·糖尿病与肥胖、脂质代谢异常·　　

2型糖尿病患者血游离脂肪酸与心血管自主神经病变相关性的研究

　　冯明 李华

　　【摘要】 目的 探讨T2DM患者血清游离脂肪酸(FFA)与合并心血管自主神经病变(CADN)的关系。 方法 选取T2DM患者(T2DM组)60例和正常健康对照(NC)组30名。T2DM组又分为T2DM未合并心血管自主神经病变组(NCADN组)34例和T2DM合并心血管自主神经病变组(CADN组)26例。研究对象均行心血管自主神经功能测定，采用酶法测定清晨空腹血清FFA，测定血糖、血脂等。 结果 较NCADN组，CADN与NC组FAA升高(P<0.01)。Logistic回归分析示FFA为CADN发生的独立危险因素。FFA与深呼吸心率差、Valsalva指数之间呈负相关，与30/15比值间呈负相关。多元回归分析FFA的影响因素为BMI、TG，偏回归系数分别为0.390和0.344。 结论 T2DM患者FFA升高是CADN发生的危险因素,肥胖、高脂饮食在促进FFA的病理性升高过程中发挥作用。

　　【关键词】 糖尿病，2型;非胰岛素依赖型;游离脂肪酸;心血管自主神经病变

Relationship between the FFA and cardiovascular autonomic neuropathy in patient with type 2 diabetes Feng Ming, Li Hua. Department of Gerontology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China

Corresponding author: Feng Ming, E-mail: fmzhongshan@126.com

　　【Abstract】 Objective To study the relationship between the free fatty acid (FFA) and cardiovascular autonomic diabetic neuropathy (CADN) in type 2 diabetic patients. Methods Sixty patients with type 2 diabetes (T2DM group), and 30 healthy subjects (NC group) were enrolled in the study. Cardiovascular autonomic function tests were performed, and 34 non-cardiovascular autonomic T2DM patients were enrolled in the NCADN group, 26 cardiovascular autonomic diabetic neuropathy T2DM patients were enrolled in the CADN group. Every patient accepted physical examination and the laboratory tests on blood lipid, blood glucose, and so on. The level of morning fasting serum FFA was measured with the enzyme method. Results Compared with the NCADN group, the level of FFA was significantly elevated in the CADN and Control groups (P<0.01). The logistic regressive analysis showed that the level of FFA was independently and significantly related to the development of CADN. The correlation analysis showed a strong negative correlation between FFA and HRV during deep breathing, Valsalva maneuver (P<0.01), and 30/15 ratio as well (P<0.05). The Stepwise regressive analysis showed that BMI and TG were related to FAA, their partial regression coefficients were 0.390 and 0.344 respectively. Conclusions　The high level of FFA is an important independent risk factor for the development of CADN. Obesity and high-fat diet play a role in increasing the level of FFA.

　　【Keywords】Diabetes mellitus, type 2; Non-insulin dependent diabetes; Free fatty acid (FFA); Cardiovascular autonomic diabetic neuropathy (CADN)