Department of Clinical Epidemiology, Steno Diabetes Center Copenhagen, Gentofte, Denmark
Department of Public Health, Aarhus Universitet, Aarhus, Midtjylland, Denmark.
BMJ Open Diabetes Res Care. 2021 Sep;9(1). doi: 10.1136/bmjdrc-2021-002121.
Diabetes is increasing among Greenlandic Inuit; however, the prevalence of cardiovascular autonomic neuropathy (CAN) is yet unknown. The assessment of CAN requires an ability to differentiate between normal and abnormal. The aim was to establish normative reference data of cardiovascular autonomic function in Greenlandic Inuit.
In this cross-sectional study, cardiovascular autonomic function was evaluated in participants without diabetes during the and in the town Qasigiannguit in 2020. Assessment included cardiovascular autonomic reflex tests (CARTs) and power spectral analysis of heart rate variability (HRV). Normative reference limits were estimated by applying piecewise linear quantile regression models at the fifth percentile. Models were adjusted for age and sex.
Based on examinations of 472 participants (61.7% females), normative reference data was established for all outcomes. Mean age was 54 years (SD 13.1). Higher age was inversely associated with all outcomes of CARTs and HRV. A linear fall in cardiovascular autonomic function tended to level off beyond age of 60 or 70 years for supine-to-upright position ratio and low frequency power. However, the number of observations in subjects older than 60 or 70 years was limited, which may have caused a flattening of the curve around that age. No other associations were found.
The general level of the CARTs and HRV for all age groups is notably lower than in previous studies from other nationalities. We speculate that sociodemographic and cultural aspects of the Greenlandic Inuit population including body mass index, smoking, physical activity and alcohol consumption may have affected the cardiovascular autonomic function.
格陵兰因纽特人中糖尿病的发病率正在上升;然而,心血管自主神经病变(CAN)的患病率尚不清楚。CAN 的评估需要能够区分正常和异常。目的是建立格陵兰因纽特人心血管自主功能的正常参考数据。
在这项横断面研究中,评估了 2020 年期间无糖尿病参与者和城镇 Qasigiannguit 的心血管自主神经功能。评估包括心血管自主反射测试(CART)和心率变异性(HRV)的功率谱分析。通过应用分段线性分位数回归模型在第五百分位数估计正常参考限值。模型根据年龄和性别进行调整。
基于对 472 名参与者(61.7%为女性)的检查,建立了所有结果的正常参考数据。平均年龄为 54 岁(SD 13.1)。较高的年龄与 CART 和 HRV 的所有结果呈负相关。心血管自主功能呈线性下降,倾向于在 60 岁或 70 岁以上的仰卧位到直立位比值和低频功率趋于平稳。然而,年龄在 60 岁或 70 岁以上的受试者的观察数量有限,这可能导致该年龄段的曲线趋于平稳。没有发现其他关联。
所有年龄组的 CART 和 HRV 的总体水平明显低于其他民族的先前研究。我们推测,格陵兰因纽特人群的社会人口学和文化方面,包括体重指数、吸烟、身体活动和饮酒,可能影响了心血管自主功能。