Charlotte Coopmans1,2, Tan Lai Zhou1,2, Ronald M A Henry1,2,3, Jordi Heijman1,4, Nicolaas C Schaper1,2,5, Annemarie Koster5,6, Miranda T Schram1,2,3, Carla J H van der Kallen1,2, Anke Wesselius7, Robert J A den Engelsman8, Harry J G M Crijns1,4, Coen D A Stehouwer9,2. 1. CARIM School for Cardiovascular Diseases, Maastricht University, Maastricht, the Netherlands. 2. Department of Internal Medicine, Maastricht University Medical Center+, Maastricht, the Netherlands. 3. Heart+Vascular Center, Maastricht University Medical Center+, Maastricht, the Netherlands. 4. Department of Cardiology, Maastricht University Medical Center+, Maastricht, the Netherlands. 5. Care and Public Health Research Institute School for Public Health and Primary Care, Maastricht University, Maastricht, the Netherlands. 6. Department of Social Medicine, Maastricht University, Maastricht, the Netherlands. 7. Department of Complex Genetics, Maastricht University, Maastricht, the Netherlands. 8. Fysiologic ECG Services, Amsterdam, the Netherlands. 9. CARIM School for Cardiovascular Diseases, Maastricht University, Maastricht, the Netherlands cda.stehouwer@mumc.nl.
Abstract
OBJECTIVE: Low heart rate variability (HRV), a marker for cardiac autonomic dysfunction, is a known feature of type 2 diabetes, but it remains incompletely understood whether this also applies to prediabetes or across the whole glycemic spectrum. Therefore, we investigated the association among prediabetes, type 2 diabetes, and measures of glycemia and HRV. RESEARCH DESIGN AND METHODS: In the population-based Maastricht Study (n = 2,107; mean ± SD age 59 ± 8 years; 52% men; normal glucose metabolism [n = 1,226], prediabetes [n = 331], and type 2 diabetes [n = 550, oversampled]), we determined 24-h electrocardiogram-derived HRV in time and frequency domains (individual z-scores, based upon seven and six variables, respectively). We used linear regression with adjustments for age, sex, and major cardiovascular risk factors. RESULTS: After adjustments, both time and frequency domain HRV were lower in prediabetes and type 2 diabetes as compared with normal glucose metabolism (standardized β [95% CI] for time domain: -0.15 [-0.27; -0.03] and -0.34 [-0.46; -0.22], respectively, P for trend <0.001; for frequency domain: -0.14 [-0.26; -0.02] and -0.31 [-0.43; -0.19], respectively, P for trend <0.001). In addition, 1-SD higher glycated hemoglobin, fasting plasma glucose, and 2-h postload glucose were associated with lower HRV in both domains (time domain: -0.16 [-0.21; -0.12], -0.16 [-0.21; -0.12], and -0.15 [-0.20; -0.10], respectively; frequency domain: -0.14 [-0.19; -0.10], -0.14 [-0.18; -0.09], and -0.13 [-0.18; -0.08], respectively). CONCLUSIONS: Both prediabetes and type 2 diabetes were independently associated with lower HRV. This is further substantiated by independent continuous associations between measures of hyperglycemia and lower HRV. These data strongly suggest that cardiac autonomic dysfunction is already present in prediabetes.
OBJECTIVE: Low heart rate variability (HRV), a marker for cardiac autonomic dysfunction, is a known feature of type 2 diabetes, but it remains incompletely understood whether this also applies to prediabetes or across the whole glycemic spectrum. Therefore, we investigated the association among prediabetes, type 2 diabetes, and measures of glycemia and HRV. RESEARCH DESIGN AND METHODS: In the population-based Maastricht Study (n = 2,107; mean ± SD age 59 ± 8 years; 52% men; normal glucose metabolism [n = 1,226], prediabetes [n = 331], and type 2 diabetes [n = 550, oversampled]), we determined 24-h electrocardiogram-derived HRV in time and frequency domains (individual z-scores, based upon seven and six variables, respectively). We used linear regression with adjustments for age, sex, and major cardiovascular risk factors. RESULTS: After adjustments, both time and frequency domain HRV were lower in prediabetes and type 2 diabetes as compared with normal glucose metabolism (standardized β [95% CI] for time domain: -0.15 [-0.27; -0.03] and -0.34 [-0.46; -0.22], respectively, P for trend <0.001; for frequency domain: -0.14 [-0.26; -0.02] and -0.31 [-0.43; -0.19], respectively, P for trend <0.001). In addition, 1-SD higher glycated hemoglobin, fasting plasma glucose, and 2-h postload glucose were associated with lower HRV in both domains (time domain: -0.16 [-0.21; -0.12], -0.16 [-0.21; -0.12], and -0.15 [-0.20; -0.10], respectively; frequency domain: -0.14 [-0.19; -0.10], -0.14 [-0.18; -0.09], and -0.13 [-0.18; -0.08], respectively). CONCLUSIONS: Both prediabetes and type 2 diabetes were independently associated with lower HRV. This is further substantiated by independent continuous associations between measures of hyperglycemia and lower HRV. These data strongly suggest that cardiac autonomic dysfunction is already present in prediabetes.
Authors: Frank C T van der Heide; Yuri D Foreman; Iris W M Franken; Ronald M A Henry; Abraham A Kroon; Pieter C Dagnelie; Simone J P M Eussen; Tos T J M Berendschot; Jan S A G Schouten; Carroll A B Webers; Miranda T Schram; Carla J H van der Kallen; Marleen M J van Greevenbroek; Anke Wesselius; Casper G Schalkwijk; Nicolaas C Schaper; Martijn C G J Brouwers; Coen D A Stehouwer Journal: Sci Rep Date: 2022-10-22 Impact factor: 4.996
Authors: Rianneke de Ritter; Simone J S Sep; Carla J H van der Kallen; Marleen M J van Greevenbroek; Marit de Jong; Rimke C Vos; Michiel L Bots; Jos P H Reulen; Alfons J H M Houben; Carroll A B Webers; Tos T J M Berendschot; Pieter C Dagnelie; Simone J P M Eussen; Miranda T Schram; Annemarie Koster; Sanne A E Peters; Coen D A Stehouwer Journal: Cardiovasc Diabetol Date: 2021-05-07 Impact factor: 8.949