Squatting Test for the Evaluation of Diabetic Cardiovascular Autonomic Neuropathy.
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概要
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Establishment of a simple and reliable test to assess cardiovascular autonomic nerve function is important since impairment of these nerves is associated with high mortality in diabetic patients. In the present study, we examined heart rate changes during standing and squatting to evaluate the integrity of parasympathetic and sympathetic nerves in a series of tests and compared the results with those of other reflex tests widely used to diagnose autonomic neuropathy: coefficient of variation of R-R intervals (CV<SUB>RR</SUB>) at rest, blood pressure changes after standing (OH), and analysis of heart rate variability on 24-h ECG recordings. In the squatting test, each subject stood still for 3 min, squatted for Lmin and then stood up for 1 min. The squatting test vagal (SqTv) and sympathetic (SqTs) ratios were calculated in 72 healthy subjects and 39 diabetics over 40 years of age. The reproducibility of the SqTv and SqTs ratios was less 6%. Because the SqTv ratio increased with age in healthy subjects and the SqTs ratio decreased, reference ranges of means±SD were obtained in 10-year intervals. Thirty-eight of 39 diabetics diagnosed as having autonomic dysfunction based on positive, findings on either CV<SUB>RR</SUB> or OH, or both, also had an abnormal SqTv and/or SqTs ratio, and those who were classified as having autonomic dysfunction by the squatting test though negative on CV<SUB>RR</SUB> and OH had abnormalities on their 24-h ECG recordings alone. The squatting test is a useful tool to simultaneously parasympathetic and sympathetic regulatory identifydys function at a relatively early stage of diabetic autonomic neuropathy.
- 一般社団法人 日本糖尿病学会の論文
一般社団法人 日本糖尿病学会 | 論文
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