糖尿病多神经病变的进展与昼夜血压变化受损之间的关系
Dai Yamagami1, Takahisa Deguchi1, Aiko Arimura1
1Department of Diabetes and Endocrine Medicine, Kagoshima University Graduate School of Medicine and Dental Sciences, Kagoshima, Japan.
Journal of diabetes investigation
|December 19, 2024
概括
糖尿病多神经病变的进展与夜间血压下降的减少和升高型血压变异性的增加有关. 这种关联独立于其他常见的风险因素.
科学领域:
- 心脏病学 心脏病学
- 神经学 神经学
- 内分泌学 在内分泌学.
背景情况:
- 糖尿病多神经病是糖尿病的常见并发症.
- 循环血压变化是心血管健康的重要指标.
- 晚间血压下降的损伤与心血管风险增加有关.
研究的目的:
- 为了研究糖尿病多神经病变的进展与昼夜血压变化受损之间的关系.
- 为了确定电生理学和临床神经病变的进展是否与昼夜血压变化的特定模式有关.
- 确定糖尿病患者中日间血压变化受损的独立预测因子.
主要方法:
- 评估了154名患有糖尿病的住院患者的24小时门诊血压监测数据.
- 根据使用巴巴分类和临床分期的糖尿病多神经病变严重程度对患者进行分类.
- 进行了常规的生物化学测试,神经传导研究和霍尔特心电图.
主要成果:
- 随着糖尿病多神经病症的严重程度的增加,夜间血压降低下降,而Riser类型的昼夜血压变化增加.
- 多变量分析显示,糖尿病神经病变的严重程度和尿路白蛋白分泌独立与Riser型变异性相关.
- 这种关联在神经病变的早期阶段 (Baba I类) 最强,并且随着病情的进展而减弱.
结论:
- 渐进性糖尿病多神经病变,特别是功能障碍,往往与日间血压变化受损有关.
- 升高类型的昼夜血压变化独立地与电生理学和临床神经病变的进展有关.
- 这种关联不论是尿中的白蛋白分泌,胰岛素治疗,抗高血压药物或BMI,都会持续存在.
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