Jeyaseeli Angeline, R Ganesan, Mathivanan Dhibika, Prabagaran Allen
Physiology, Sri Venkateswaraa Medical College Hospital and Research Centre, Puducherry, IND.
Microbiology, Indira Gandhi Medical College and Research Institute, Puducherry, IND.
Cureus. 2023 Jul 27;15(7):e42541. doi: 10.7759/cureus.42541. eCollection 2023 Jul.
Background Cardiac autonomic neuropathy (CAN) is a major complication of type 2 diabetes mellitus (T2DM). Hyperglycaemia and hypertriglyceridemia are known risk factors in the development of CAN with T2DM. The triglyceride glucose (TyG) index is calculated using both the fasting blood glucose (FBG) and fasting triglyceride levels (FTG). There is a paucity of literature revealing a direct relationship between the TyG index and CAN in T2DM patients of the south Indian population. Objective To assess the TyG index levels in T2DM with and without CAN. Methods A cross-sectional study was performed, involving 100 T2DM patients (58 males and 42 females) aged between 30 and 60 years, who attended medicine OPD, Sri Venkateswaraa Medical College, Hospital and Research Centre (SVMCH & RC) during the study period. Age, duration of illness, height, weight, waist circumference (WC), hip circumference (HC), body mass index (BMI), systolic blood pressure (SBP) and diastolic blood pressure (DBP) were measured. Glycated hemoglobin (HbA1C) and lipid profile values were taken from patients' recent medical records. Ewing autonomic function tests were used to diagnose CAN, which included heart rate response to standing, heart rate response to deep breathing, heart rate response to Valsalva maneuver, blood pressure response to standing and blood pressure response to isometric handgrip. FBG and FTG were measured and the TyG index was calculated from these parameters. Statistical Product and Service Solutions (SPSS) (IBM SPSS Statistics for Windows, Version 20.0, Armonk, NY) was used for the statistical analysis and a 'P' value < 0.05 was considered statistically significant. Results In our study, out of 100 T2DM patients, 42 patients were diagnosed with CAN. The mean levels of TyG Index, HbA1C, FBG, FTG, BMI and WC were significantly (p<0.05) higher in T2DM patients with CAN when compared to T2DM without CAN. We couldn't find any significant difference (p<0.05) in age, duration of illness, blood pressure and lipid profile parameters between the groups. Conclusion We found that abdominal obesity, hyperglycemia, and hypertriglyceridemia are the risk factors for developing CAN in T2DM patients. Our study results also showed that the TyG index can be used to predict CAN in T2DM patients.
背景 心脏自主神经病变（CAN）是2型糖尿病（T2DM）的主要并发症。高血糖和高甘油三酯血症是T2DM患者发生CAN的已知危险因素。甘油三酯葡萄糖（TyG）指数通过空腹血糖（FBG）和空腹甘油三酯水平（FTG）计算得出。在印度南部人群的T2DM患者中，鲜有文献揭示TyG指数与CAN之间的直接关系。目的 评估合并和不合并CAN的T2DM患者的TyG指数水平。方法 进行了一项横断面研究，纳入了100例年龄在30至60岁之间的T2DM患者（58例男性和42例女性），这些患者在研究期间到斯里兰卡文卡特斯瓦拉医学院医院及研究中心（SVMCH & RC）内科门诊就诊。测量了年龄、病程、身高、体重、腰围（WC）、臀围（HC）、体重指数（BMI）、收缩压（SBP）和舒张压（DBP）。糖化血红蛋白（HbA1C）和血脂谱值取自患者近期的病历。采用尤因自主神经功能测试来诊断CAN，包括站立时心率反应、深呼吸时心率反应、瓦尔萨尔瓦动作时心率反应、站立时血压反应和等长握力时血压反应。测量FBG和FTG，并根据这些参数计算TyG指数。使用统计产品与服务解决方案（SPSS）（IBM SPSS Statistics for Windows，版本20.0，纽约州阿蒙克）进行统计分析，P值<0.05被认为具有统计学意义。结果 在我们的研究中，100例T2DM患者中有42例被诊断为CAN。与不合并CAN的T2DM患者相比，合并CAN的T2DM患者的TyG指数、HbA1C、FBG、FTG、BMI和WC的平均水平显著更高（p<0.05）。我们未发现两组之间在年龄、病程、血压和血脂谱参数方面存在任何显著差异（p<0.05）。结论 我们发现腹型肥胖、高血糖和高甘油三酯血症是T2DM患者发生CAN的危险因素。我们的研究结果还表明，TyG指数可用于预测T2DM患者的CAN。
