| Objective:To study the screening methods of cardiac autonomic neuropathy in patients who are diagnosed type 2 diabetes. To find out the clinical features and risk factors of diabetic cardiac autonomic neuropathy. To evaluate the relationship between diabetic cardiac autonomic neuropathy and the other complications.Methods:One hundred and fifty patients who were diagnosed type 2 diabetes and seventy five people who without diabetes were examinanted in patients during a period between August,2009 and March,2010. The general situation of the patients was listed in the questionnaire. Body mass measurements including height, weight, waist circumference and hip circumference, resting blood pressure, fasting blood measures, HbA1c were investigated. Camon CR6-45NM Fundus Camera was to determine the retinopathy of patients, as well as VP-1000 automatic analyzer atherosclerosis was to determine baPWV and ABI of the patients. NSS and NDS were used to evaluate diabetic peripheral neuropathy. diabetic cardiac autonomic neuropathy was diagnosed by three methods:the classic experiments,4-hour Holter and Ezscan. The data were analyzed by SPSS 18.0. Results:Ⅰ. The differences between three methods which were used to diagnose diabetic cardiovascular autonomic neuropathyⅰ. The average age of the 150 type 2 diabetes patients was 59.36±8.75 years old. There were 80 male and 70 female. Over the same period 75 people without diabetic, the average age of 57.19±6.52 years old. There were 39 male and 36 female.ⅱ. The positive rate of diabetic cardiovascular autonomic neuropathy was 48.67% with Ezscan,44% with classic experiments, and 3.33% with 4-hour Holter。ⅲ. In the patients whose classic experiments is positive, the sensitivity, specificity, positive predictive value and negative predictive value of 4-hour Holter was 6.1%,98.8%, 80.0% and 40.8%. The component of Ezscan was 58.3%,57.8%,63.6% and 52.1%.ⅳ. The ROC curve was made according to Ezscan, and the area under the curve was 0.627, the most referral at the top left of ROC curve was 33.5%(sensitivity 83.3%, specificity 32.1%).Ⅱ. The comparison of clinical features between classic experiments and Ezscan.i. Age, blood pressure, bapwv and the prevalence of DPN were all increased and GFR was decreased in CAN+ subjects than those CAN-subjects by classic experiments.ⅱ. Age, course of disease, waist, BMI, body fat index, blood pressure, creatinine, triglyceride, bapwv and prevalence of DPN were all increased in CAN+ subjects than those CAN-subjects by Ezscan.ⅲ. In CAN+ subjects by Ezscan, the waist was thicker and BMI was higher than other by the classic experiments.ⅳ. Ezscan was more simple and faster than other two methods, with a higher positive rate of CAN. Ezscan can promote more abnormal factors.Ⅲ. The risk factor of diabetic cardiovascular autonomic neuropathy and the relationship between it and other complications.ⅰ. Diagnosed with Ezscan, diabetic cardiovascular autonomic neuropathy was associated with other complications; age was the same risk factor of diabetic cardiovascular autonomic neuropathy, diabetic macroangiopathy and albuminuria.ⅱ. GFR by Ezscan was associated with GFR by C-G formula (0.493, P<0.01)Conclusion:ⅰ. Compared with other methods, Ezscan is more simple and faster, with a higher positive rate and sensitivity. It promotes more abnormal factors. So we believe it can be used as a new screening method of cardiac autonomic neuropathy.ⅱ. Age and BMI are the risk factors of diabetic cardiac autonomic neuropathy. Early diagnosis and weight control should be tightly carried out to defer diabetic cardiac autonomic neuropathy. ⅲ. Diabetic cardiac autonomic neuropathy is associated with other diabetic complication. |
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