JCEM:1型糖尿病患者心血管自主神经功能障碍与外周动脉硬化的关系

2019-03-01 xing.T 网络

由此可见,在1型糖尿病中,外周AS和动脉粥样硬化都与CAN有关。诸如ABI等简单方法可以识别未确诊的自主神经功能障碍患者。

血管自主神经病变(CAN)似乎有助于1型糖尿病患者的外周动脉硬化(AS)。AS患者的CAN是否与伴随无症状动脉粥样硬化疾病(aPAD)相关仍不清楚。近日,内分泌和代谢性疾病领域权威杂志Journal of Clinical Endocrinology & Metabolism上发表了一篇研究文章,该研究旨在评估1型糖尿病和AS患者的CAN风险及其与动脉粥样硬化之间潜在关联。

该研究为横断面研究,以教学医院的1型糖尿病门诊为基础,纳入了264名1型糖尿病患者。AS由踝肱指数(ABI)>1.2来定义,aPAD由趾臂指数和多普勒超声检查来确定,CAN由血压和心率对活动站立的反应以及Ewing和Clarke检查来衡量。该研究的主要观察指标为AS患者伴有CAN的几率。CAN的几率也是根据存在AS和伴随的aPAD计算得到。

研究人群平均年龄为35±11岁,疾病持续时间为19±10年,平均HbA1c为7.5±1.3%。73名(28%)患者有外周AS,其中28名患者表现出aPAD。AS患者的CAN患病率为48%[37-59],但ABI正常的患者仅为23%[18-30](OR为3.1 [1.7-5.4])。伴随aPAD的增加,CAN的OR为4.5(2.0-10.1)。在调整aPAD和相关的血管危险因素后,AS仍与副交感神经功能障碍相关。

由此可见,在1型糖尿病中,外周AS和动脉粥样硬化都与CAN有关。诸如ABI等简单方法可以识别未确诊的自主神经功能障碍患者。

原始出处:

Lía Nattero-Chávez.et al.Association of cardiovascular autonomic dysfunction with peripheral arterial stiffness in patients with type 1 diabetes.J Clin Endocrinol Metab. 2019.https://doi.org/10.1210/jc.2018-02729

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    2019-11-19 achengzhao
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    2019-06-12 smallant2015
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  5. 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  6. 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  7. 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    2019-03-01 一个字-牛

    学习了谢谢分享

    0

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