Department of Neurology, University of Maryland and Maryland VA Healthcare System, Baltimore, MD, United States of America.
Department of Neurology, University of Maryland and Maryland VA Healthcare System, Baltimore, MD, United States of America.
Auton Neurosci. 2020 Dec;229:102722. doi: 10.1016/j.autneu.2020.102722. Epub 2020 Sep 11.
Although there is considerably more data showing an association between type 2 diabetes mellitus (T2DM) and autonomic neuropathy, accumulating evidence indicates that cardiovascular autonomic neuropathy (CAN) is common in persons with impaired glucose tolerance (IGT). Furthermore, CAN may occur early after a metabolic insult and obesity, especially among mean, and seems to play an important role in the early pathogenesis of CAN. Autonomic symptoms are common in subjects with IGT. In addition to defects in CAN, in subjects with IGT, there is impaired sudomotor function and abnormalities of endothelial peripheral vasoreactivity. At the present time, the only interventions that may be effective in preventing or reversing IGT associated autonomic neuropathy are lifestyle improvement. These include a tailored diet and exercise program. Other approaches that may be beneficial include modulation of oxidative stress and improvement of metabolic regulation in subjects with IGT. Interventions are most likely to be effective early in the course of disease and therefore it is extremely important to have early diagnosis of IGT and autonomic neuropathy.
虽然有相当多的数据表明 2 型糖尿病（T2DM）与自主神经病变之间存在关联，但越来越多的证据表明，心血管自主神经病变（CAN）在糖耐量受损（IGT）人群中很常见。此外，CAN 可能在代谢损伤和肥胖后早期发生，尤其是在平均水平，并且似乎在 CAN 的早期发病机制中发挥重要作用。IGT 患者中自主症状很常见。除了 CAN 缺陷外，IGT 患者还存在出汗功能障碍和内皮外周血管反应异常。目前，可能对预防或逆转 IGT 相关自主神经病变有效的干预措施仅为改善生活方式。这些措施包括量身定制的饮食和运动方案。其他可能有益的方法包括调节氧化应激和改善 IGT 患者的代谢调节。干预措施在疾病早期最有可能有效，因此，早期诊断 IGT 和自主神经病变极其重要。
