高甘油三酯血症患者的小神经纤维损伤与心脏自主神经功能障碍

Small nerve fibre damage and cardiac autonomic dysfunction in patients with hypertriglyceridaemia.

作者信息

Bashir Bilal, Pasha Raabya, Kamath Anoushka, Malik Rayaz A, Ferdousi Maryam, Soran Handrean

机构信息

Faculty of Biology, Medicine and Health, University of Manchester, United Kingdom; Department of Endocrinology, Diabetes & Metabolism, Manchester University NHS Foundation Trust, United Kingdom; NIHR/WELLCOME Trust Clinical Research Facility, Manchester, United Kingdom.

Faculty of Biology, Medicine and Health, University of Manchester, United Kingdom.

出版信息

Atherosclerosis. 2025 Jun;405:119186. doi: 10.1016/j.atherosclerosis.2025.119186. Epub 2025 Apr 4.

DOI:10.1016/j.atherosclerosis.2025.119186

PMID:40367727

Abstract

BACKGROUND & OBJECTIVES: Hypertriglyceridaemia (HTG) is an independent risk factor for small fibre neuropathy in patients with type 1, type 2 diabetes, and obesity. This study assessed for evidence of small nerve fibre damage and cardiac autonomic dysfunction in individuals with HTG, without diabetes.

METHODS

Participants with HTG (n=60) and age and sex-matched controls (n=31) underwent assessment of the lipid profile, neuropathic symptoms and disability, corneal confocal microscopy (CCM) and cardiac autonomic nerve function tests.

RESULTS

Triglyceride (TG) concentration was significantly higher [6.0 (3.6-8.7) vs 1.1 (0.7-1.4) mmol/L, p < 0.001], and HDL-C [0.9 (0.7-1.2) vs 1.5 (1.3-1.8) mmol/L, p < 0.001) was lower in the HTG group. The Neuropathy Symptom Profile score [2 (0-5) vs 0, p < 0.001], Neuropathy Disability Score [2 (0-3) vs 0, p < 0.001] and vibration perception threshold [8.9 (5.5-10.5) vs 3.0 (2.0-4.0) volts, p < 0.001] were higher, whilst corneal nerve fibre density (CNFD) [28.9 (5.9) vs 35.1 (7.2) no./mm, p < 0.001], corneal nerve branch density (CNBD) [50.0 (30.4-66.5) vs 76.1 (56.2-112.5) no./mm, p < 0.001], corneal nerve fibre length (CNFL) [19.8 (4.8) vs 26.0 (6.2) mm/mm, p < 0.001], deep breathing heart rate variability (DB-HRV) [18 (13-20) vs 25 (20-30) beats/min, p < 0.001], E-I ratio [1.13 (1.09-1.20) vs 1.25 (1.18-1.31), p < 0.001], valsalva ratio [1.29 (1.18-1.49) vs. 1.47 (1.28-1.59), p = 0.01] and 30-15 ratio [1.24 (1.16-1.36) vs. 1.40 (1.27-1.49), p = 0.002] were lower in the HTG group compared to controls. Serum TG concentration correlated negatively with CCM parameters and cardiac autonomic function tests.

CONCLUSION

HTG, independent of diabetes, is associated with signs and symptoms of neuropathy, small nerve fibre damage and cardiac autonomic dysfunction.

摘要

背景与目的

高甘油三酯血症（HTG）是1型糖尿病、2型糖尿病及肥胖患者发生小纤维神经病变的独立危险因素。本研究评估无糖尿病的HTG个体中小神经纤维损伤及心脏自主神经功能障碍的证据。

方法

HTG患者（n = 60）及年龄、性别匹配的对照组（n = 31）接受血脂谱、神经病变症状及残疾情况、角膜共焦显微镜检查（CCM）及心脏自主神经功能测试评估。

结果

HTG组甘油三酯（TG）浓度显著更高[6.0（3.6 - 8.7）vs 1.1（0.7 - 1.4）mmol/L，p < 0.001]，高密度脂蛋白胆固醇（HDL-C）更低[0.9（0.7 - 1.2）vs 1.5（1.3 - 1.8）mmol/L，p < 0.001]。神经病变症状评分[2（0 - 5）vs 0，p < 0.001]、神经病变残疾评分[2（0 - 3）vs 0，p < 0.001]及振动觉阈值[8.9（5.5 - 10.5）vs 3.0（2.0 - 4.0）伏特，p < 0.001]更高，而角膜神经纤维密度（CNFD）[28.9（5.9）vs 35.1（7.2）条/mm，p < 0.001]、角膜神经分支密度（CNBD）[50.0（30.4 - 66.5）vs 76.1（56.2 - 112.5）条/mm，p < 0.001]、角膜神经纤维长度（CNFL）[19.8（4.8）vs 26.0（6.2）mm/mm，p < 0.001]、深呼吸心率变异性（DB - HRV）[18（13 - 20）vs 25（20 - 30）次/分钟，p < 0.001]、E - I比值[1.13（1.09 - 1.20）vs 1.25（1.18 - 1.31），p < 0.001]、瓦尔萨尔瓦比值[1.29（1.18 - 1.49）vs 1.47（1.28 - 1.59），p = 0.01]及30 - 15比值[1.24（1.16 - 1.36）vs 1.40（1.27 - 1.49），p = 0.002]在HTG组低于对照组。血清TG浓度与CCM参数及心脏自主神经功能测试呈负相关。