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新诊断2型糖尿病患者的心脏自主神经病变

Cardiac Autonomic Neuropathy in Newly Diagnosed Patients With Type 2 Diabetes Mellitus.

作者信息

Siddiqui Md Sabah, Dev Vishnu, Khandelwal Ekta

机构信息

General Medicine, All India Institute of Medical Sciences, Raipur, Raipur, IND.

Physiology/Autonomic & Vascular Functions, All India Institute of Medical Sciences, Raipur, Raipur, IND.

出版信息

Cureus. 2023 Oct 20;15(10):e47366. doi: 10.7759/cureus.47366. eCollection 2023 Oct.

Abstract

INTRODUCTION

Cardiac autonomic neuropathy (CAN) is a debilitating complication in diabetes mellitus, leading to life-threatening arrhythmias and various impairments. Its prevalence varies widely, and early detection and management are crucial. This study investigates the prevalence of CAN in newly diagnosed type 2 diabetes mellitus patients in Central India, comparing them to a control group.

METHODOLOGY

This case-control study included 35 newly diagnosed type 2 diabetes mellitus patients and 35 age-matched healthy controls from the general population. Cardiac autonomic function testing (AFT) was done by heart rate variability (HRV), the deep breathing test (DBT), the cold pressor test (CPT), and the lying-to-standing test (LST). Parameters were recorded and analyzed using statistical tests.

RESULTS

Patients with type 2 diabetes mellitus had significantly higher weight, BMI, fasting blood sugar, post-prandial blood sugar, urine albumin-creatinine ratios, and systolic and diastolic blood pressure than controls. Abnormalities in HRV and E: I ratio during the DBT and CPT were more prevalent in these patients. Parasympathetic dysfunction (delta HR) and a lower E: I ratio were also significantly high in this group. Also, LST results suggested a greater likelihood of orthostatic symptoms in the patients' group.

CONCLUSION

This study highlights the importance of AFT in diagnosing early CAN in newly diagnosed patients. Early diagnosis and management of diabetic CAN are essential to prevent complications.

摘要

引言

心脏自主神经病变(CAN)是糖尿病的一种使人衰弱的并发症,可导致危及生命的心律失常和各种功能障碍。其患病率差异很大,早期检测和管理至关重要。本研究调查了印度中部新诊断的2型糖尿病患者中CAN的患病率,并将他们与对照组进行比较。

方法

本病例对照研究纳入了35名新诊断的2型糖尿病患者和35名年龄匹配的来自普通人群的健康对照者。通过心率变异性(HRV)、深呼吸试验(DBT)、冷加压试验(CPT)和卧立位试验(LST)进行心脏自主神经功能测试(AFT)。使用统计检验记录和分析参数。

结果

2型糖尿病患者的体重、体重指数、空腹血糖、餐后血糖、尿白蛋白肌酐比值以及收缩压和舒张压均显著高于对照组。在这些患者中,DBT和CPT期间HRV和E:I比值异常更为普遍。该组中副交感神经功能障碍(心率变化)和较低的E:I比值也显著较高。此外,LST结果表明患者组出现体位性症状的可能性更大。

结论

本研究强调了AFT在新诊断患者早期CAN诊断中的重要性。糖尿病CAN的早期诊断和管理对于预防并发症至关重要。

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