Menon Anil S, Dixit Abhinav, Garg M K, Girish R
Department of Endocrinology, Command Hospital, Lucknow, Uttar Pradesh, India.
Department of Cardiology, Command Hospital, Lucknow, Uttar Pradesh, India.
Indian J Endocrinol Metab. 2017 Mar-Apr;21(2):282-285. doi: 10.4103/ijem.IJEM_542_16.
To study the prevalence of cardiac autonomic neuropathy (CAN) in patients with Type 2 diabetes mellitus at high risk for foot ulcers.
We screened patients attending diabetic clinic for identifying patients at high risk for foot ulcers. Those with foot risk category 1, 2 and 3 as per criteria of Foot Care Interest Group were subjected to battery of cardiovascular autonomic reflex tests. Those with one abnormal test were termed as probable CAN and those with two abnormal tests as definite CAN. Those with postural fall in blood pressure with one other abnormal test were termed to have advanced CAN.
A total of 74 patients were recruited in the study. The prevalence of abnormal cardiovascular autonomic reflex test was sustained hand grip 81%, E/I ratio 66.2%, 30:15 ratio 28.3% and orthostatic hypotension 13.5%. The prevalence of possible CAN was 31.0% (23/74) and definite CAN was 66.2% (49/74). Ten patients had advanced CAN. There was no observable difference in presence of probable or definite CAN in three risk category for foot ulcers.
We found a high prevalence of CAN in subgroup of diabetic patients at increased risk for foot ulcer.
研究足部溃疡高危2型糖尿病患者心脏自主神经病变（CAN）的患病率。
我们对糖尿病门诊患者进行筛查，以确定足部溃疡高危患者。根据足部护理兴趣小组的标准，将足部风险等级为1、2和3级的患者进行一系列心血管自主反射测试。一项测试异常的患者被称为可能患有CAN，两项测试异常的患者被称为确诊CAN。伴有体位性血压下降且另一项测试异常的患者被称为患有晚期CAN。
本研究共纳入74例患者。心血管自主反射测试异常的患病率分别为：持续握力81%、E/I比值66.2%、30:15比值28.3%和体位性低血压13.5%。可能患有CAN的患病率为31.0%（23/74），确诊CAN的患病率为66.2%（49/74）。10例患者患有晚期CAN。在足部溃疡的三个风险等级中，可能患有或确诊CAN的情况没有明显差异。
我们发现足部溃疡风险增加的糖尿病患者亚组中CAN的患病率很高。
