|Title||Diabetes, glucose, insulin, and heart rate variability: the Atherosclerosis Risk in Communities (ARIC) study.|
|Publication Type||Journal Article|
|Year of Publication||2005|
|Authors||Schroeder EB, Chambless LE, Liao D, Prineas RJ, Evans GW, Rosamond WD, Heiss G|
|Corporate Authors||Atherosclerosis Risk in Communities(ARIC) study|
|Date Published||2005 Mar|
|Keywords||Arteriosclerosis, Blood Pressure, Body Mass Index, Cross-Sectional Studies, Diabetes Mellitus, Diabetic Angiopathies, Disease Progression, Educational Status, Female, Heart Rate, Humans, Insulin, Male, Middle Aged, Smoking|
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.
|Alternate Journal||Diabetes Care|
|Grant List||5-R01-HL-55669 / HL / NHLBI NIH HHS / United States |
5-T32-HL-07055 / HL / NHLBI NIH HHS / United States
N01-HC-55015 / HC / NHLBI NIH HHS / United States
N01-HC-55016 / HC / NHLBI NIH HHS / United States
N01-HC-55018 / HC / NHLBI NIH HHS / United States
N01-HC-55019 / HC / NHLBI NIH HHS / United States
N01-HC-55020 / HC / NHLBI NIH HHS / United States
N01-HC-55021 / HC / NHLBI NIH HHS / United States
N01-HC-55022 / HC / NHLBI NIH HHS / United States