Physiotherapy Department, Cardiovascular Physiotherapy Laboratory, Nucleus of Research in Physical Exercise, Federal University of São Carlos, São Paulo, Brazil.
Department of Medicine, Federal University of São Carlos, São Paulo, Brazil.
Diabetol Metab Syndr. 2014 Feb 1;6(1):13. doi: 10.1186/1758-5996-6-13.
Individuals with diabetes may develop cardiac autonomic dysfunction that may be evaluated by heart rate variability (HRV). The aim was evaluated heart rate variability (HRV) of individuals with type 2 diabetes, without cardiovascular autonomic neuropathy (CAN), in response to active postural maneuver by means of nonlinear analysis (symbolic analysis, Shannon and conditional entropy) and correlate HRV parameters between them, glycated hemoglobin and diabetes duration.
Nineteen men with type 2 diabetes without CAN (T2D) and nineteen healthy men (CG), age-range from 40 to 60 years were studied. We assessed HRV in supine and orthostatic position using symbolic analysis (0V%, 1V%, 2LV% and 2UV%), Shannon and conditional entropy (SE and NCI).
In supine position T2D presented higher sympathetic modulation (0V%) than CG. However, there was not any difference between groups for indexes of complexity (SE and NCI). Furthermore, T2D presented a preserved response of cardiac autonomic modulation after active postural maneuver.
The present study showed that individuals with type 2 diabetes without CAN presented higher cardiac sympathetic modulation. However, the complexity of HRV was not influenced by imbalance of the autonomic modulation in individuals with type 2 diabetes. In addition, the response of autonomic nervous system in the heart remains preserved after active postural maneuver in individuals with type 2 diabetes, possibly due to the lack of CAN in this group.
糖尿病患者可能会出现心脏自主神经功能障碍，可以通过心率变异性（HRV）进行评估。本研究旨在通过非线性分析（符号分析、Shannon 和条件熵）评估无心血管自主神经病变（CAN）的 2 型糖尿病（T2D）患者对主动姿势改变的心率变异性（HRV），并分析它们之间的 HRV 参数、糖化血红蛋白和糖尿病病程的相关性。
研究纳入了 19 名年龄在 40 至 60 岁之间的无 CAN 的 T2D 男性患者（T2D 组）和 19 名健康男性（CG 组）。我们使用符号分析（0V%、1V%、2LV%和 2UV%）、Shannon 和条件熵（SE 和 NCI）评估仰卧位和直立位的 HRV。
仰卧位时，T2D 组的交感神经调节（0V%）高于 CG 组。然而，两组间的复杂性指数（SE 和 NCI）没有差异。此外，T2D 组在主动姿势改变后仍保持心脏自主神经调节的反应。
本研究表明，无 CAN 的 T2D 患者存在较高的心脏交感神经调节。然而，HRV 的复杂性不受 T2D 患者自主神经调节失衡的影响。此外，在 T2D 患者中，主动姿势改变后自主神经系统对心脏的反应仍然保持，这可能是由于该组患者中缺乏 CAN。
