Relationship Between Heart Rate Variability And Peripheral Neuropathy In Type 2 Diabetes Mellitus

Background and objective:With the increasing number of diabetic patients in China,the proportion of death caused by diabetes complicated with cardiovascular disease has also increased significantly.Therefore,it is particularly important to seek an indicator that can early identify or assess the risk of cardiovascular disease in diabetic patients.Diabetic autonomic neuropathy is the main complication of diabetes that cardiac autonomic neuropathy(cardiacautonomicneuropathy,CAN),CAN associated with arrhythmia and sudden death risk highly [1];However,there is no clear diagnostic standard for CAN [2].HRV analysis is a simple and rapid method to assess changes in cardiac autonomic nervous system(autonomic nervous system,ANS)regulation and to assess its damage.Same as diabetic peripheral neuropathy(diabetic peripheral neuropathy,DPN)incidence of neuropathy and fatality rate is higher,we assume that the DPN with autonomic neuropathy patients with type 2 diabetes change is closely related to the purpose of this study is through the retrospective analysis in patients with type 2 diabetes patients with DPN with various values of HRV in patients without DPN and other laboratory and imaging index,study its associated with DPN and led to the decrease of the HRV of possible risk factors.Method:A total of 320 inpatients with type 2 diabetes diagnosed in China-Japan Hospital of Jilin University from January 2016 to December 2020 were selected,and then divided into non-DPN group(n= 132,54% male)and DPN group(n=188,50% male)according to whether they had combined occurrence of DPN.Into the group of patients with general information collected,including gender,age,duration of diabetes,smoking history,detailed history,24 hours dynamic electrocardiogram(24h ECG)and heart colour to exceed to check the indicators,laboratory indexes including collected on an empty stomach blood glucose(FBG),insulin,C peptide and glycosylated hemoglobin(Hb A1C),total cholesterol(TC),triglyceride(TG),high-density lipoprotein(HDL-C),low density lipoprotein(LDL-C),retinol binding protein(inhibition,collecting blood sugar 2 hours after meal,insulin,C peptide,etc.Statistical analysis was performed on the above indicators to compare whether there were differences between the two groups of patients,and to analyze the correlation between the occurrence of DPN and HRV and other risk factors.Result:Two groups of subjects in the general data comparison,sex,smoking history,no significant differences between the two groups(P > 0.05),and has significant difference in age and course of the disease,laboratory indexes Hb A1 C,fasting C peptide,2 hours C peptide,LDL,HDL-C and urinary inhibition index between significant differences(P<0.05),fasting insulin,insulin,TC,TG and retinol 2 hours in there was no significant difference between the two groups.SDNN and SDANN in non-DPN group were significantly higher than those in DPN group,while RMSSD and PNN50 were significantly lower than those in DPN group.The results of frequency domain comparison showed that there was no significant difference in LF/HF between the two groups,but the total power,LF,HF and other indicators were more serious,and the non-DPN group were higher than the DPN group.Comparison of cardiac structure and function between the two groups showed that E/E ’in the non-DPN group was lower than that in the DPN group,the difference was statistically significant,while FS in the non-DPN group was higher than that in the DPN group,the difference was statistically significant(P<0.05).Multivariate Logistic regression showed that course of disease,PNN50,Hb A1 c and HDL-C were independent factors affecting the occurrence of outcome(P<0.05).Conclusions:Type 2 diabetes mellitus patients with DPN PNN50 significantly below not merge patients with DPN,prompt impaired cardiac autonomic nervous system regulation.