Niu Sheng-Wen, Huang Jiun-Chi, Chen Szu-Chia, Lin Hugo Y-H, Kuo I-Ching, Wu Pei-Yu, Chiu Yi-Wen, Chang Jer-Ming
Division of Nephrology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.
Department of Internal Medicine, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.
Front Aging Neurosci. 2018 Feb 20;10:43. doi: 10.3389/fnagi.2018.00043. eCollection 2018.
Heart rate variability (HRV) represents changes in the time between successive heart beats, and it has been used to assess the autonomic nervous system. Previous studies have reported autonomic dysfunction in diabetic patients undergoing hemodialysis (HD), however, no studies have evaluated the effects of age on changes in HRV in these patients. The aim of this study was to examine the effects of age on changes in HRV in diabetic HD patients. We enrolled 84 diabetic patients receiving maintenance HD. HRV was measured before and after HD to assess changes in HRV (ΔHRV). The patients were divided into two groups based on their age (65 years< or ≥65 years). Compared to the patients aged <65 years, those aged ≥65 years had a higher high frequency (HF) % ( = 0.032) before HD. The patients aged <65 years had a significant increase in very low frequency, low frequency (LF), and HF after HD. The patients aged ≥65 years had a significant increase in LF, but a significant decrease in HF% after HD. There was a significant interaction between age and change of HF% ( = 0.023) after HD. After multivariate adjustments for clinical, biochemical data and medications, systolic blood pressure, total cholesterol, hemoglobin, and hemoglobin were associated with ΔLF, whereas cerebrovascular disease, systolic blood pressure, and fasting glucose were associated with ΔHF% in patients aged ≥65 years. Our study demonstrated significant changes in HRV after HD in diabetic patients. In the patients aged ≥65 years, LF was increased, whereas HF% was decreased significantly after HD. Among the HRV parameters, age had an interaction with the change of HF%.
心率变异性（HRV）代表连续心跳之间时间的变化，并且已被用于评估自主神经系统。先前的研究报道了接受血液透析（HD）的糖尿病患者存在自主神经功能障碍，然而，尚无研究评估年龄对这些患者HRV变化的影响。本研究的目的是检验年龄对糖尿病HD患者HRV变化的影响。我们纳入了84例接受维持性HD的糖尿病患者。在HD前后测量HRV以评估HRV的变化（ΔHRV）。根据年龄（<65岁或≥65岁）将患者分为两组。与<65岁的患者相比，≥65岁的患者在HD前高频（HF）%更高（=0.032）。<65岁的患者在HD后极低频、低频（LF）和HF显著增加。≥65岁的患者在HD后LF显著增加，但HF%显著降低。HD后年龄与HF%变化之间存在显著交互作用（=0.023）。在对临床、生化数据和药物进行多变量调整后，收缩压、总胆固醇、血红蛋白和血红蛋白与ΔLF相关，而在≥65岁的患者中，脑血管疾病、收缩压和空腹血糖与ΔHF%相关。我们的研究表明糖尿病患者HD后HRV有显著变化。在≥65岁的患者中，HD后LF增加，而HF%显著降低。在HRV参数中，年龄与HF%的变化存在交互作用。
