青少年糖尿病患者的微量白蛋白尿与心率变异性。
Microalbuminuria and heart rate variability in adolescents with diabetes.
机构信息
Diabetes Research and Education, College of Nursing, University of Arizona, P.O. Box 210203, Tucson, AZ 5721-0203, USA.
出版信息
J Pediatr Health Care. 2010 Jan-Feb;24(1):34-41. doi: 10.1016/j.pedhc.2009.01.002. Epub 2009 Apr 11.
INTRODUCTION
Limited clinical and research data are available on early renal and cardiovascular complications in youth with diabetes. The possible associations of elevated microalbuminuria to creatinine (MC) ratios with heart rate variability (HRV) were explored in adolescents with type 1 (T1DM) or type 2 (T2DM) diabetes.
METHODS
A descriptive study was conducted with 41 adolescents with diabetes (n = 31 T1DM vs. n = 10 T2DM). Twenty-four hour Holter recordings for determining HRV, urine spot checks for MC ratio, and the most recent measures of glycosylated hemoglobin (A1c) were obtained.
RESULTS
HRV was significantly lower in the T2DM group, while body mass index percentile, triglycerides, and diastolic blood pressure were significantly higher. For the T1DM group, clinical case examples provided evidence of elevated MC ratios (>30 mirog/mg) occurring in two female subjects who also had decreased HRV measures.
DISCUSSION
Although HRV was not significantly associated with MC ratios for the sample, individual clinical findings can be a warning sign for some adolescents with diabetes. Current recommendations for screening of early renal complications and associated treatment are provided.
简介
关于青少年糖尿病患者早期肾脏和心血管并发症的临床和研究数据有限。本研究旨在探讨 1 型（T1DM）或 2 型（T2DM）糖尿病青少年中，尿微量白蛋白与肌酐（MC）比值升高与心率变异性（HRV）的可能相关性。
方法
本研究为描述性研究，纳入 41 名糖尿病青少年（n=31 例 T1DM 与 n=10 例 T2DM）。记录 24 小时动态心电图以评估 HRV，留取尿 MC 比值的随机尿标本，以及最近一次糖化血红蛋白（A1c）的检测结果。
结果
T2DM 组 HRV 明显更低，而体重指数百分位数、甘油三酯和舒张压明显更高。对于 T1DM 组，临床病例提供了证据，表明两名女性患者的 MC 比值升高（>30 mirog/mg），同时 HRV 指标也降低。
讨论
尽管该样本中 HRV 与 MC 比值无显著相关性，但个体临床发现可能是一些糖尿病青少年的预警信号。目前提供了早期肾脏并发症筛查和相关治疗的建议。
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