Meurman J H, Collin H L, Niskanen L, Töyry J, Alakuijala P, Keinänen S, Uusitupa M
Institute of Dentistry, University of Helsinki, Finland.
Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1998 Jul;86(1):69-76. doi: 10.1016/s1079-2104(98)90152-4.
The purpose of this investigation was to study the flow rate and organic constituents of whole saliva in relation to autonomic nervous function in patients with non-insulin-dependent diabetes.
We studied the associations of saliva factors and autonomic nervous function in 45 patients with non-insulin-dependent diabetes (mean age, 68 +/- 6 years) and 77 control subjects (mean age, 67 +/- 5 years). The metabolic evolution was well known over a 10-year period from the time of diagnosis. Resting and paraffin-wax-stimulated whole saliva samples were collected and analyzed. Autonomic nervous function was evaluated by measuring heart rate variation during deep breathing and change in systolic blood pressure during orthostatic testing and by means of power spectral analysis of heart rate variability while standing. The effect of drugs used on saliva was also studied.
No difference was seen in flow rate between the patients with diabetes and the control subjects; resting flow rates were 0.3 +/- 0.3 ml/min in the patients with diabetes and 0.3 +/- 0.2 ml/min in the control subjects, and stimulated flow rates were 1.2 +/- 1.4 ml/min in the patients with diabetes and 1.2 +/- 0.8 ml/min in the control subjects. The number of drugs used daily correlated with salivary flow rates of the control subjects (p < 0.001) but not with flow rates of the patients with diabetes. The effect of xerogenic medication on salivary flow rates was stronger in patients with diabetes than in control subjects, however. There were no statistically significant differences between patients with diabetes and control subjects in the organic constituents of saliva. The stimulated saliva secretion was associated with total power (rs = 0.343; p = 0.035), medium-frequency power (rs = 0.375; p = 0.020), and high-frequency power (rs = 0.414; p = 0.010) of heart rate variability in patients with diabetes.
Saliva secretion might be more affected by xerogenic drugs and autonomic nervous dysfunction in patients with non-insulin-dependent diabetes than in nondiabetic control subjects.
本研究旨在探讨非胰岛素依赖型糖尿病患者全唾液流速及有机成分与自主神经功能的关系。
我们研究了45例非胰岛素依赖型糖尿病患者（平均年龄68±6岁）和77例对照者（平均年龄67±5岁）唾液因子与自主神经功能的相关性。从诊断时起的10年期间，患者的代谢演变情况已知。收集并分析静息和石蜡刺激后的全唾液样本。通过测量深呼吸时的心率变化、直立试验时收缩压的变化以及站立时心率变异性的功率谱分析来评估自主神经功能。还研究了所用药物对唾液的影响。
糖尿病患者与对照者的唾液流速无差异；糖尿病患者静息流速为0.3±0.3 ml/min，对照者为0.3±0.2 ml/min；糖尿病患者刺激后流速为1.2±1.4 ml/min，对照者为1.2±0.8 ml/min。每日用药数量与对照者的唾液流速相关（p<0.001），但与糖尿病患者的流速无关。然而，致口干药物对糖尿病患者唾液流速的影响比对对照者更强。糖尿病患者与对照者唾液的有机成分无统计学显著差异。糖尿病患者刺激后的唾液分泌与心率变异性的总功率（rs = 0.343；p = 0.035）、中频功率（rs = 0.375；p = 0.020）和高频功率（rs = 0.414；p = 0.010）相关。
与非糖尿病对照者相比，非胰岛素依赖型糖尿病患者的唾液分泌可能更易受致口干药物和自主神经功能障碍的影响。
