2型糖尿病患者血脂紊乱类型与心率变异性相关性分析

An Association Analysis of Different Types of Dyslipidemia and Heart Rate Variability in Patients with Type 2 Diabetes

目的研究2型糖尿病患者血脂紊乱类型对心率变异性的影响。方法本研究为横断面研究,纳入湖北省人民医院2014年1月~2016年5月就医的725例2型糖尿病患者,其中血脂正常组231例患者为对照组,高甘油三酯组41例、高低密度脂蛋白胆固醇组20例、低高密度脂蛋白胆固醇组273例、高甘油三酯合并低高密度脂蛋白胆固醇组160例作为研究组。收录患者一般临床数据、糖代谢情况、甘油三酯、总胆固醇、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇、血浆致动脉硬化指数、24h动态心电图测定心率变异性(HRV)时域和频域参数。采用方差分析、χ~2检验、Pearson相关分析、偏相关性分析探讨2型糖尿病患者血脂紊乱类型与心率变异性关系。结果 TG组、LDL-C组、HDL-C组、TG+HDL-C组与血脂正常组相比心率变异性明显降低,差异有统计学意义(P<0.05)。但偏相关性分析显示TG、AIP与心率变异性呈负相关,HDL-C与心率变异性呈正相关,差异有统计学意义(P<0.05)。结论甘油三酯(TG)增高、间接反应s LDL-C含量的血浆致动脉硬化指数(AIP)增高、高密度脂蛋白胆固醇降低与2型糖尿病患者心率变异性降低相关。

Objective To study the effect of different types of dyslipidemia on heart rate variability in patients with type 2 diabetes. Methods Cohort study was carried out at Renmin Hospital of Wuhan University during January 2014 to May 2016. Total 725 patients with type 2 diabetes were recruited, including 231 patients without dyslipidemla and 494 patients with dyslipidemia. Clinical parameters were collected from electronic medical records system. Using variance analysis, chi square test, Pearson correlation analysis and partial correlation analysis, we explored an association of different types of dyslipidemia and heart rate variability in patients with type 2 diabetes. Results TG,LDL - C,HDL - C, TG ＋ HDL - C group significantly decreased heart rate variability compared group without dyslipidemia （P 〈 0.05 ）. But the partial correlation analysis showed that only atherogenic index of plasma and Triglyceride （TG） were negatively correlated with heart rate variability, HDL cholesterol was positively correlated with heart rate variability, and the difference was statistically significant （P 〈 0.05）. Conclusion Triglyceride （TG） , atherogenic index of plasma（AIP） ,HDL cholesterol were related to the reduction heart rate variability in patents with type 2 diabetes.