Characteristics of deceleration capacity and Tp-e/QT value in different age groups of patients with diabetic autonomic neuropathy
10.3969/j.issn.1006-6187.2017.06.003
- VernacularTitle:不同年龄段2型糖尿病伴心血管自主神经病变患者心率减速力和Tp-e/QT比值的变化特点研究
- Author:
Weiwei JIANG
;
Ping LIU
;
Huiling LIU
- Keywords:
Diabetes mellitus;
Cardiovascular;
Autonomic neuropathy;
Deceleration capacity;
Tp-e/QT value
- From:
Chinese Journal of Diabetes
2017;25(6):497-502
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate characteristics of deceleration capacity (DC) and Tp-e/QT value in different age groups of patients with diabetic autonomic neuropathy, and to analyze their influencing factors. Methods A total of 487 subjects were enrolled in this study, and divided into three groups:patients with diabetic autonomic neuropathy (DM+CAN group,n=287), normal glucose tolerance patients with diabetic autonomic neuropathy (CAN group,n=130) and healthy controls (NC group,n=150).Then the DM+CAN group were further divided into three subgroups according to age tertiles:the lowest tertile group (35.0~47.2 years old,n=91),the middle tertile group (47.3~59.6 years old,n=116)and the highest tertile group (59.7~72.0 years old,n=80).All subjects were underwent 24-hour dynamic electrocardiogram recordings.DC and Tp-e/QT values were calculated,and then the correlation between DC and Tp-e/QT with other indicators was analyzed. Results The levels of WC,SBP,BMI,FPG,HbA1c,FIns and HOMA-IR were higher in DM+CAN group than in CAN group and in NC group (P<0.05 or P<0.01).DC increased and Tp-e/QT decreased from DM+CAN group,CAN group to NC group,and the pairwise comparisons were statistically significant (P<0.05 or P<0.01).DM duration,WC,FPG,FIns,HbA1c,HOMA-IR,hypertension and CHD ratio were higher in the highest tertile group and middle tertile group than in the lowest tertile group (P<0.05 or P<0.01).DM duration and FIns were higher in the highest tertile group than in middle tertile group (P<0.05 or P<0.01).RHR and AHR were lower in the highest tertile group than in the lowest tertile group (P<0.05),and there were no statistical significant difference between the middle tertile group and the lowest tertile group (P>0.05).DC increased [(2.90±0.47) vs (4.22±0.41) vs (4.97±0.35) ms],and the Tp-e/QT decreased [(0.23±0.05) vs (0.18±0.03) vs (0.12±0.02)] from the highest tertile group to the lowest tertile group,(P<0.05 or P<0.01),and the pairwise comparisons were statistically significant (P<0.05 or P<0.01).Multiple stepwise regression analysis showed that age,DM duration,WC,FPG,HbA1c,complicated with hypertension and coronary heart disease (CHD) were risk factors for DC and Tp-e/QT values (P<0.05). Conclusion Together with the increased age,DC level is reduced and Tp-e/QT value increased in patients with diabetic autonomic neuropathy.Dynamic electrocardiogram should be considered in patients with advanced age,long DM duration,high level of WC,FPG,HbA1c,and complicated with hypertension and CHD,in order to prevent the occurrence of cardiovascular events effectively.
