Insulin resistance and reduced cardiac autonomic function in older adults: the Atherosclerosis Risk in Communities study.

TitleInsulin resistance and reduced cardiac autonomic function in older adults: the Atherosclerosis Risk in Communities study.
Publication TypeJournal Article
Year of Publication2020
AuthorsPoon AK, Whitsel EA, Heiss G, Soliman EZ, Wagenknecht LE, Suzuki T
Secondary AuthorsLoehr LR
JournalBMC Cardiovasc Disord
Volume20
Issue1
Pagination217
Date Published2020 05 11
ISSN1471-2261
KeywordsAge Factors, Aged, Autonomic Nervous System, Biomarkers, Blood Glucose, Female, Heart, Heart Rate, Humans, Insulin, Insulin Resistance, Male, Prospective Studies, Triglycerides, United States
Abstract

BACKGROUND: Prior studies have shown insulin resistance is associated with reduced cardiac autonomic function measured at rest, but few studies have determined whether insulin resistance is associated with reduced cardiac autonomic function measured during daily activities.

METHODS: We examined older adults without diabetes with 48-h ambulatory electrocardiography (n = 759) in an ancillary study of the Atherosclerosis Risk in Communities Study. Insulin resistance, the exposure, was defined by quartiles for three indexes: 1) the homeostatic model assessment of insulin resistance (HOMA-IR), 2) the triglyceride and glucose index (TyG), and 3) the triglyceride to high-density lipoprotein cholesterol ratio (TG/HDL-C). Low heart rate variability, the outcome, was defined by

RESULTS: The average age was 78 years, 66% (n = 497) were women, and 58% (n = 438) were African American. Estimates of association were not robust at all levels of HOMA-IR, TyG, and TG/HDL-C, but suggest that high indexes were associated consistently with indicators of vagal activity. High HOMA-IR, high TyG, and high TG/HDL-C were consistently associated with low RMSSD (OR: 1.68 (1.00, 2.81), OR: 2.03 (1.21, 3.39), and OR: 1.73 (1.01, 2.91), respectively). High HOMA-IR, high TyG, and high TG/HDL-C were consistently associated with low HF (OR: 1.90 (1.14, 3.18), OR: 1.98 (1.21, 3.25), and OR: 1.76 (1.07, 2.90), respectively).

CONCLUSIONS: In older adults without diabetes, insulin resistance was associated with reduced cardiac autonomic function - specifically and consistently for indicators of vagal activity - measured during daily activities. Primary prevention of insulin resistance may reduce the related risk of cardiac autonomic dysfunction.

DOI10.1186/s12872-020-01496-z
Alternate JournalBMC Cardiovasc Disord
PubMed ID32393179
PubMed Central IDPMC7216367
Grant ListR01HL116900 / HL / NHLBI NIH HHS / United States
HHSN268201700001I / HL / NHLBI NIH HHS / United States
HHSN268201700002I / HL / NHLBI NIH HHS / United States
HHSN268201700003I / HL / NHLBI NIH HHS / United States
HHSN268201700005I / HL / NHLBI NIH HHS / United States
HHSN268201700004I / HL / NHLBI NIH HHS / United States
2 T32 HL 7055 / HL / NHLBI NIH HHS / United States