TITLE

Diabetes, glucose, insulin, and heart rate variability: the Atherosclerosis Risk in Communities (ARIC) study

AUTHOR(S)
Schroeder, Emily B.; Chambless, Lloyd E.; Duanping Liao; Prineas, Ronald J.; Evans, Gregory W.; Rosamond, Wayne D.; Heiss, Gerardo; Liao, Duanping; Atherosclerosis Risk in Communities (ARIC) study
PUB. DATE
March 2005
SOURCE
Diabetes Care;Mar2005, Vol. 28 Issue 3, p668
SOURCE TYPE
Academic Journal
DOC. TYPE
journal article
ABSTRACT
Objective: To describe the progression of autonomic impairment among individuals with diabetes and pre-diabetic metabolic impairments.Research Design and Methods: We investigated the consequence of diabetes and pre-diabetic metabolic impairments on the 9-year change in heart rate variability (HRV) in a population-based cohort of 6,245 individuals aged 45-64 years at baseline and cross-sectional associations among 9,940 individuals.Results: Diabetic subjects had a more rapid temporal decrease in HRV conditional on baseline HRV than nondiabetic subjects. Adjusted mean annual changes (95% CI) (ms/year) in the SD of all normal-to-normal R-R intervals were -0.65 (-0.69 to -0.61) for those with normal fasting glucose vs. -0.95 (-1.09 to -0.81) for diabetic subjects, in root mean square of successive differences in normal-to-normal R-R intervals -0.35 (-0.39 to -0.30) vs. -0.66 (-0.82 to -0.51), and in R-R interval 6.70 (6.37-7.04) vs. 3.89 (2.72-5.05). While we found cross-sectional associations between decreased HRV and diabetes and nondiabetic hyperinsulinemia and a weak inverse association with fasting glucose, neither impaired fasting glucose nor nondiabetic hyperinsulimenia was associated with a measurably more rapid decline in HRV than normal.Conclusions: Cardiac autonomic impairment appears to be present at early stages of diabetic metabolic impairment, and progressive worsening of autonomic cardiac function over 9 years was observed in diabetic subjects. The degree to which pre-diabetic metabolic impairments in insulin and glucose metabolism contribute to decreases in cardiac autonomic function remains to be determined.
ACCESSION #
16563458

 

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