Chung Jin Ook, Park Seon-Young, Cho Dong Hyeok, Chung Dong Jin, Chung Min Young
Division of Endocrinology and Metabolism Division of Gastroenterology and Hepatology, Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Republic of Korea.
Medicine (Baltimore). 2017 Apr;96(15):e6586. doi: 10.1097/MD.0000000000006586.
To investigate the relationship among anemia, physiological serum bilirubin levels, and cardiovascular autonomic neuropathy (CAN) in subjects with type 2 diabetes. In total, 2230 subjects with type 2 diabetes were evaluated in this cross-sectional study. CAN was diagnosed with a cardiovascular reflex test. The prevalence of anemia was greater in subjects with CAN. In multivariable analysis, the relationship between anemia and CAN remained statistically significant after adjusting for the risk factors (odds ratio [OR] 1.39; 95% confidence interval [CI] 1.07-1.80, P = .015). Additional adjustment for serum bilirubin concentrations abolished this relationship (OR 1.20, 95% CI 0.91-1.58, P = .189). Anemia is positively associated with the prevalence of CAN in subjects with type 2 diabetes. In addition, our results suggest that the putative increased CAN risk associated with anemia might be mediated by a correlated decrease in serum bilirubin levels.
旨在研究2型糖尿病患者贫血、生理性血清胆红素水平与心血管自主神经病变（CAN）之间的关系。在这项横断面研究中，共评估了2230例2型糖尿病患者。通过心血管反射试验诊断CAN。CAN患者中贫血的患病率更高。在多变量分析中，校正危险因素后，贫血与CAN之间的关系仍具有统计学意义（优势比[OR] 1.39；95%置信区间[CI] 1.07 - 1.80，P = 0.015）。进一步校正血清胆红素浓度后，这种关系消失（OR 1.20，95% CI 0.91 - 1.58，P = 0.189）。贫血与2型糖尿病患者CAN的患病率呈正相关。此外，我们的结果表明，贫血相关的CAN风险增加可能是由血清胆红素水平的相应降低介导的。
