, Amy; Dupont, William D.; Ramirez, Claudia E.; Diedrich, André; Okamoto, Luis E.; Raj, Satish R.; Robertson, David; Peltier, Amanda C.; Biaggioni, Italo; Shibao, Cyndya A.

In: Clinical Autonomic Research, Vol. 25, No. 5, 01.10.2015, p. 309-315.

Research output: Contribution to journalArticle

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T1 - Residual sympathetic tone is associated with reduced insulin sensitivity in patients with autonomic failure

AU - Celedonio, Jorge E.

AU - Arnold, Amy

AU - Dupont, William D.

AU - Ramirez, Claudia E.

AU - Diedrich, André

AU - Okamoto, Luis E.

AU - Raj, Satish R.

AU - Robertson, David

AU - Peltier, Amanda C.

AU - Biaggioni, Italo

AU - Shibao, Cyndya A.

PY - 2015/10/1

Y1 - 2015/10/1

N2 - Purpose: Parkinson disease, an α-synucleinopathy, is associated with reduced insulin sensitivity, impaired glucose tolerance, and diabetes mellitus. Importantly, these metabolic alterations have been shown to contribute to disease progression. The purpose of this study was to determine if reduced insulin sensitivity is also present in other α-synucleinopathies associated with autonomic failure. Methods: We studied 19 patients with multiple system atrophy and 26 patients with pure autonomic failure. For comparison, we studied 8 healthy controls matched for body mass index. Insulin sensitivity and beta cell function were calculated using fasting glucose and insulin levels according to the homeostatic model assessment 2. A multiple linear regression model was performed to determine factors that predict insulin sensitivity in autonomic failure. Results: There was a significant difference in insulin sensitivity among groups (P = 0.048). This difference was due to lower insulin sensitivity in multiple system atrophy patients: 64 % [interquartile range (IQR), 43 to 117] compared to healthy controls 139 % (IQR, 83 to 212), P = 0.032. The main factor that contributed to the reduced insulin sensitivity was the presence of supine hypertension and residual sympathetic tone. Conclusions: Multiple system atrophy patients have reduced insulin sensitivity that is associated with residual sympathetic activation and supine hypertension. These patients may therefore be at high risk for development of impaired glucose tolerance and diabetes mellitus.

AB - Purpose: Parkinson disease, an α-synucleinopathy, is associated with reduced insulin sensitivity, impaired glucose tolerance, and diabetes mellitus. Importantly, these metabolic alterations have been shown to contribute to disease progression. The purpose of this study was to determine if reduced insulin sensitivity is also present in other α-synucleinopathies associated with autonomic failure. Methods: We studied 19 patients with multiple system atrophy and 26 patients with pure autonomic failure. For comparison, we studied 8 healthy controls matched for body mass index. Insulin sensitivity and beta cell function were calculated using fasting glucose and insulin levels according to the homeostatic model assessment 2. A multiple linear regression model was performed to determine factors that predict insulin sensitivity in autonomic failure. Results: There was a significant difference in insulin sensitivity among groups (P = 0.048). This difference was due to lower insulin sensitivity in multiple system atrophy patients: 64 % [interquartile range (IQR), 43 to 117] compared to healthy controls 139 % (IQR, 83 to 212), P = 0.032. The main factor that contributed to the reduced insulin sensitivity was the presence of supine hypertension and residual sympathetic tone. Conclusions: Multiple system atrophy patients have reduced insulin sensitivity that is associated with residual sympathetic activation and supine hypertension. These patients may therefore be at high risk for development of impaired glucose tolerance and diabetes mellitus.

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