Subclinical inflammation and endothelial dysfunction are linked to cardiac autonomic neuropathy in type 2 diabetes
Subclinical inflammation and endothelial dysfunction are linked to cardiac autonomic neuropathy in type 2 diabetes
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DOI：
10.1007/s40200-019-00435-w
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发表时间：
2019-12-01
影响因子：
2.8
通讯作者：
Hussain, M. Ejaz
中科院分区：
文献类型：
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作者：
Bhati, Pooja;Alam, Rizwan;Hussain, M. Ejaz
目的 本研究旨在探讨 T2DM 患者炎症和内皮功能生物标志物与心脏自主控制指标之间的关联。方法 招募 50 名 T2DM 患者参与本研究。对于心脏自主神经功能，进行了心血管自主反射测试（CART）和心率变异性（HRV）分析。收集血样用于评估炎症和内皮功能生物标志物。进行针对糖尿病病程、血糖控制、腰围、高血压、血脂异常、二甲双胍和他汀类药物调整的多变量线性回归分析，以检查生物标志物与心脏自主功能参数之间的关联。结果 Interleukin-6 与总功率 (p = .009) 和低频功率 (p = .04) 呈负相关。 Interleukin-18 和高敏 C 反应蛋白与心脏迷走神经控制指标呈负相关 (p < .05)。一氧化氮和内皮一氧化氮合酶均与心脏迷走神经控制指数呈正相关 (p < .05)，而内皮素-1 并未显示出与心脏自主功能参数的任何独立关联。结论 炎症和内皮功能的生物标志物与心脏迷走神经控制和整体 HRV 的测量相关，这表明 T2DM 亚临床炎症、内皮功能障碍和心脏自主神经功能障碍之间存在某些病理生理学联系。
Purpose The present study aimed to examine association between inflammatory and endothelial function biomarkers and indices of cardiac autonomic control in T2DM patients. Methods 50 T2DM patients were recruited for this study. For cardiac autonomic function, cardiovascular autonomic reflex tests (CARTs) and heart rate variability (HRV) analysis was performed. Blood samples were collected for evaluating inflammatory and endothelial function biomarkers. Multivariable linear regression analysis adjusted for diabetes duration, glycemic control, waist circumference, hypertension, dyslipidemia, metformin, and statins was performed to examine the association between the biomarkers and cardiac autonomic function parameters. Results Interleukin-6 was inversely related to total power (p = .009) and low frequency power (p = .04). Interleukin-18 and high sensitivity C-reactive protein inversely correlated with measures of cardiac vagal control (p < .05). Both nitric oxide and endothelial nitric oxide synthase were positively linked with cardiac vagal control indices (p < .05) whereas endothelin-1 did not show any independent association with cardiac autonomic function parameters. Conclusions Biomarkers of inflammation and endothelial function are associated with measures of cardiac vagal control and global HRV which suggest that there is some pathophysiological link between subclinical inflammation, endothelial dysfunction and cardiac autonomic dysfunction in T2DM.