Assessment of heart rate variability and adaptive capacity in children with type I diabetes
Annotation. Heart damage in type I diabetes in children is an understudied and at the same time dangerous complication. The aim of the study was to examine heart rate variability (HRV) and changes in adaptive capacity in children with type 1 diabetes mellitus (DM) depending on the duration of the disease. 38 children (16 boys and 22 girls) aged 6 to 17 years with type I diabetes were examined. Daily ECG monitoring with HRV analysis using the software and hardware complex “DiaCard-1” and the program “CardioBiorhythm” (JSC Solveig, Kyiv) was performed. Indicators of statistical (time domain) and spectral (frequency domain) analysis were evaluated: Mean, SDNN-i, rMSSD, pNN50, IN, AMо, VLF, LF, HF, LF/HF, activity index of regulatory systems. All children with type I diabetes had a statistically significant decrease in the mean values of Mean, SDNN-i, pNN50 (and in girls rMSSD and SDANN) and increased tension index (Baevsky) and fashion amplitude (AMo). Correlation analysis of all cases (Spearman's rank correlation) revealed a correlation between IN and AMo with the duration of the disease. PARS significantly exceed the limits of physiological values. It is established that the vast majority of patients in both groups are in a state of functional stress of adaptive capacity. With increasing duration of the disease, heart rate increases, parasympathetic and sympathetic influences weaken, the tension of adaptive mechanisms increases, the function of heart rate scattering weakens and the function of rhythm concentration increases, which indicates the transformation of functional autonomic disorders into autonomic. Thus, in children with type I diabetes mellitus, a progressive decrease in heart rate variability, progressive lesion of the parasympathetic link of the VNS, decrease in heart rate dislocation function and increase in rhythm concentration function and functional stress of adaptive mechanisms are determined.
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