1型糖尿病患者的压力反射敏感性

Martiniskova Zuzana, Kucera Pavol, Sykora Marek, Kollar Branislav, Goldenberg Zoltan, Turcani Peter

1st Department of Neurology, University Hospital, Faculty of Medicine, Comenius University, Bratislava, Slovakia.

Neuro Endocrinol Lett. 2009;30(4):491-5.

OBJECTIVES

To date, the clinical usefulness of measuring baroreflex sensitivity (BRS) to detect impairment of the autonomic nervous system in patients with diabetes mellitus (DM) type I has not been evaluated sufficiently (Mlcáková et al. 2008). The aim of the current study was the determination and statistical comparison of the mean values of BRS in our DM type I patients cohort and in a control group of healthy volunteers as well as the determination of BRS value dependency on the duration of diabetes and the level of glycemic control in DM I patients. We also aimed to determine the inter-individual and intra-individual variability of BRS in our patients.

MATERIAL AND METHODS

We examined 100 patients with type I diabetes mellitus (37 women and 63 men, mean age 30 years, duration of the disease >or= 10 years) and 40 healthy, age- and sex-matched, subjects. Data from the patient cohort were subsequently analysed for duration of the diabetes and the level of glycemic control as assessed by glycated haemoglobin (HbA1c). We used a simple proportional test to compare the occurrence of impaired BRS in the patient cohort and the control group, and a simple linear regression to assess associations between BRS and duration of the diabetes and the levels of glycemic control.

RESULTS

The mean BRS value in our group of diabetic patients and the control group were 10.15 ms/mmHg and 13.35 ms/mmHg, respectively. II. Statistically significant association between BRS impairment and the duration of the disease or level of glycemic control was not confirmed in our patient cohort. III. We observed an increased inter-individual variability and a relatively low intra-individual variability of BRS in patients with DM type I.

CONCLUSIONS

We found a statistically highly significant difference between the proportions of impaired BRS in the group of diabetics vs. control. However, BRS did not correlate with the duration of the disease or with the level of glycemic control significantly. Albeit not reaching statistical significance, trends could be observed, which we consider clinically interesting.

目的

迄今为止，测量压力反射敏感性（BRS）以检测1型糖尿病（DM）患者自主神经系统损害的临床实用性尚未得到充分评估（Mlcáková等人，2008年）。本研究的目的是测定并统计比较我们的1型糖尿病患者队列和健康志愿者对照组中BRS的平均值，以及确定1型糖尿病患者中BRS值与糖尿病病程和血糖控制水平的相关性。我们还旨在确定患者中BRS的个体间和个体内变异性。

材料与方法

我们检查了100例1型糖尿病患者（37名女性和63名男性，平均年龄30岁，病程≥10年）和40名年龄、性别匹配的健康受试者。随后分析患者队列的数据，以了解糖尿病病程和糖化血红蛋白（HbA1c）评估的血糖控制水平。我们使用简单比例检验比较患者队列和对照组中BRS受损的发生率，并使用简单线性回归评估BRS与糖尿病病程和血糖控制水平之间的关联。