Department of Physiology, Kasturba Medical College, Manipal University, Light House Hill Road, Mangalore 1, Karnataka, India.
Diabetes Res Clin Pract. 2012 Aug;97(2):313-21. doi: 10.1016/j.diabres.2012.05.001. Epub 2012 May 19.
Progression of cardiac autonomic dysfunction (CADF) in relation to severity of diabetic autonomic neuropathy is well documented. But its progression while coexisting with somatic neuropathy (PNP) and cardiovascular disease (CVD) is less described. We monitored CADF over a period of one year in relation to PNP and CVD in patients with type 2 diabetes mellitus.
Cardiac autonomic function was assessed in 104 type 2 diabetics. Based on complications study subjects were divided into four subgroups: Group A (No complications); Group B (with CVD); Group C (with PNP); Group D (with CVD and PNP). The parameters measured were: Expiratory:Inspiratory ratio (E:I ratio) and standard deviation of all the N-N intervals (SDNN). These parameters were measured at the baseline and at follow-up. Data analysis was done by employing suitable statistical tests.
In Group B: SDNN declined (p<0.001); E:I ratio did not change. In Group C: E:I ratio declined (p<0.01); SDNN did not change. In Group D: SDNN and E:I ratio declined significantly (p<0.001).
CADF coexisting with PNP and CVD deteriorates with time. E:I ratio and SDNN are suitable markers in monitoring CADF coexisting with PNP and CVD respectively in type 2 diabetes mellitus.
糖尿病自主神经病变（CADF）的进展与糖尿病自主神经病变的严重程度有关，这已得到充分证明。但是，在同时存在躯体神经病变（PNP）和心血管疾病（CVD）的情况下，其进展情况描述较少。我们在一年的时间内监测了 2 型糖尿病患者的 CADF 与 PNP 和 CVD 的关系。
我们评估了 104 例 2 型糖尿病患者的心脏自主神经功能。根据并发症，研究对象分为四组：A 组（无并发症）；B 组（有 CVD）；C 组（有 PNP）；D 组（有 CVD 和 PNP）。测量的参数包括：呼气：吸气比值（E：I 比值）和所有 NN 间期的标准差（SDNN）。这些参数在基线和随访时进行测量。通过使用适当的统计检验进行数据分析。
B 组：SDNN 下降（p<0.001）；E：I 比值没有变化。C 组：E：I 比值下降（p<0.01）；SDNN 没有变化。D 组：SDNN 和 E：I 比值显著下降（p<0.001）。
CADF 与 PNP 和 CVD 共存时会随着时间的推移而恶化。E：I 比值和 SDNN 分别是监测 2 型糖尿病 CADF 与 PNP 和 CVD 共存的合适标志物。
