Study of the effect of pancreatic beta-cell function and homocysteine and urinary microalbumin/creatinine ratio on heart rate variability in patients with type 2 diabetes mellitus

SONG Wen-jing; WEI Li

doi:10.16048/j.issn.2095-5561.2024.06.10

Abstract：Objective To investigate the correlation of heart rate variability(HRV)with pancreatic β-cell function and homocysteine(Hcy)and urinary microalbumin/creatinine ratio(ACR)in patients with type 2 diabetes mellitus(T2DM).Methods A total of 300 T2DM patients were selected as the study subjects,including 156 males and 144 females,aged(55.54±8.90)years old,ranging form 32 to 78 years old.Patients were divided into normal HRV group(100 ms≤SDNN≤180 ms,n=163)and reduced HRV group(SDNN＜100 ms,n=137)according to 24 h standard diviation of NN intervals(SDNN).General data,biochemical indexes and HRV indexes of patients in normal HRV group and declining HRV group were collected,and the correlation between pancreatic β cell function,Hcy and ACR and the decline of HRV in T2DM patients was analyzed.The risk factors of HRV decline in T2DM patients were evaluated by Logistic regression model.Receiver operator characteristic curve was drawn to analyze the predictive value of predictive indicators for HRV decline in T2DM patients.Results Compared with the HRV normal group,the HRV decline group was older,had a longer disease duration,higher levels of fasting glucose(FPG),glycosylated hemoglobin(HbA1c),Hcy,fasting C-peptide(C0),and ACR,lower levels of postprandial 2-h C-peptide(C2)and C2/C0,SDNN,the mean of the normal RR intervals of 5-min standard deviation(SDANN),the number of beats with a difference of more than 50 ms between adjacent normal RR intervals as a percentage of the total number of sinus beats(pNN50),the root mean square of the difference between adjacent RR intervals(rMSSD),the low-frequency power(LF),and the high-frequency power(HF)levels were lower,and the differences were statistically significant(P＜0.05).The analysis showed that there was a significant positive correlation between C2,C2/C0,and HRV indexes(P＜0.05),and a significant negative correlation between C0,Hcy,ACR,and HRV indexes(P＜0.05).Analysis by logistic regression model showed that longer disease duration,higher FPG,higher Hcy,higher C0,lower C2,lower C2/C0,and higher ACR were independent risk factors for decreased HRV in patients with T2DM(P＜0.05).Course of disease,FPG,Hcy,C0,C2,C2/C0,ACR,and the combination of all indexes have certain value in predicting the decline of HRV in T2DM patients,and the combined value is higher.Conclusion Disease duration,FPG,Hcy,C0,C2,C2/C0,and ACR are independent risk factors for HRV decline in patients with T2DM,all of which have some predictive value,and the combined predictive value is higher.