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心脏自主神经病变改变了2型糖尿病中肥胖和低血糖之间的关联
Wenjing Zhang1,2, Yiquan Huang1,2, Ziwei Zhou1,2
1Department of Cardiology, the First Affiliated Hospital of Sun Yat-Sen University, 58 Zhongshan 2nd Road, Guangzhou, 510080, China.
肥胖与2型糖尿病患者患有心脏自主神经病变 (CAN) 的严重低血糖风险较低有关. 然而,在没有 CAN 的患者中没有观察到这种关联,这突显了 CAN 的修饰作用.
科学领域:
- 心脏病学 心脏病学
- 内分泌学 在内分泌学.
- 糖尿病学 糖尿病学
背景情况:
- 以前的研究表明,在2型糖尿病中,较高的体重指数 (BMI) 和降低的低血糖之间存在相关性.
- 这种关系对心脏自主神经病变 (CAN) 患者的影响尚不清楚.
研究的目的:
- 研究2型糖尿病患者肥胖和严重低血糖之间的关联.
- 确定心脏自主神经病变 (CAN) 是否影响肥胖和低血糖之间的关系.
主要方法:
- 从ACCORD试验中对7789名2型糖尿病参与者的分析.
- 心脏自主神经病变 (CAN) 由SDNN < 8.2 ms和RMSSD < 8.0 ms定义.
- 肥胖症定义为BMI≥30 kg/m2;结果是严重的低血糖症 (HAA/HMA). 分析使用了COX回归模型.
主要成果:
- 在癌症患者中,肥胖与严重低血糖症 (HAA/HMA) 的风险明显降低 (HR 0.51/0.57).
- 在没有CAN的患者中,没有发现肥胖和严重低血糖之间的显著关联 (HAA/HMA:HR 0.98/0.97).
- 增加的BMI与减少的严重低血糖事件相关,仅在患有CAN的参与者中.
结论:
- 心脏自主神经病变 (CAN) 显著改变了2型糖尿病中肥胖和低血糖之间的关联.
- 患有CAN的2型糖尿病患者应对低血糖风险保持警,即使在控制体重时也是如此.
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