Jaffe R S, Aoki T T, Rohatsch P L, Disbrow E A, Fung D L
Department of Anesthesiology, University of California Davis 95616, USA.
Clin Auton Res. 1995 Jun;5(3):155-8. doi: 10.1007/BF01826198.
A total of 24 subjects with type I insulin-dependent diabetes mellitus were studied. Cardiac parasympathetic function was measured by supine heart rate variability (HRV) in the respiratory frequency 0.10-0.50 Hz and the sympathetic index was measured as the ratio of HRV between 0.055 and 0.098 Hz to that between 0.004 and 0.5 Hz. Factors assessing diabetic control and complications, and factors unrelated to diabetes but possibly influencing HRV, were recorded. Association with depressed HRV was assessed with correlation, and prediction of depressed HRV was determined with multiple regression. Factors associated with depressed HRV but not independently predictive were renal dysfunction and elevated thyroid stimulating hormone. Elevated glycosylated haemoglobin was not significantly correlated with depressed HRV. Four factors (presence of diabetic retinopathy, male gender, duration of diabetes and increasing age) were significant in the regression and sufficed to predict 81% of the sample variance. The relative weights (beta) were -0.65, 0.40, -0.40 and 0.26, respectively. Supine sympathetic index was not sufficient to demonstrate sympathetic dysfunction. It is proposed that the regression model may be used to identify patients likely to have cardiac parasympathetic autonomic dysfunction.
共对24名I型胰岛素依赖型糖尿病患者进行了研究。通过测量仰卧位时呼吸频率在0.10 - 0.50赫兹之间的心率变异性（HRV）来评估心脏副交感神经功能，并将交感神经指数测量为0.055至0.098赫兹之间的HRV与0.004至0.5赫兹之间的HRV之比。记录了评估糖尿病控制和并发症的因素，以及与糖尿病无关但可能影响HRV的因素。通过相关性评估与HRV降低的关联，并通过多元回归确定HRV降低的预测因素。与HRV降低相关但并非独立预测因素的是肾功能不全和促甲状腺激素升高。糖化血红蛋白升高与HRV降低无显著相关性。四个因素（糖尿病视网膜病变的存在、男性性别、糖尿病病程和年龄增长）在回归中具有显著性，足以预测样本方差的81%。相对权重（β）分别为 -0.65、0.40、-0.40和0.26。仰卧位交感神经指数不足以证明交感神经功能障碍。建议使用该回归模型来识别可能存在心脏副交感神经自主神经功能障碍的患者。
