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Cardiac autonomic dysfunction in type 2 diabetes - effect of hyperglycemia and disease duration.

Tarvainen MP, Laitinen TP, Lipponen JA, Cornforth DJ, Jelinek HF - Front Endocrinol (Lausanne) (2014)

Bottom Line: Heart rate variability (HRV) is reduced in diabetes mellitus (DM) patients, suggesting dysfunction of cardiac autonomic regulation and an increased risk for cardiac events.Duration of diabetes was strongly associated with decrease in HRV, the most significant decrease in HRV was found within the first 5-10 years of the disease.In conclusion, elevated blood glucose levels have an unfavorable effect on cardiac autonomic function and this effect is pronounced in long-term T2DM patients.

View Article: PubMed Central - PubMed

Affiliation: Department of Applied Physics, University of Eastern Finland , Kuopio , Finland ; Department of Clinical Physiology and Nuclear Medicine, Kuopio University Hospital , Kuopio , Finland.

ABSTRACT
Heart rate variability (HRV) is reduced in diabetes mellitus (DM) patients, suggesting dysfunction of cardiac autonomic regulation and an increased risk for cardiac events. The aim of this paper was to examine the associations of blood glucose level (BGL), glycated hemoglobin (HbA1c), and duration of diabetes with cardiac autonomic regulation assessed by HRV analysis. Resting electrocardiogram (ECG), recorded over 20 min in supine position, and clinical measurements of 189 healthy controls and 93 type 2 DM (T2DM) patients were analyzed. HRV was assessed using several time-domain, frequency-domain, and non-linear methods. HRV parameters showed a clear difference between healthy controls and T2DM patients. Hyperglycemia was associated with increase in mean heart rate and decrease in HRV, indicated by negative correlations of BGL and HbA1c with mean RR interval and most of the HRV parameters. Duration of diabetes was strongly associated with decrease in HRV, the most significant decrease in HRV was found within the first 5-10 years of the disease. In conclusion, elevated blood glucose levels have an unfavorable effect on cardiac autonomic function and this effect is pronounced in long-term T2DM patients. The most significant decrease in HRV related to diabetes and thus presence of autonomic neuropathy was observed within the first 5-10 years of disease progression.

No MeSH data available.


Related in: MedlinePlus

Box plots of most significant associations between clinical characteristics, BGL, HbA1c, and duration of diabetes (***p ≤ 0.001; **p ≤ 0.01; *p ≤ 0.05). Descriptions as in Figure 2.
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Figure 3: Box plots of most significant associations between clinical characteristics, BGL, HbA1c, and duration of diabetes (***p ≤ 0.001; **p ≤ 0.01; *p ≤ 0.05). Descriptions as in Figure 2.

Mentions: Associations between BGL, HbA1c, disease duration, and other clinical characteristics provided in Table 1 were next examined using Spearman’s correlation. BGL was naturally associated with HbA1c, but also with disease duration (r = 0.185, p = 0.011), triglyceride level (r = 0.201, p = 0.036), and use of anti-cholesterol medication (r = 0.145, p = 0.046). HbA1c was also associated with disease duration (r = 0.226, p = 0.013) but not with any other clinical measure except BGL. In addition, disease duration was associated with LDL (r = -0.239, p = 0.015) and DBP (r = −0.187, p = 0.008). These main associations within the clinical variables are illustrated in Figure 3.


Cardiac autonomic dysfunction in type 2 diabetes - effect of hyperglycemia and disease duration.

Tarvainen MP, Laitinen TP, Lipponen JA, Cornforth DJ, Jelinek HF - Front Endocrinol (Lausanne) (2014)

Box plots of most significant associations between clinical characteristics, BGL, HbA1c, and duration of diabetes (***p ≤ 0.001; **p ≤ 0.01; *p ≤ 0.05). Descriptions as in Figure 2.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4126058&req=5

Figure 3: Box plots of most significant associations between clinical characteristics, BGL, HbA1c, and duration of diabetes (***p ≤ 0.001; **p ≤ 0.01; *p ≤ 0.05). Descriptions as in Figure 2.
Mentions: Associations between BGL, HbA1c, disease duration, and other clinical characteristics provided in Table 1 were next examined using Spearman’s correlation. BGL was naturally associated with HbA1c, but also with disease duration (r = 0.185, p = 0.011), triglyceride level (r = 0.201, p = 0.036), and use of anti-cholesterol medication (r = 0.145, p = 0.046). HbA1c was also associated with disease duration (r = 0.226, p = 0.013) but not with any other clinical measure except BGL. In addition, disease duration was associated with LDL (r = -0.239, p = 0.015) and DBP (r = −0.187, p = 0.008). These main associations within the clinical variables are illustrated in Figure 3.

Bottom Line: Heart rate variability (HRV) is reduced in diabetes mellitus (DM) patients, suggesting dysfunction of cardiac autonomic regulation and an increased risk for cardiac events.Duration of diabetes was strongly associated with decrease in HRV, the most significant decrease in HRV was found within the first 5-10 years of the disease.In conclusion, elevated blood glucose levels have an unfavorable effect on cardiac autonomic function and this effect is pronounced in long-term T2DM patients.

View Article: PubMed Central - PubMed

Affiliation: Department of Applied Physics, University of Eastern Finland , Kuopio , Finland ; Department of Clinical Physiology and Nuclear Medicine, Kuopio University Hospital , Kuopio , Finland.

ABSTRACT
Heart rate variability (HRV) is reduced in diabetes mellitus (DM) patients, suggesting dysfunction of cardiac autonomic regulation and an increased risk for cardiac events. The aim of this paper was to examine the associations of blood glucose level (BGL), glycated hemoglobin (HbA1c), and duration of diabetes with cardiac autonomic regulation assessed by HRV analysis. Resting electrocardiogram (ECG), recorded over 20 min in supine position, and clinical measurements of 189 healthy controls and 93 type 2 DM (T2DM) patients were analyzed. HRV was assessed using several time-domain, frequency-domain, and non-linear methods. HRV parameters showed a clear difference between healthy controls and T2DM patients. Hyperglycemia was associated with increase in mean heart rate and decrease in HRV, indicated by negative correlations of BGL and HbA1c with mean RR interval and most of the HRV parameters. Duration of diabetes was strongly associated with decrease in HRV, the most significant decrease in HRV was found within the first 5-10 years of the disease. In conclusion, elevated blood glucose levels have an unfavorable effect on cardiac autonomic function and this effect is pronounced in long-term T2DM patients. The most significant decrease in HRV related to diabetes and thus presence of autonomic neuropathy was observed within the first 5-10 years of disease progression.

No MeSH data available.


Related in: MedlinePlus