TY - JOUR
T1 - Both Prediabetes and Type 2 Diabetes Are Associated With Lower Heart Rate Variability
T2 - The Maastricht Study
AU - Coopmans, Charlotte
AU - Zhou, Tan Lai
AU - Henry, Ronald M. A.
AU - Heijman, Jordi
AU - Schaper, Nicolaas C.
AU - Koster, Annemarie
AU - Schram, Miranda T.
AU - van der Kallen, Carla J. H.
AU - Wesselius, Anke
AU - den Engelsman, Robert J. A.
AU - Crijns, Harry J. G. M.
AU - Stehouwer, Coen D. A.
N1 - Funding Information:
Funding and Duality of Interest. This study was supported by the European Regional Devel-opmentFundviaOP-Zuid,theProvinceofLimburg, Dutch Ministry of Economic Affairs (grant 31O.041), Stichting De Weijerhorst (Maastricht, the Netherlands), the Pearl String Initiative Diabetes (Amsterdam, the Netherlands), CARIM School for Cardiovascular Diseases (Maastricht, the Netherlands), Stichting Annadal (Maastricht, the Netherlands), and Health Foundation Limburg (Maastricht, the Netherlands) and by unrestricted grants from Janssen-Cilag B.V. (Tilburg, the Netherlands), Novo Nordisk Farma B.V. (Alphen aan den Rijn, the Netherlands), and Sanofi-Aventis Netherlands B.V. (Gouda, the Netherlands). No other potential conflicts of interest relevant to this article were reported. Author Contributions. C.C. and T.L.Z. performed data collection and statistical analysis and wrote the manuscript. J.H. performed data analysis. R.M.A.H., J.H., N.C.S., A.K., M.T.S., C.J.H.v.d.K., and A.W. critically reviewed the manuscript. R.J.A.d.E. contributed to data analysis. H.J.G.M.C. and C.D.A.S. conceived the study and cowrote the manuscript. T.L.Z. and C.D.A.S. are the guarantors of this work and, as such, had full access to all of the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis. Prior Presentation. Parts of this study were presented in abstract form at the 53rd Annual Meeting of the European Association for the Study of Diabetes, Lisbon, Portugal, 11–15 September 2017.
Publisher Copyright:
© 2020 by the American Diabetes Association.
PY - 2020/5
Y1 - 2020/5
N2 - 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 beta [95% CI] for time domain: -0.15 [-0.27; -0.03] and -0.34 [-0.46; -0.22], respectively, P for trend
AB - 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 beta [95% CI] for time domain: -0.15 [-0.27; -0.03] and -0.34 [-0.46; -0.22], respectively, P for trend
KW - ATHEROSCLEROTIC CARDIOVASCULAR-DISEASE
KW - SUDDEN CARDIAC DEATH
KW - GLUCOSE-TOLERANCE
KW - MICROVASCULAR DYSFUNCTION
KW - AUTONOMIC FUNCTION
KW - ALL-CAUSE
KW - HYPERGLYCEMIA
KW - DETERMINANTS
KW - MECHANISMS
KW - FAILURE
U2 - 10.2337/dc19-2367
DO - 10.2337/dc19-2367
M3 - Article
C2 - 32161051
SN - 0149-5992
VL - 43
SP - 1126
EP - 1133
JO - Diabetes Care
JF - Diabetes Care
IS - 5
ER -