Liu Wei-Min, Liu Hsin-Ru, Chen Po-Wei, Chang Huai-Ren, Liao Chen-Mao, Liu An-Bang
Department of Computer Science and Information Engineering, National Chung Cheng University, Chiayi 621301, Taiwan.
Department of Medical Research, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien 970473, Taiwan.
Entropy (Basel). 2022 Mar 29;24(4):473. doi: 10.3390/e24040473.
Cardiac autonomic neuropathy (CAN) is a common complication of diabetes mellitus, and can be assessed using heart rate variability (HRV) and the correlations between systolic blood pressure (SBP) and ECG R-R intervals (RRIs), namely baroreflex sensitivity (BRS). In this study, we propose a novel parameter for the nonlinear association between SBP and RRIs based on multiscale cross-approximate entropy (MS-CXApEn). Sixteen male adult Wistar Kyoto rats were equally divided into two groups: streptozotocin-induced diabetes and age-matched controls. RRIs and SBP were acquired in control rats and the diabetic rats at the onset of hyperglycemia and insulin-treated euglycemia to determine HRV by the ratio of low-frequency to high-frequency power (LF/HF) and Poincaré plot as SSR (SD1/SD2), BRS, and MS-CXApEn. SSR and BRS were not significantly different among the three groups. The LF/HF was significantly higher in the hyperglycemic diabetics than those in the controls and euglycemic diabetic rats. MS-CXApEn was higher in the diabetic hyperglycemic rats than the control rats from scales 2 to 10, and approached the values of controls in diabetic euglycemic rats at scales 9 and 10. Conclusions: We propose MS-CXApEn as a novel parameter to quantify the dynamic nonlinear interactions between SBP and RRIs that reveals more apparent changes in early diabetic rats. Furthermore, changes in this parameter were related to correction of hyperglycemia and could be useful for detecting and assessing CAN in early diabetes.
心脏自主神经病变（CAN）是糖尿病的常见并发症，可通过心率变异性（HRV）以及收缩压（SBP）与心电图R-R间期（RRIs）之间的相关性（即压力反射敏感性，BRS）进行评估。在本研究中，我们基于多尺度交叉近似熵（MS-CXApEn）提出了一个用于量化SBP与RRIs之间非线性关联的新参数。将16只成年雄性Wistar Kyoto大鼠平均分为两组：链脲佐菌素诱导的糖尿病组和年龄匹配的对照组。在对照大鼠以及糖尿病大鼠出现高血糖症时和胰岛素治疗使血糖正常时采集RRIs和SBP，通过低频与高频功率之比（LF/HF）以及Poincaré图（以SSR表示，即SD1/SD2）、BRS和MS-CXApEn来确定HRV。三组之间的SSR和BRS无显著差异。高血糖糖尿病大鼠的LF/HF显著高于对照组和血糖正常的糖尿病大鼠。糖尿病高血糖大鼠从尺度2到10的MS-CXApEn高于对照大鼠，在尺度9和10时，血糖正常的糖尿病大鼠的MS-CXApEn接近对照大鼠的值。结论：我们提出MS-CXApEn作为一个新参数来量化SBP与RRIs之间的动态非线性相互作用，该参数在早期糖尿病大鼠中显示出更明显的变化。此外，该参数的变化与高血糖的纠正有关，可能有助于早期糖尿病中CAN的检测和评估。
