QTc and autonomic neuropathy in diabetes: Effects of acute hyperglycaemia and n-3 PUFA
QTc and autonomic neuropathy in diabetes: Effects of acute hyperglycaemia and n-3 PUFA
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DOI：
10.1016/j.numecd.2006.09.006
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发表时间：
2007-12-01
影响因子：
3.9
通讯作者：
Frontoni, Simona
中科院分区：
文献类型：
--
作者：
Santini, Vanina;Ciampittiello, Giuseppina;Frontoni, Simona
背景和目标：自主神经功能也受到高血压的调节，在血压和心脏功能的控制中发挥着至关重要的作用。这种生理机制的破坏对糖尿病患者的心血管死亡率产生了深刻的影响。我们研究了自主神经功能障碍对QTc间期和交感-迷走神经平衡（LF/HF）的影响，以响应急性高血压和膜电稳定方法和结果：24例2型糖尿病患者，无（N-：n = 13）或（N+：n = 11）自主神经病变和13名健康受试者（C）在24小时内和2小时高血压钳夹期间进行BP和ECG监测。糖尿病患者夜间的Δ QTc变钝（0.5 +/- 2.5 vs. C：2.9 +/-2.5%，p = 0.001），N+患者的Δ LF/HF降低（-2.8 +/- 38.2 vs. C = 34.8 +/-28.1%，p = 0.02）。在高血压期间，C组QTc增加; C组和N-组LF/HF显著增加。一个6个月的治疗n-3 PUFA部分恢复ALF/HF和Δ QTc（2.1 +/- 1.40，p = 0.04与基础）只有在N-。结论：高血压增加QTc间期和交感神经活动;电膜稳定改善自主神经功能，只有在没有明显的自主神经病变。除了血糖控制之外，还应该采取新的方法来防止自主神经功能的破坏。(c)2006 Elsevier B. V.保留所有权利。
Background and aims: Autonomic function is also regulated by glycaemia and exerts a crucial role in the control of blood pressure and cardiac function. The disruption of this physiological mechanism impacts deeply on cardiovascular mortality in diabetes. We investigated the influence of autonomic dysfunction on QTc interval and on sympatho-vagal balance (LF/HF), in response to acute hyperglycaemia and to membrane electrical stabilization (n-3 PUFA).Methods and results: Twenty-four type 2 diabetic patients, without (N-: n = 13) or with (N+: n = 11) autonomic neuropathy and 13 healthy subjects (C) underwent BP and ECG monitoring during a 24-h period and during a 2-h hyperglycaemic clamp. Delta QTc during the night was blunted in diabetics (0.5 +/- 2.5 vs. C: 2.9 +/- 2.5%, p = 0.001), and Delta LF/HF was decreased in N+ (-2.8 +/- 38.2 vs. C = 34.8 +/- 28.1%, p = 0.02). During hyperglycaemia, QTc increased in C; LF/HF significantly increased in C and N-. A 6-month treatment with n-3 PUFA partially restored ALF/HF and Delta QTc (2.1 +/- 1.40, p = 0.04 vs. basal) only in N-.Conclusion: Hyperglycaemia increases QTc interval and sympathetic activity; electrical membrane stabilization improves autonomic function only in the absence of overt autonomic neuropathy. Strategies to prevent the disruption of autonomic function with newer approaches, other than just glucose control, should be implemented. (c) 2006 Elsevier B.V. All rights reserved.