Cardiovascular autonomic neuropathy associates with nephropathy lesions in American Indians with type 2 diabetes
Cardiovascular autonomic neuropathy associates with nephropathy lesions in American Indians with type 2 diabetes
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DOI：
10.1016/j.jdiacomp.2016.03.008
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发表时间：
2016-07-01
影响因子：
3
通讯作者：
Pop-Busui, Rodica
中科院分区：
文献类型：
--
作者：
Wheelock, Kevin M.;Jaiswal, Mamta;Pop-Busui, Rodica
目的：心血管自主神经病变（CAN）预测临床糖尿病肾病（DN）。我们调查DN结构性病变和CAN.Methods之间的关系：六十三皮马印第安人与2型糖尿病进行肾活检后，6年的临床试验测试氯沙坦与安慰剂的肾保护作用。CAN的平均评估时间为9.2年。CAN变量包括呼气/吸气比（E/I）、正常R-R间期的标准差（sdNN）、低频和高频信号功率及其比值（LF、HF、LF/HF）;较低的值反映更严重的神经病变。CAN与肾脏结构变量的相关性通过校正年龄、性别、糖尿病病程、血压、HbA 1c、肾小球滤过率和试验期间治疗分配的线性回归进行评估。（部分r =-0.35，p = 0.01）和LF（r =-032，p = 0.02）;肾小球基底膜宽度与除LF/HF外的所有CAN指标呈负相关（r = -0.28至-0.42，p < 0.05）;滤过表面密度与sdNN、LF和HF呈正相关肾皮质间质体积分数与HF呈负相关（r =-0.27，p = 0.04）。爱思唯尔公司出版
Aims: Cardiovascular autonomic neuropathy (CAN) predicts clinical diabetic nephropathy (DN). We investigated the relationship between DN structural lesions and CAN.Methods: Sixty three Pima Indians with type 2 diabetes underwent kidney biopsies following a 6-year clinical trial testing the renoprotective efficacy of losartan vs. placebo. CAN was assessed a median 9.2 years later. CAN variables included expiration/inspiration ratio (E/I), standard deviation of the normal R-R interval (sdNN), and low and high frequency signal power and their ratio (LF, HF, LF/HF); lower values reflect more severe neuropathy. Associations of CAN with renal structural variables were assessed by linear regression adjusted for age, sex, diabetes duration, blood pressure, HbA1c, glomerular filtration rate, and treatment assignment during the trial.Results: Global glomerular sclerosis was negatively associated with sdNN (partial r = -0.35, p = 0.01) and LF (r = -032, p = 0.02); glomerular basement membrane width was negatively associated with all measures of CAN except for LF/HF (r = -0.28 to -0.42, p < 0.05); filtration surface density was positively associated with sdNN, LF, and HF (r = 0.31 to 0.38, p < 0.05); and cortical interstitial fractional volume was negatively associated with HF (r = -0.27, p = 0.04).Conclusions: CAN associates with DN lesions. Published by Elsevier Inc.