成人2型糖尿病对静息自主神经调节和主动直立试验反应的影响

Veerendra Kamath
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摘要

背景:心血管自主神经病变是2型糖尿病(DM2)最常见的并发症之一。心率变异性(HRV)是心脏自主调节的一种无创测量方法。HRVIs降低是一种独立的心血管危险因素,已被认为是死亡风险增加的标志。很少有研究测量印度DM2中HRV的变化。目的:通过HRV指标分析DM2患者的自主神经调节反应。方法:横断面研究20例年龄在30- 50岁的2型糖尿病患者,年龄和性别均为非糖尿病患者作为对照。满足纳入标准和排除标准并给予书面知情同意的受试者被随机邀请参加研究。初步评估HTN、高脂血症、吸烟、心血管疾病、家族H/o DM2、FBS >130 mg/di、体重指数>25 kg/m、DM2、疾病持续时间和心率。血压:使用power (adinstruments)记录心电图。时域、频域变量和非近邻参数使用Lab Chart•软件从ecg测量。结果与结论:时域变量即AverageRR、SDRR、SDARR、rMSSD和pnns0(%)和频域变量;高频(HF)功率、低频(LF)功率和甚低频(LF)功率非线性变量与正常对照组相比,糖尿病患者的s01和SD2降低,但无统计学意义。其中一个原因可能是样本量太小。研究应在大样本量中重复进行。
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Impact of Diabetes Type 2 in Adults on Autonomic Modulation at Rest and in Response to the Active Orthostatic Test
Background : Cardiovascular autonomic neuropathy Is one of the most common complications of Diabetes Mellitus Type 2(DM2). Heart rate variability (HRV} Is a noninvasive measure of cardiac autonomicmodulation. Reduced HRVIs an Independent cardiovascula rrisk factor and has been proposed as amarker of increased risk of mortality.Very few studies have measured Changesin HRV in DM2 in India. Objectives: To analyze the autonomic modulation responses In DM2 patients by means of HRV indices. Methodology: Across-sectional study of 20 Type 2 Diabetic mellitus from age groups 30-S0 years and age and gender matchenon-diabetic subjects as controls. Subjects satisfying in clusion and exclusion criteria and gave written informed consent were randomly invited to take partin the study. Initial assessment was done for HTN, hyperlipidemia, smoking, cardiovascular disease, family H/o DM2, FBS >130 mg/di, Body mass index >25 kg/m,DM2, duration of disease, and Heart rate. Bloodpressure: Electrocardiogram wasrecordedusingPower (ADlnstruments). The time domain, frequencydomainvariables, and nonli near parameters was meas ured from ECGusing Lab Chart• software. Results and Conclusion : Time domain Variablesnamely AverageRR, SDRR,SDARR,rMSSD andPNNS0(%) and Frequency domain Variables; High frequency (HF) power, Low frequency (LF) power and Very Lowfrequency (LF)power Non-Linear Variables; S01and SD2 were reuced in patients with diabetes Mellitus compared to normal control but was not statistically significant. One of the reasons couldbesmallsamplesize. Study should be repeated in large sample size.
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