Huang Xin, Bao Yun, Wang Jie, Tian Limin
School of Clinical Medicine, Ningxia Medical University, 750000 Yinchuan, Ningxia, China.
Department of Endocrinology, Gansu Provincial Hospital, 730000 Lanzhou, Gansu, China.
Rev Cardiovasc Med. 2024 Jul 3;25(7):244. doi: 10.31083/j.rcm2507244. eCollection 2024 Jul.
Cardiac autonomic neuropathy (CAN) is a severe complication of type 1 diabetes mellitus (T1DM). This meta-analysis aimed to synthesize relevant literature on the prevalence of CAN and its risk factors in individuals with T1DM.
We screened relevant literature from databases based on predefined search criteria until June 28, 2022. Data extraction and quality assessment were conducted independently by two reviewers. A meta-analysis was conducted to determine the prevalence of CAN and its risk factors in individuals with T1DM using a random-effects model. A subgroup analysis was conducted to assess variations in CAN prevalence based on diabetes duration, diagnostic criteria, study quality, study design, and geographic region of the participants.
A total of 21 studies provided information on the prevalence of CAN, while 18 studies explored the potential risk factors for CAN. The overall estimated prevalence of CAN in individuals with T1DM was 25.8% (95% confidence interval (95% CI): 0.208-0.307), with no significant differences observed among the five regions. Additionally, smoking, lipid abnormalities, hypertension, duration of diabetes, increased body mass index, elevated glycated haemoglobin concentrations, and presence of chronic complications of diabetes, such as diabetic retinopathy, diabetic neuropathy, and diabetic nephropathy, were associated with a higher prevalence of CAN in individuals with diabetes.
CAN is prevalent in individuals with T1DM worldwide. Efforts should be made to improve early screening and intervention for CAN, as well as to implement strategies aimed at improving or controlling early risk factors associated with CAN.
心脏自主神经病变（CAN）是1型糖尿病（T1DM）的一种严重并发症。本荟萃分析旨在综合有关T1DM患者中CAN患病率及其危险因素的相关文献。
我们根据预定义的检索标准从数据库中筛选相关文献，截至2022年6月28日。由两名审阅者独立进行数据提取和质量评估。采用随机效应模型进行荟萃分析，以确定T1DM患者中CAN的患病率及其危险因素。进行亚组分析，以评估基于糖尿病病程、诊断标准、研究质量、研究设计和参与者地理区域的CAN患病率差异。
共有21项研究提供了CAN患病率的信息，18项研究探讨了CAN的潜在危险因素。T1DM患者中CAN的总体估计患病率为25.8%（95%置信区间（95%CI）：0.208 - 0.307），五个区域之间未观察到显著差异。此外，吸烟、脂质异常、高血压、糖尿病病程、体重指数增加、糖化血红蛋白浓度升高以及糖尿病慢性并发症（如糖尿病视网膜病变、糖尿病神经病变和糖尿病肾病）的存在与糖尿病患者中CAN的较高患病率相关。
CAN在全球T1DM患者中普遍存在。应努力改善CAN的早期筛查和干预，并实施旨在改善或控制与CAN相关的早期危险因素的策略。
