2型糖尿病一级亲属的心率变异性与颈动脉内中膜厚度的关系

Relation of heart rate variability and carotid intima media thickness in the first degree relatives of type 2 diabetes

目的检测2型糖尿病(T2DM)一级亲属(FDR s)颈动脉内中膜厚度(IMT)及心率变异性(HRV),并分析它们之间的关系。方法随机选取46例健康者(NGT组)、57例FDR s及59例T2DM患者,分别测定其空腹胰岛素、空腹血糖、餐后2 h血糖、TC、TG、HDL-C及LDL-C,同时计算胰岛素敏感性指数(IAI)。彩色多普勒超声测量受试者的颈总动脉(CCA)和颈内动脉(ICA)的IMT,动态心电监测分析HRV。结果CCA-IMT、ICA-IMT在NGT、FDR s及T2DM组依次升高,且FDR s组较NGT组升高(P<0.05);T2DM组的ICA-IMT较NGT和FDR s组升高(P均<0.05);HRV各项指标[时域指标:总体标准差(SDNN)、均值标准差(SDANN)、标准差平均值指数(SDNN)、差值均方平方根(rMSSD);频域指标:低频(LF)、高频(HF)]在NGT、FDR s及T2DM组依次减低(P均<0.05),FPG、IAI及TG均与CCA-IMT、ICA-IMT相关(复相关系数r=0.562、0.492,P均<0.05)。结论在糖耐量正常的T2DM患者FDR s中,已经存在IMT增厚及HRV异常,且二者密切相关。

Objective To study the heart rate variability（HRV） and carotid intima media thickness （IMT） in the first degree relatives of type 2 diabetes （FDRs）, and analized their relationship. Methods Healthy controls （IMT） ,57 FDRs and 59 type 2 diabetes （T2DM） patients were enrolled. Fasting insulin, fasting plasma glucose, 2 h PG, totle cholesterol, triglyeride, high density lipoprotein-cholesterol and low density lipoprotein-cholesterol, and calculated insulin sensitivity （IAI）. IMT of mmon carotid artery（CCA） and internal carotid artery（ICA） was detected by color Doppler ultrasound, HRV was analyzed by dynamic electrocardio-monitor. Results CCA-IMT,ICA-IMT in NGT,FDRs and T2DM group were higher by turns,and higher in FDRs group than that in NGT group（P 〈0.05） ; ICA-IMT level in T2DM group was higher than that in NGT group and FDRs group （ all P 〈 0.05） ; HRV indexes, such as SDNN, SDANN, SDNN, rMSSD, and frequency domain analysis indexes, namely LF, HF were decreased by turns in NGT group, FDRs group and T2DM group（ all P 〈 0.05 ）, FPG, IAI and TG were related with CCA-IMT and ICA-IMT（ r = 0. 562,0. 492 ,P 均 〈 0.05 ）. CCA-IMT and ICA-IMT were higher in FDRs and T2DM than that in control group （ P 〈 0.05 ）. HRV （ SDNN, SDANN, rMSSD, LF, HF） was lower in FDRs and T2DM than that in control （P 〈0.05） ,IAI was lower in FDRS and T2DM than that in control group（P 〈 0.05）. HRV was negatively related with theseverity of IMT. Conclusions There are abnormal HRV indexs and IMT thickening in the FDRs of T2DM patients, and they have intimate relations.