The Study Of Correlation Between NT-ProBNP And Diabetic Autonomic Neuropathy

Objective:To study changes of N-terminal pro brain natriuretic peptide (NT-proBNP) in diabetic autonomic neuropathy (DAN), and to illustrate the correlation between NT-proBNP and DAN.Methods:We selected 75 cases T2DM according to the 1999 WHO diagnostic criteria in the Endocrinology department of People's Hospital of Jilin province from July 2008 to October 2009. Among them, simple T2DM were 40 cases (T2DM Group), male 21 cases, female 19 cases, the average age was 57.28±6.77 years old, average course of disease was 3.48±1.53 years old. Type 2 Diabetes Mellitus with autonomic neuropathy were 35 cases (T2DAN Group),15 cases of male and 20 female, average age was 12.20±4.86 years old, average course of disease was 12.20±4.86 years old. And 21 healthy persons from Medical Center of People's Hospital of Jilin province were selected as normal control group,13 cases of male and 8 female, average age was 59.95±7.15 years old. All selected persons were determined related indicators such as fasting plasma glucose (FPG), postprandial 2 hours blood glucose (PG2h), fasting C peptide (FC-P), glycosylated hemoglobin (HbA1c), body height, body weight, Body Mass Index (BMI), Waist-hip Ratio (WHR), blood pressure (BP), Triglyceride (TG), Total Cholesterol (TC), and the expressions of NT-proBNP in the peripheral blood of the patients and healthy were detected with ELISA. Autonomic neuropathy measured by traditional autonomic nerve function test, total score 0-2 is normal,3-5 is doubtful, above 6 is abnormal (doubtful and abnormal all look as abnormal in statistics). Used the SPSS17.0 for windows statistical package Count Data, measurement data with mean±standard deviation (x±s), all groups compared using t test, Pearson correlation analysis was applied for the bivariable relationship. P<0.05 consider There was a significant difference.Results:1. The N-terminal pro brain natriuretic peptide (NT-proBNP) levels of T2DM group, T2DAN group were 91.38±12.49,164.00±57.17,90.00±10.83. The NT-proBNP levels of T2DAN group compared with T2DM group and normal control group had a very significant difference (P<0.01), T2DM Group compared with normal control group had not a very significant difference (P>0.05).2. T2DAN group compared with T2DM group, course of disease, FPG, HbA1c, FC-P had a very significant difference (P<0.01), correlation coefficient (r) were 0.957,0.932,0.912,-0.755 (P<0.01). Age, height, weight, BMI, BP,2hPG, TG, TC had not difference between T2DAN group and T2DM Group (P> 0.05).3. The level of NT-proBNP had correlations with HR in horizontal position, change of SBP from supine to standing, HR variability with deep respiration, HR variability with postural change,30:15 ratio, Valsalva ratio in T2DAN group, correlation coefficient (r) were 0.876.0.924,-0.766,-0.698,-0.732,-0.812(P<0.01)Conclusion:1. The NT-proBNP level of T2DAN group was significantly higher than T2DM group and normal control group. Found the level of NT-proBNP increase more and more with the progress by traditional autonomic nerve function test in T2DAN group. NT-proBNP is not only the significant predictors of Type 2 Diabetes Mellitus with autonomic neuropathy, but also the significant role in their occurrence and development. NT-proBNP has important clinical significance to diagnose T2 DAN earlier.2. FPG, H b A,c, and FC-P levels in T2DM is the major risk factors for T2DAN. Controlling these risk factors can have an active role to delay the occurrence of T2DAN.