{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T04:38:56Z","timestamp":1792471136474,"version":"4.5.0"},"reference-count":41,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T00:00:00Z","timestamp":1785196800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T00:00:00Z","timestamp":1785196800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100017618","name":"Division of Diabetes, Endocrinology, and Metabolic Diseases","doi-asserted-by":"publisher","award":["R01\u2010DK126837\u201001A1"],"award-info":[{"award-number":["R01\u2010DK126837\u201001A1"]}],"id":[{"id":"10.13039\/100017618","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100017618","name":"Division of Diabetes, Endocrinology, and Metabolic Diseases","doi-asserted-by":"publisher","award":["U01 DK119083"],"award-info":[{"award-number":["U01 DK119083"]}],"id":[{"id":"10.13039\/100017618","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001648","name":"European Foundation for the Study of Diabetes","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100001648","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["dom-pubs.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Diabetes Obesity Metabolism"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>To quantify the association between cardiovascular autonomic neuropathy (CAN) and heart failure (HF) in individuals with type 2 diabetes (T2D).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods<\/jats:title>\n                    <jats:p>Two hundred T2D individuals were recruited from two Danish outpatient clinics between 2021\u20132024. CAN was defined by abnormal cardiovascular autonomic reflex test results. HF outcomes included the primary outcome of elevated N\u2010terminal pro\u2010brain natriuretic peptide (NT\u2010proBNP) levels &gt;\u2009125\u2009pg\/mL, WATCH\u2010DM risk score. Symptomatic HF was defined by New York Heart Association (NYHA) classification score \u2265II. We assessed the association between measures of CAN and HF using logistic and linear regressions, adjusting for confounders and testing for effect modification between CAN, NYHA, and WATCH\u2010DM risk scores.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 176 individuals with NT\u2010proBNP assessments, the median (interquartile range [IQR]) age was 63 (IQR: 55, 70) years, 61% were men, and median diabetes duration was 17\u2009years (IQR: 11, 24). Among 134 individuals with valid CAN assessment, 40% had CAN and 52% of those had elevated NT\u2010proBNP compared to 23% of individuals without CAN. In the fully adjusted model, CAN was associated with 6.2 times higher odds (95% CI: 2.1; 20.8) of elevated NT\u2010proBNP levels compared to individuals without CAN. The association remained statistically significant in asymptomatic individuals, and in individuals with a low\u2010to\u2010moderate WATCH\u2010DM risk score.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>CAN is associated with elevated NT\u2010proBNP levels in individuals asymptomatic for HF. This suggests that CAN may complement established biomarkers to identify individuals with earlier HF stages, for timelier treatment initiation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/dom.71100","type":"journal-article","created":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T01:58:02Z","timestamp":1785290282000},"page":"9356-9366","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Cardiovascular Autonomic Neuropathy and Indices of Heart Failure in Type 2 Diabetes: The\n                    <scp>CANCAN<\/scp>\n                    Study"],"prefix":"10.1111","volume":"28","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7209-2675","authenticated-orcid":false,"given":"Jonas R.","family":"Schaarup","sequence":"first","affiliation":[{"name":"Department of Public Health Aarhus University  Aarhus Denmark"},{"name":"Steno Diabetes Center Aarhus  Aarhus Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lasse","family":"Bjerg","sequence":"additional","affiliation":[{"name":"Department of Public Health Aarhus University  Aarhus Denmark"},{"name":"Steno Diabetes Center Aarhus  Aarhus Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5782-3476","authenticated-orcid":false,"given":"Christian S.","family":"Hansen","sequence":"additional","affiliation":[{"name":"Steno Diabetes Center Copenhagen  Herlev Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel R.","family":"Witte","sequence":"additional","affiliation":[{"name":"Department of Public Health Aarhus University  Aarhus Denmark"},{"name":"Steno Diabetes Center Aarhus  Aarhus Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Henrik H.","family":"Thomsen","sequence":"additional","affiliation":[{"name":"Medical Diagnostic Center University Clinic for Innovative Patient Pathways, Regional Hospital Central Jutland  Viborg Denmark"},{"name":"Department of Clinical Medicine Aarhus University  Aarhus Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jesper","family":"Fleischer","sequence":"additional","affiliation":[{"name":"Department of Clinical Medicine Aarhus University  Aarhus Denmark"},{"name":"Steno Diabetes Center Zealand  Holb\u00e6k Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rodica","family":"Pop\u2010Busui","sequence":"additional","affiliation":[{"name":"Department of Medicine, Endocrinology and Diabetes Oregon Health and Science University  Portland Oregon USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Signe T.","family":"Andersen","sequence":"additional","affiliation":[{"name":"Steno Diabetes Center Aarhus  Aarhus Denmark"},{"name":"Department of Medicine G\u00f8dstrup Hospital  Herning 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