长期糖尿病患者心血管自主神经病变的临床特征与流行病学
Clinical Characteristics and Epidemiology of Cardiovascular Autonomic Neuropathy in Peoples With Long-Standing Diabetes.
作者信息
Lee Sook Jung, Kim Chong Hwa, Jeong Su Jin, Yun Jae-Seung, Won Jong Chul, Lee Jae Hyuk, Park Ie Byung, Lee Chang Won, Kwon Hyuk-Sang, Park Tae Sun
机构信息
Division of Endocrinology and Metabolism, Department of Internal Medicine, Incheon Sejong General Hospital, Incheon, Korea.
Division of Endocrinology and Metabolism, Department of Internal Medicine, Sejong General Hospital, Bucheon, Korea.
出版信息
J Korean Med Sci. 2025 Jul 21;40(28):e154. doi: 10.3346/jkms.2025.40.e154.
BACKGROUND
Cardiovascular autonomic neuropathy (CAN) is a frequently underdiagnosed complication of diabetes mellitus that contributes to increased mortality and morbidity rates. This multicenter study investigated the epidemiology and clinical characteristics of CAN in patients with long-term diabetes.
METHODS
Retrospective data were collected from 884 individuals with diabetes who were assessed for CAN across eight hospitals in Korea. CAN was diagnosed using electrocardiography and cardiovascular autonomic function tests, including the heart rate-corrected QT interval and Ewing's method. This study evaluated the clinical characteristics, cardiovascular autonomic nerve function test results, and risk factors associated with CAN.
RESULTS
Among the 884 patients, 778 (88%) were diagnosed with CAN (DCAN), while 106 (12%) were not (non-DCAN). Individuals with DCAN were older, had a longer duration of diabetes, and had higher creatinine levels. The DCAN group showed decreased time and frequency parameters of heart rate variability (HRV). A multiple logistic regression analysis revealed that a longer diabetes duration, older age, and higher creatinine level were significant risk factors for CAN.
CONCLUSION
CAN was associated with advanced age, a longer duration of diabetes, higher creatinine levels, and lower time and frequency HRV parameters.
背景
心血管自主神经病变（CAN）是糖尿病一种常被漏诊的并发症，会导致死亡率和发病率上升。这项多中心研究调查了长期糖尿病患者中CAN的流行病学和临床特征。
方法
从韩国八家医院接受CAN评估的884例糖尿病患者中收集回顾性数据。使用心电图和心血管自主功能测试（包括心率校正QT间期和尤因方法）诊断CAN。本研究评估了临床特征、心血管自主神经功能测试结果以及与CAN相关的危险因素。
结果
在884例患者中，778例（88%）被诊断为糖尿病性心血管自主神经病变（DCAN），而106例（12%）未被诊断为糖尿病性心血管自主神经病变（非DCAN）。DCAN患者年龄更大，糖尿病病程更长，肌酐水平更高。DCAN组心率变异性（HRV）的时间和频率参数降低。多因素logistic回归分析显示，糖尿病病程更长、年龄更大和肌酐水平更高是CAN的显著危险因素。
结论
CAN与高龄、糖尿病病程更长、肌酐水平更高以及较低的HRV时间和频率参数相关。
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