肥胖的2型糖尿病患者心率变异性及相关因素分析

目的 通过对肥胖的2型糖尿病患者心率变异性分析（HRV）,探讨肥胖、糖尿病对心脏自主神经功能的影响及其临床意义.方法 128例2型糖尿病患者根据体重指数（BMI）分为肥胖2型糖尿病组（52例）和非肥胖2型糖尿病组（76例）,应用24 h动态心电图心率变异性频谱分析技术检测HRV,与正常组对照并进行分析.结果 肥胖2型糖尿病患者正常R-R间期的标准差、每5 min R-R间期平均值的标准差、每5 min R-R间期标准差的平均值、总频谱功率、低频段功率、低频段功率/高频段功率均显著低于非肥胖2型糖尿病患者（P〈0.05,P〈0.01）;肥胖2型糖尿病患者SDNN与病程、体重指数、胰岛素抵抗指数、空腹胰岛素、糖化血红蛋白呈负相关.结论 肥胖的2型糖尿病患者心率变异性下降,与肥胖、胰岛素抵抗有关.

Analysis of heart rate variability and relative factors in patients with obese type diabetes mellitus

Objective To observe the change of the heart rate variability（HRV） and research dysfunction of the autonomic nervous system in patients with obese type diabetes mellitus（DM）. Methods 128 cases with type 2 DM were divided into 2 groups：obesity（52 eases） and non - obesity（76 cases） according to body mass index（BMI）. The 24 - hour dynamic electrocardiographic spectral analysis of heart rate variability was performed, then all data were compared with normal subjects. Result Compared with the type 2 DM non - obese group, the SDNN, SDANN, SDNN index, TF, LF and LF/HF were decreased （P 〈 0.05,P 〈 0. 01 ） in the type 2 D M obese group. The SDNN of obese type 2 diabetes mellitus was negatively correlated with course of diabetes, BMI, HOMA - IR, FINS and HbA1 c. Conclusion HRV is decreased in patients with obese type 2 diabetes mellitus,might contribute to obesity and insulin resistance.