Duvnjak L, Vucković S, Pepeonik Z, Metelko Z
University Clinic for Diabetes, Endocrinology and Metabolic Disease "Vuk Vrhovac", Zagreb, Croatia.
Diabetes Nutr Metab. 2003 Apr;16(2):102-8.
In order to investigate factors related to the development of retinopathy in 122 normotensive and normoalbuminuric patients 24 hr-blood pressure (BP) measurement and autonomic tests based on standard, vector and spectral analysis of heart rate variation (HRV) were performed. Retinopathy was found in 47 patients with significantly longer duration of diabetes and prevalence of autonomic neuropathy (9.5 +/- 5.5; 59.6%) in comparison with 75 patients without retinopathy (5.29 +/- 4.9; 16%), (p < 0.05). Patients were matched according to age, gender, HbA1c and 24-hr urinary albumin excretion rate. Maximal night systolic, mean night and day diastolic BPs were significantly higher in patients with retinopathy (118.94 +/- 11; 62.94 +/- 8.1; 74.3 +/- 7.2 mmHg) as compared to patients without it (115.03 +/- 8.9; 59.65 +/- 7.1; 71.75 +/- 5.7) (p = 0.03). Maximal night systolic BP was inversely related to power high frequency (HF; r = -0.28, p = 0.05) and deep breathing CV (r = -0.23, p = 0.02). Mean night diastolic BP was inversely related to power mid frequency (r = -0.21, p = 0.03), HF (r = -0.32, p = 0.005), CV deep breathing (r = -0.27, p = 0.005) and mean circular resultant deep breathing (r = -0.24, p = 0.003); mean day diastolic BP to power HF (r = -0.22, p = 0.02). In multiple regression analysis retinopathy was associated with the duration of diabetes (beta = 0.53) and autonomic neuropathy (beta = 0.28) (p < 0.001). Autonomic neuropathy was related to BP elevation and retinopathy in normotensive and normoalbuminuric Type 1 diabetic patients.
为了研究122例血压正常且尿白蛋白正常的患者视网膜病变的相关因素，我们进行了24小时血压（BP）测量以及基于心率变异性（HRV）的标准、向量和频谱分析的自主神经测试。在47例患有视网膜病变的患者中，糖尿病病程显著更长，自主神经病变患病率为（9.5±5.5；59.6%），而75例无视网膜病变的患者中，患病率为（5.29±4.9；16%），（p<0.05）。患者根据年龄、性别、糖化血红蛋白（HbA1c）和24小时尿白蛋白排泄率进行匹配。与无视网膜病变的患者相比，有视网膜病变的患者夜间最大收缩压、夜间平均血压和日间舒张压显著更高（分别为118.94±11；62.94±8.1；74.3±7.2 mmHg）（115.03±8.9；59.65±7.1；71.75±5.7）（p = 0.03）。夜间最大收缩压与高频功率（HF；r = -0.28，p = 0.05）和深呼吸变异系数（r = -0.23，p = 0.02）呈负相关。夜间平均舒张压与中频功率（r = -0.21，p = 0.03）、HF（r = -0.32，p = 0.005）、深呼吸变异系数（r = -0.27，p = 0.005）和深呼吸平均圆周结果（r = -0.24，p = 0.003）呈负相关；日间平均舒张压与HF功率（r = -0.22，p = 0.02）呈负相关。在多元回归分析中，视网膜病变与糖尿病病程（β = 0.53）和自主神经病变（β = 0.28）相关（p<0.001）。自主神经病变与血压正常且尿白蛋白正常的1型糖尿病患者的血压升高和视网膜病变有关。
