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2型糖尿病患者的心血管自主神经病变;使用心血管自主神经反射测试研究其与经典心血管危险因素的关联:一项横断面研究

Cardiovascular autonomic neuropathy in people with type 2 diabetes mellitus; investigation of its association with classical cardiovascular risk factors using cardiovascular autonomic reflex tests: a cross-sectional study.

作者信息

Osailan Ahmad

机构信息

Department of Physical Therapy and Health Rehabilitation, College of Applied Medical Sciences, Prince Sattam Bin Abdulaziz University, Alkharj, Saudi Arabia.

出版信息

Egypt Heart J. 2021 May 13;73(1):44. doi: 10.1186/s43044-021-00168-3.

Abstract

BACKGROUND

People with type 2 diabetes mellitus (DM) are at increased risk of cardiovascular disease (CVD). Cardiovascular autonomic neuropathy (CAN) is an underdiagnosed risk factor for CVD, which is prevalent among people with 2DM and can lead to CVD and CVD-related mortality. Little is known about the risk factors associated with CAN in type 2DM. Thus, the study was aimed to assess CAN using five cardiovascular autonomic reflex tests (represented by Ewing's score) and explore the factors associated with CAN in people with type 2DM. The studied factors include traditional and serological CVD risk factors obtained from a fasting blood sample and cardiorespiratory fitness (CRF) obtained via attainment of the highest peak of volumes of O (VO).

RESULTS

Univariate analysis revealed a significant positive correlation between resting systolic blood pressure (SBP) and Ewing's score (r=0.47, p=.02) and an inverse correlation between VO and Ewing's score (r=-0.64, p=.001). Multivariate linear regression revealed that a significant model that included resting SBP and VO explained 93.8% of Ewing's score variance.

CONCLUSION

CAN was associated with two CVD parameters, including resting SBP and CRF, which may indicate the importance of controlling these two factors to prevent or reduce CAN in people with type 2DM.

摘要

背景

2型糖尿病(DM)患者患心血管疾病(CVD)的风险增加。心血管自主神经病变(CAN)是CVD的一个未被充分诊断的危险因素,在2型糖尿病患者中普遍存在,可导致CVD及CVD相关死亡率。关于2型糖尿病中与CAN相关的危险因素知之甚少。因此,本研究旨在使用五项心血管自主神经反射测试(以尤因评分表示)评估CAN,并探索2型糖尿病患者中与CAN相关的因素。研究因素包括从空腹血样中获得的传统和血清学CVD危险因素,以及通过达到氧摄取量(VO)最高峰获得的心肺适能(CRF)。

结果

单因素分析显示静息收缩压(SBP)与尤因评分之间存在显著正相关(r = 0.47,p = 0.02),VO与尤因评分之间存在负相关(r = -0.64,p = 0.001)。多变量线性回归显示,包含静息SBP和VO的显著模型解释了尤因评分变异的93.8%。

结论

CAN与两个CVD参数相关,包括静息SBP和CRF,这可能表明控制这两个因素对于预防或降低2型糖尿病患者的CAN的重要性。

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