Lower heart rate variability is associated with higher plasma concentrations of IL-6 in type 1 diabetes
Lower heart rate variability is associated with higher plasma concentrations of IL-6 in type 1 diabetes
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DOI：
10.1530/eje-07-0090
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发表时间：
2007-07-01
影响因子：
5.8
通讯作者：
Vendrell, J.
中科院分区：
文献类型：
--
作者：
Gonzalez-Clemente, J-M;Vilardell, C.;Vendrell, J.
目的：在1型糖尿病患者中，心血管自主神经病变(CAN)是与胰岛素抵抗相关的心血管危险因素，而胰岛素抵抗又与低度全身炎症有关。心率变异性降低(HRV)被认为是CAN的首批指标之一。因为自主神经系统与全身性炎症相互作用。设计：对120例14年前诊断为I型糖尿病的受试者进行横断面研究。方法：记录：1)临床特征：性别、年龄、体重指数、腰臀比。2)血浆肿瘤坏死因子a受体I和2的可溶性部分、IL-6和C反应蛋白的水平；3)通过估计葡萄糖处置速率(EGDR)来评估胰岛素抵抗；以及4)CAN的测试：深呼吸反应的心率变异性(Ell Ratio)、Valsalva动作反应的HRV。结果：Ell比值与血浆IL-6浓度呈显著负相关(r=-0.244)。P=0.032)，在调整了潜在的混杂因素(年龄、性别)后仍然显著。HbAlc，WHR。舒张压是甘油三酯，HI)L-胆固醇。视网膜病，肾病。周围神经病。胰岛素用量与吸烟：r=-0.231，P=0.039)。未发现炎症相关蛋白、CaN检测和eGDR之间的其他显著关联。结论：这些发现提示1型糖尿病患者的低度炎症与CaN的早期改变之间存在联系，可能在CAN的发病机制和/或其临床意义中具有重要意义。
Objective: In type 1 diabetes, cardiovascular autonomic neuropathy (CAN) is associated Xvith cardiovascular risk factors related to insulin resistance, which in turn are associated with low-grade systemic inflammation. Reduced heart rate variability (HRV) is considered one of the first indicators of CAN. Since the autonomic nervous system interacts with systemic inflammation. we evaluated CAN to study its possible association with low-grade systemic inflammation.Design: Cross-sectional study of a group of 120 subjects diagnosed with type I diabetes mellitus 14 years before.Methods: Information recorded: 1) clinical characteristics: sex, age, body mass index, waist-to-hip ratio (WHR). blood pressure (BP), smoking, alcohol intake, insulin dose, HbAlc, and lipid profile; 2) plasma levels of soluble fractions of tumour necrosis factor a receptors I and 2, IL-6, and C-reactive protein; 3) insulin resistance by estimation of the glucose disposal rate (eGDR): and 4) tests for CAN: HRV in response to deep breathing (Ell ratio), HRV in response to the Valsalva maneuver. and changes in systolic BP responding to standing.Results: A significant negative correlation was found between Ell ratio and plasma concentrations of IL-6 (r= -0.244. P=0.032), which remained significant after adjusting for potential confounding factors (age, sex. HbAlc, WHR. diastolic BE triglycerides, HI)L-cholesterol. retinopathy, nephropathy. peripheral neuropathy. insulin dose, and smoking: r= -0.231, P=0.039). No other significant associations were found between inflammation-related proteins, tests for CAN, and eGDR.Conclusions: These findings suggest a link between low-grade inflammation and early alterations of CAN in type 1 diabetes and may be of importance in the pathogenesis of CAN and/or its clinical implications.