Electrophysiologic Associativity Study Of Autonomic Nerve Tests In Type 2 Diabetes Mellitus

Obiective The article is to analyze the associativity among the autonomic nerves and to prove whether the peripherial and visceral,the sympathetic and parasympathetic autonomic nerves are impaired simultaneously in type 2 diabetic mellitus.And then give the support for the choice of autonomic electrophysiologic test in the patients.Methods The elected must exclude the cases those the autonomic system is impaired not by diabetes and unable to accomplish the electrophysiologic tests autonomously.The patient group is comprised of 19 type 2 diabetes mellitus and the control one 17 normal blood glucose.They are balanced in age,gender and body mass index.The autonomic symptom profile,sympathetic skin response and cardiovascular autonomic function test,including heart rate response to deep breathing,Valsalva maneuver,30:15 ratio,handgrip test and postural blood pressure messure,are undertaken to analyze the associativity among them.Statistic methods involved include t test,rank-sum test,receiver operator characteristic curve,Spearman associativity analysis and others.All data is dealed with by SPSS 11.5 software.Results 1,The abnormal rate of ASP,SSR and CAF in the patient group is 14/19(73.7%),8/19(42.1%),14/19(73.7%),and the control one 3/17(17.6%),0/17(0.0%),1/17(5.9%),respectively,P value is 0.001,0.003,0.000,respectively. There is significant statistical difference between the groups.2,In the patient group,the Spearman coefficient correlation between ASP and SSR,ASP and CAF,SSR and CAF is 0.510, 0.938,0.550,P value is 0.026,0.000 and 0.015,respectively. Statistical significance presents among each other.SSR correlates statistically with heart rate response to deep breathing,handgrip test,postural blood pressure messure and uncorrelated with the Valsalva maneuver,30:15 ratio. The Spearman coefficient correlation of them is 0.510,0.509,0.511,0.380,0.037, and P value 0.026,0.026, 0.025,0.108 and 0.882,respectively.3,The positive predictive value of SSR is 100%,and the negative predictive value 45.5%.Conclusion 1,ASP can be used to evaluate the autonomic symptoms. 2,CAF is feasible and convenient to carry out.3,The combination of SSR and CAF does not raise positive detection rate. The CAF test need more cooperation. SSR may displace of those who unable to fulfil the CAF test.But it may increase the rate of missed diagnosis.4,The associativity between the peripherial and visceral,the sympathetic and parasympathetic autonomic electrophysiologic tests is powerful in type 2 diabetes mellitus,which may reflect simultaneously impaired of the autonomic nerves.