RESUMO
We observe, in patients with type 2 diabetes of recent onset, the activity of the autonomic nervous system and glucose metabolic impairment. The data indicate the hyperactivity of the sympathetic and minimal changes in glucose values. The role played by glycemia appeared to be less important than that represented by insulin resistance.
Assuntos
Sistema Nervoso Autônomo/metabolismo , Glicemia/metabolismo , Diabetes Mellitus Tipo 2/sangue , Monitorização Fisiológica/métodos , Adulto , Sistema Nervoso Autônomo/efeitos dos fármacos , Sistema Nervoso Autônomo/fisiopatologia , Automonitorização da Glicemia , Estudos Transversais , Diabetes Mellitus Tipo 2/tratamento farmacológico , Diabetes Mellitus Tipo 2/fisiopatologia , Eletrocardiografia , Feminino , Hemoglobinas Glicadas/metabolismo , Frequência Cardíaca/efeitos dos fármacos , Humanos , Hipoglicemiantes/uso terapêutico , Resistência à Insulina , Itália/epidemiologia , Masculino , Metformina/uso terapêutico , Pessoa de Meia-IdadeRESUMO
BACKGROUND: Aim of the study was to assess QTc interval by a 24-hour ECG recording in a group of HIV-infected individuals with a basal prolonged QTc. The risk factors associated with QTc prolongation and the indices of cardiovascular autonomic control were also evaluated. METHODS: A case-control study was performed using as cases 32 HIV-infected patients with prolonged (>440 msec) QTc interval as assessed by Holter ECG, and as controls 64 HIV-infected subjects with normal QTc interval. Autonomic function was evaluated by heart rate variability analysis during 24-hour recording. RESULTS: Duration of HIV disease was significantly longer among cases than among controls (p=0.04). Waist/hip ratio was also higher among cases than among controls (p=0.05). Frequency domain analysis showed the absence of physiologic decrease of low frequency (LF) in the night period in both cases and controls. The LF night in cases showed a statistically significant reduction when compared with controls (p=0.007). CONCLUSIONS: In our study group, QTc interval prolongation was associated with a longer duration of HIV infection and with a greater waist/hip ratio. HIV patients with QTc interval prolongation and with a longer duration of HIV infection were more likely to have an impairment of parasympathetic and sympathetic cardiac component.