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糖尿病性周围神经病变中的心脏自主神经病变

Cardiac Autonomic Neuropathy in Diabetic Peripheral Neuropathy.

作者信息

Naik Balaji, Pandey Abhishek, Dasgupta Riddhi, Shivaprasad Channabasappa

机构信息

Diabetes and Endocrinology, Sapthagiri Institute of Medical Sciences and Research Centre, Bengaluru, IND.

Medicine, Institute of Medical Sciences, Banaras Hindu University, Varanasi, IND.

出版信息

Cureus. 2024 Aug 25;16(8):e67777. doi: 10.7759/cureus.67777. eCollection 2024 Aug.

DOI:10.7759/cureus.67777
PMID:39323701
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11422742/
Abstract

Background Cardiac autonomic neuropathy (CAN) is the most underdiagnosed consequence of diabetes because standard hospital settings do not provide consistent diagnostic criteria or testing resources. It is still unclear how diabetic peripheral neuropathy (DPN) and CAN are related. Therefore, this study aimed to determine the prevalence of CAN in individuals with type 2 diabetes mellitus who had isolated DPN without other microvascular or macrovascular complications. Methodology A total of 35 type 2 diabetes mellitus patients with isolated DPN (group 1) and an equal number of sex- and age-matched patients without DPN (group 2) underwent CAN testing. Results were compared between the two groups. Results A significantly higher prevalence of isolated parasympathetic (28.57 vs. 11.42%), isolated sympathetic (22.85 vs. 8.57%), and combined autonomic dysfunction (37.14 vs. 2.85%) was found in the neuropathic group compared to the non-neuropathic group. Group 1 exhibited more abnormal parasympathetic nervous system test results and increased diastolic pressure during sustained handgrip compared to group 2 (all p-values <0.05). Conclusions A significantly higher prevalence of cardiac autonomic dysfunction is seen in patients with DPN without other microvascular or macrovascular complications, irrespective of age, sex, or duration of diabetes mellitus. Patients with a higher body mass index were found to have significantly increased cardiac autonomic dysfunction.

摘要

背景

心脏自主神经病变(CAN)是糖尿病最易被漏诊的并发症,因为标准医院环境未提供一致的诊断标准或检测资源。糖尿病性周围神经病变(DPN)与CAN之间的关系仍不清楚。因此,本研究旨在确定无其他微血管或大血管并发症的孤立性DPN的2型糖尿病患者中CAN的患病率。

方法

共有35例孤立性DPN的2型糖尿病患者(第1组)和同等数量的年龄和性别匹配的无DPN患者(第2组)接受CAN检测。比较两组结果。

结果

与非神经病变组相比,神经病变组中孤立性副交感神经病变(28.57%对11.42%)、孤立性交感神经病变(22.85%对8.57%)和联合自主神经功能障碍(37.14%对2.85%)的患病率显著更高。与第2组相比,第1组表现出更多异常的副交感神经系统检测结果,且持续握力时舒张压升高(所有p值<0.05)。

结论

在无其他微血管或大血管并发症的DPN患者中,无论年龄、性别或糖尿病病程如何,心脏自主神经功能障碍的患病率显著更高。发现体重指数较高的患者心脏自主神经功能障碍显著增加。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3430/11422742/8a446a9fa8af/cureus-0016-00000067777-i03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3430/11422742/b5e6e505f5fb/cureus-0016-00000067777-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3430/11422742/b2247a3b4cba/cureus-0016-00000067777-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3430/11422742/8a446a9fa8af/cureus-0016-00000067777-i03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3430/11422742/b5e6e505f5fb/cureus-0016-00000067777-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3430/11422742/b2247a3b4cba/cureus-0016-00000067777-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3430/11422742/8a446a9fa8af/cureus-0016-00000067777-i03.jpg

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Summary of Revisions: Standards of Care in Diabetes-2023.修订摘要:《2023年糖尿病护理标准》
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