The relationship between heart rate variability and urine albumin/creatinine ratio in patients with type 2 diabetes
10.3760/cma.j.cn311282-20200817-00581
- VernacularTitle:2型糖尿病患者心率变异性与尿白蛋白/肌酐比值的相关性研究
- Author:
Xiaohai ZHOU
1
;
Ning LIN
;
Hanbei CHEN
;
Qing SU
Author Information
1. 上海交通大学医学院附属新华医院内分泌科，上海 200092
- Keywords:
Diabetes mellitus, type 2;
Heart rate variability;
Urine albumin/creatinine ratio
- From:
Chinese Journal of Endocrinology and Metabolism
2021;37(9):800-806
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the relationship between heart rate variability (HRV) and urine albumin/creatinine ratio (ACR) in patients with type 2 diabetes.Methods:A total of 1 543 patients with type 2 diabetes were selected from the Department of Endocrinology of Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine, and all the participants received 24-hour Holter monitoring and ACR measurement. HRV parameters include the standard deviation of all normal to normal intervals (SDNN), root mean square differences of successive RR intervals (rMSSD), the percent of adjacent RR intervals with a difference greater than 50 ms (PNN50), low frequency (LF), high frequency (HF), the ratio of LF to HF (LF/HF). Multivariate linear regression was used to analyze the relationship between HRV and ACR. Logistic regression was performed to further analyze the relationship between HRV and albuminuria while HRV parameter was divided into ≤25% (Q1) and ≥25% (Q2-Q4).Results:Multivariate linear regression results showed that the decrease of HRV parameters [ln(SDNN), ln(PNN50), ln(LF), ln(HF), ln(LF/HF)] was closely related to the increase of ln(ACR) (all P<0.05). Logistic regression analysis results showed that SDNN( OR=1.669, 95% CI 1.290-2.159), PNN50( OR=1.372, 95% CI 1.063-1.770), LF( OR=1.918, 95% CI 1.441-2.551), and LF/HF ( OR=1.623, 95% CI 1.220-2.183) were independent risk factors for albuminuria (all P<0.05); Furthermore, logistic regression analysis stratified by the median duration of diabetes (10 years) and cardiovascular disease found that in patients with diabetes≤10 years or without cardiovascular disease, the risk of albuminuria in the SDNN and LF Q1 group were higher than that in the Q2-Q4 group; while in patients with diabetes>10 years or with cardiovascular disease, the risk of albuminuria in the SDNN, PNN50, LF, and LF/HF Q1 group were higher than that in the Q2-Q4 group. Conclusion:The reduction of HRV parameters in patients with type 2 diabetes is closely related to the increase of ACR. With the progress of diabetes, more HRV parameters demonstrated predictive effect for risk of albuminuria.
