Özgür Senem, Ceylan Özben, Şenocak Filiz, Örün Utku A, Doğan Vehbi, Yılmaz Osman, Keskin Mahmut, Aycan Zehra, Okutucu Sercan, Karademir Selmin
1Department of Pediatric Cardiology,Dr. Sami Ulus Children's Hospital,Ankara,Turkey.
2Department of Pediatric Endocrinology,Dr. Sami Ulus Children's Hospital,Ankara,Turkey.
Cardiol Young. 2014 Oct;24(5):872-9. doi: 10.1017/S1047951113001224. Epub 2013 Sep 9.
To evaluate heart rate variability by Holter monitoring in type 1 diabetic children compared with a healthy control group and determine the factors modifying heart rate variability.
This was designed as a prospective study comparing 28 patients, diagnosed with type 1 diabetes and under follow-up, with 27 healthy control group subjects.
The patients were aged 9.9 ± 4.2 years in the diabetic group, including 13 (46.5%) girls and 15 (53.5%) boys. The healthy control group comprised 20 (74%) girls and seven boys (26%) with an average age of 8.6 ± 3.7 years. The search for factors modifying heart rate variability yielded the following correlations: for the time-dependent variables, negative between age and both average and maximal heart rate (r = -0.263 and -0.460, respectively), negative between haemoglobin A1c and percentage of differences between adjacent RR intervals >50 ms, positive between diabetes duration and square root of the mean of the sum of squares of differences between adjacent NN intervals. The average heart rate and percentage of differences between adjacent RR intervals >50 ms was significantly higher in the girls than the boys in all groups. With regard to the frequency-dependent factors affecting heart rate variability, correlations were found between haemoglobin A1c level and both total power and very low frequency (r = -0.751 and -0.644) and between very low frequency and diabetes duration.
A reduction in heart rate variability parameters was observed in type 1 diabetes mellitus patients who had a long disease duration or were poorly controlled, as compared with healthy controls.
通过动态心电图监测评估1型糖尿病儿童的心率变异性，并与健康对照组进行比较，确定影响心率变异性的因素。
本研究为前瞻性研究，将28例确诊为1型糖尿病且正在接受随访的患者与27名健康对照组受试者进行比较。
糖尿病组患者年龄为9.9±4.2岁，其中女孩13例（46.5%），男孩15例（53.5%）。健康对照组包括20名女孩（74%）和7名男孩（26%），平均年龄为8.6±3.7岁。对影响心率变异性的因素进行研究，得出以下相关性：对于时间依赖性变量，年龄与平均心率和最大心率均呈负相关（r分别为-0.263和-0.460），糖化血红蛋白与相邻RR间期差值>50 ms的百分比呈负相关，糖尿病病程与相邻NN间期差值平方和均值的平方根呈正相关。在所有组中，女孩的平均心率和相邻RR间期差值>50 ms的百分比均显著高于男孩。关于影响心率变异性的频率依赖性因素，发现糖化血红蛋白水平与总功率和极低频均呈相关性（r分别为-0.751和-0.644），极低频与糖尿病病程也呈相关性。
与健康对照组相比，病程长或控制不佳的1型糖尿病患者的心率变异性参数降低。
