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心率变化和静止心率对2型糖尿病死亡率的相互作用
Yiquan Huang1, Peihan Xie1, Shaozhao Zhang1
1Cardiology Department, First Affiliated Hospital of Sun Yat-Sen University, China; NHC Key Laboratory of Assisted Circulation (Sun Yat-Sen University), China.
低心率变化 (HRV) 和高静止心率 (RHR) 一起显著增加2型糖尿病患者的死亡风险. 这些因素在协同作用下相互作用,强调了评估风险分层的重要性.
科学领域:
- 心脏病学 心脏病学
- 内分泌学 在内分泌学.
- 公共卫生 公共卫生
背景情况:
- 心率变化 (HRV) 和静止心率 (RHR) 是重要的心血管指标.
- 传统上,HRV和RHR是独立分析的,可能缺少组合的预后信息.
研究的目的:
- 研究HRV和RHR对2型糖尿病患者死亡率的综合影响.
- 为了确定HRV和RHR是否相互作用来预测死亡风险.
主要方法:
- 分析了来自ACCORD试验的7,529名参与者,测量HRV (SDNN,rMSSD) 和RHR.
- 定义异常HRV (<25百分位) 和高RHR (>75百分位).
- 验证了来自动脉样硬化多民族研究的2型糖尿病子集 (n=745) 中的研究结果.
主要成果:
- 低SDNN (HRV的度量) 与高RHR相结合,显著增加了所有原因死亡风险 (HR 1.68).
- 无论是低HRV还是高RHR单独都没有与与正常水平相比增加的死亡率显著相关.
- 在HRV和RHR状态之间观察到显著的乘法和加法相互作用 (P相互作用<0.05).
结论:
- HRV与死亡率之间的关联受到RHR水平在2型糖尿病中显著的影响.
- 低HRV和高RHR对死亡风险具有相互依存和协同作用.
- 对HRV和RHR的综合评估为2型糖尿病死亡率提供了增强的预后价值.
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