{"id":1759,"date":"2025-02-07T10:03:09","date_gmt":"2025-02-07T10:03:09","guid":{"rendered":"https:\/\/blogs.uef.fi\/uefllt\/?p=1759"},"modified":"2025-02-07T10:03:09","modified_gmt":"2025-02-07T10:03:09","slug":"orthostatic-test-shows-higher-systolic-blood-pressure-and-sympathetic-response-in-uncomplicated-type-1-diabetes-patients-with-normal-v%cc%87o2max-vs-healthy-controls","status":"publish","type":"post","link":"https:\/\/blogs.uef.fi\/uefllt\/2025\/02\/07\/orthostatic-test-shows-higher-systolic-blood-pressure-and-sympathetic-response-in-uncomplicated-type-1-diabetes-patients-with-normal-v%cc%87o2max-vs-healthy-controls\/","title":{"rendered":"Orthostatic test shows higher systolic blood pressure and sympathetic response in uncomplicated type 1 diabetes patients with normal V\u0307O2max vs. healthy controls"},"content":{"rendered":"\n

Tyypin 1 diabetes mellitus (T1DM) on autoimmuunisairaus, joka vaikuttaa moniin kehon j\u00e4rjestelmiin. Vaikka sairauden pitk\u00e4n aikav\u00e4lin vaikutukset tunnetaan hyvin, sen varhaiset vaikutukset autonomisen hermoston ja verenkiertoelimist\u00f6n toimintaan voivat j\u00e4\u00e4d\u00e4 huomaamatta. Varsinkin autonominen neuropatia on vakava tila T1DM-potilailla, joka on usein alidiagnosoitu, eik\u00e4 sill\u00e4 ole yhten\u00e4isi\u00e4 diagnostisia kriteerej\u00e4 (Agashe ja Petak 2018). Lis\u00e4ksi T1DM-potilailla on heikentynyt kyky siet\u00e4\u00e4 fyysist\u00e4 rasitusta (Agashe ja Petak 2018), mik\u00e4 saattaa vaikuttaa autonomisen hermoston testituloksiin ja vaikeuttaa niiden tulkintaa. Halusimme selvitt\u00e4\u00e4, miten T1DM vaikuttaa syd\u00e4men s\u00e4\u00e4telyj\u00e4rjestelm\u00e4\u00e4n autonomisen hermoston testeiss\u00e4 tilanteessa, jossa T1DM-potilailla ei ole muita sairauksia ja heid\u00e4n aerobinen kuntonsa vastaa perusterveit\u00e4 verrokkeja.<\/p>\n\n\n\n

\"\"<\/figure>\n\n\n\n

Tutkimuksen tausta ja tavoitteet<\/h2>\n\n\n\n

T\u00e4m\u00e4 tutkimus suoritettiin HUMEA-laboratoriossa<\/a> yhteisty\u00f6ss\u00e4 It\u00e4-Suomen yliopiston terveystieteiden, liikunta- ja urheilul\u00e4\u00e4ketieteen sek\u00e4 teknillisen fysiikan laitoksen kanssa. Julkaistu tutkimus on osa DIAMES \u2013 Diabetes Mellitus Exercise and Stress -tutkimusprojektia.<\/a> Tutkimme, l\u00f6ytyyk\u00f6 T1DM-potilailla varhaisia merkkej\u00e4 autonomisen hermoston ja verenkierron s\u00e4\u00e4telyn muutoksista, kun heid\u00e4n maksimaalinen hapenottokykyns\u00e4 (V\u0307O2max) on normaali ja heid\u00e4n liikuntam\u00e4\u00e4r\u00e4ns\u00e4 vastaa verrokkeja. Autonomisen hermoston toimintaa arvioimme sykkeen, sykev\u00e4livaihtelun (HRV) ja verenpaineen avulla.<\/p>\n\n\n\n

\"\"
Humea lab\/Uef<\/a><\/figcaption><\/figure>\n\n\n\n

Tutkimusasetelma ja menetelm\u00e4t<\/h2>\n\n\n\n

Tutkimukseen osallistui 14 T1DM-potilasta ja 31 perustervett\u00e4 verrokkia. T1DM-potilailla ei ollut muita diagnosoituja sairauksia, jotta voimme keskitty\u00e4 vain T1DM:n vaikutuksiin syd\u00e4n- ja verenkiertoelimist\u00f6ss\u00e4. Osallistujille tehtiin:<\/p>\n\n\n\n

– Syv\u00e4hengitystesti hermoston vasteen arvioimiseksi<\/p>\n\n\n\n

– Ortostaattinen testi, jossa mitattiin verenpaine ja syke levossa ja pystyasennossa<\/p>\n\n\n\n

– Kliininen rasituskoe maksimaalisen hapenottokyvyn m\u00e4\u00e4ritt\u00e4miseksi<\/p>\n\n\n\n

\"\"
Kuvassa syv\u00e4\u00e4nhengitystestin rytmi.<\/figcaption><\/figure>\n\n\n\n
\"\"<\/a>
Kuvassa ortostaattisen testin hydraulinen testip\u00f6yt\u00e4. P\u00f6yt\u00e4 kallistuu hallitusti, ja kallistusaika on tarkasti s\u00e4\u00e4detty viiteen sekuntiin, mik\u00e4 varmistaa testin toistettavuuden ja turvallisuuden.<\/figcaption><\/figure>\n\n\n\n

Keskeiset tulokset<\/h2>\n\n\n\n

Syv\u00e4hengitystesti<\/h3>\n\n\n\n

– Syv\u00e4hengitystestiss\u00e4 ei havaittu merkitt\u00e4vi\u00e4 eroja T1DM-ryhm\u00e4n ja verrokkien v\u00e4lill\u00e4.<\/p>\n\n\n\n

Ortostaattinen testi<\/h3>\n\n\n\n

– T1DM-ryhm\u00e4ll\u00e4 havaittiin korkeampi systolinen verenpaine levossa ja pystyasennossa verrattuna verrokkeihin.<\/p>\n\n\n\n

– Pystyasennossa syd\u00e4men syke oli korkeampi T1DM-ryhm\u00e4ll\u00e4 kuin verrokeilla.<\/p>\n\n\n\n

– HRV-analyysi osoitti, ett\u00e4 hermoston toiminnan s\u00e4\u00e4tely muuttui enemm\u00e4n T1DM-ryhm\u00e4ll\u00e4 pystyasennossa. Erityisesti sympaattisen hermoston aktiivisuus lis\u00e4\u00e4ntyi ja parasympaattinen aktiivisuus v\u00e4heni T1DM-ryhm\u00e4ss\u00e4.<\/p>\n\n\n\n

Kliininen rasituskoe<\/h3>\n\n\n\n

– Maksimaalinen hapenottokyky (V\u0307O2max) ei eronnut T1DM-ryhm\u00e4n ja verrokkien v\u00e4lill\u00e4.<\/p>\n\n\n\n

Johtop\u00e4\u00e4t\u00f6kset ja merkitys<\/h2>\n\n\n\n

Tutkimuksessa emme havainneet kliinisesti merkitsevi\u00e4 muutoksia autonomisen hermoston testeiss\u00e4, mutta hienovaraisia tilastollisesti merkitsevi\u00e4 eroja esiintyi. Vaikka T1DM-potilailla on normaali V\u0307O2max, heid\u00e4n syd\u00e4men ja verenkierron s\u00e4\u00e4telyj\u00e4rjestelm\u00e4ns\u00e4 n\u00e4ytt\u00e4\u00e4 toimivan eri tavalla kuin perusterveill\u00e4 verrokeilla, erityisesti ortostaattisissa olosuhteissa. Havaitut hienovaraiset erot voivat viitata kehon pyrkimykseen kompensoida T1DM:n vaikutuksia ja yll\u00e4pit\u00e4\u00e4 verenkierron tasapainoa (Cherney ym. 2014, Sasson 2012). T\u00e4m\u00e4 voi vaikuttaa muun muassa verenpaineen hallintaan ja syd\u00e4men sykevasteisiin.<\/p>\n\n\n\n

Havainnot korostavat tarvetta kehitt\u00e4\u00e4 varhaisia testej\u00e4, joilla voidaan tunnistaa n\u00e4m\u00e4 muutokset ennen mahdollisten terveysongelmien kehittymist\u00e4. Jatkotutkimukset voivat auttaa ymm\u00e4rt\u00e4m\u00e4\u00e4n, miten el\u00e4m\u00e4ntapatekij\u00e4t, kuten liikunta, vaikuttaa syd\u00e4men ja verenkierron toimintaan T1DM:ss\u00e4.<\/p>\n\n\n\n

L\u00e4hteet<\/h2>\n\n\n\n

Agashe S, Petak S. Cardiac autonomic neuropathy in diabetes mellitus. Methodist DeBakey Cardiovascular Journal 2018;14:251\u2013256. doi:10.14797\/mdcj-14-4-251<\/p>\n\n\n\n

Cherney DZ, ym. The effect of empagliflozin on arterial stiffness and heart rate variability in subjects with uncomplicated type 1 diabetes mellitus. Cardiovascular Diabetology 2014;13:28. doi:10.1186\/1475-2840-13-28<\/p>\n\n\n\n

Sasson AN. Renal hyperfiltration related to diabetes mellitus and obesity in human disease. World Journal of Diabetes 2012;3:1. doi:10.4239\/wjd.v3.i1.1<\/p>\n\n\n\n

T\u00e4m\u00e4 blogikirjoitus perustuu tutkimusartikkeliin: Sorola, S., Hyryl\u00e4, V., Eronen, T. et al. Orthostatic test shows higher systolic blood pressure and sympathetic response in uncomplicated type 1 diabetes patients with normal V\u0307O2max vs. healthy controls. Clin Auton Res (2024). <\/em>https:\/\/doi.org\/10.1007\/s10286-024-01094-5<\/a><\/p>\n\n\n\n

Tutkimusta rahoittivat EFSD\/JDRF\/Lilly sek\u00e4 Diabetestutkimuss\u00e4\u00e4ti\u00f6<\/a>.<\/p>\n\n\n\n

Terveisin,
Samu Sorola
V\u00e4it\u00f6skirjatutkija
It\u00e4-Suomen yliopisto
Biol\u00e4\u00e4ketieteen laitos \/ Liikunta- ja urheilul\u00e4\u00e4ketiede
Teknillisen fysiikan laitos
Yhteiskuntatieteiden laitos

<\/p>\n\n\n\n

<\/p>\n","protected":false},"excerpt":{"rendered":"

Tyypin 1 diabetes mellitus (T1DM) on autoimmuunisairaus, joka vaikuttaa moniin kehon j\u00e4rjestelmiin. Vaikka sairauden pitk\u00e4n aikav\u00e4lin vaikutukset tunnetaan hyvin, sen varhaiset vaikutukset autonomisen hermoston ja verenkiertoelimist\u00f6n toimintaan voivat j\u00e4\u00e4d\u00e4 huomaamatta. Varsinkin autonominen neuropatia on vakava tila T1DM-potilailla, joka on usein alidiagnosoitu, eik\u00e4 sill\u00e4 ole yhten\u00e4isi\u00e4 diagnostisia kriteerej\u00e4 (Agashe ja Petak 2018). Lis\u00e4ksi T1DM-potilailla on heikentynyt […]<\/p>\n","protected":false},"author":481,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"_monsterinsights_skip_tracking":false,"_monsterinsights_sitenote_active":false,"_monsterinsights_sitenote_note":"","_monsterinsights_sitenote_category":0,"footnotes":""},"categories":[115],"tags":[257,42,16,256,46,7],"class_list":["post-1759","post","type-post","status-publish","format-standard","hentry","category-tutkimus","tag-diabetestutkimussaatio","tag-humea","tag-liikunta-ja-urheilulaaketiede-2","tag-teknillinen-fysiikka","tag-tyypin-1-diabetes","tag-uef"],"acf":[],"yoast_head":"\nOrthostatic test shows higher systolic blood pressure and sympathetic response in uncomplicated type 1 diabetes patients with normal V\u0307O2max vs. healthy controls - UEF Liikunta- ja urheilul\u00e4\u00e4ketiede<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/blogs.uef.fi\/uefllt\/2025\/02\/07\/orthostatic-test-shows-higher-systolic-blood-pressure-and-sympathetic-response-in-uncomplicated-type-1-diabetes-patients-with-normal-v\u0307o2max-vs-healthy-controls\/\" \/>\n<meta property=\"og:locale\" content=\"fi_FI\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Orthostatic test shows higher systolic blood pressure and sympathetic response in uncomplicated type 1 diabetes patients with normal V\u0307O2max vs. healthy controls - UEF Liikunta- ja urheilul\u00e4\u00e4ketiede\" \/>\n<meta property=\"og:description\" content=\"Tyypin 1 diabetes mellitus (T1DM) on autoimmuunisairaus, joka vaikuttaa moniin kehon j\u00e4rjestelmiin. 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Vaikka sairauden pitk\u00e4n aikav\u00e4lin vaikutukset tunnetaan hyvin, sen varhaiset vaikutukset autonomisen hermoston ja verenkiertoelimist\u00f6n toimintaan voivat j\u00e4\u00e4d\u00e4 huomaamatta. Varsinkin autonominen neuropatia on vakava tila T1DM-potilailla, joka on usein alidiagnosoitu, eik\u00e4 sill\u00e4 ole yhten\u00e4isi\u00e4 diagnostisia kriteerej\u00e4 (Agashe ja Petak 2018). 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