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

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 o...

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Published inFrontiers in endocrinology (Lausanne) Vol. 5; p. 130
Main Authors Tarvainen, Mika P, Laitinen, Tomi P, Lipponen, Jukka A, Cornforth, David J, Jelinek, Herbert F
Format Journal Article
LanguageEnglish
Published Switzerland Frontiers Media S.A 01.01.2014
Subjects
Blood Glucose
cardiac autonomic neuropathy
duration
Endocrinology
HbA1c
Heart rate variability
Hyperglycemia
duration
blood glucose
hyperglycemia
heart rate variability
HbA1c
cardiac autonomic neuropathy
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Summary: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.
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Reviewed by: Federico Biscetti, Catholic University School of Medicine, Italy; Zhong Q. Wang, Pennington Biomedical Research Center, USA
This article was submitted to Diabetes, a section of the journal Frontiers in Endocrinology.
Edited by: Luiz Clemente Souza Pereira Rolim, Universidade Federal de São Paulo, Brazil
ISSN:1664-2392
1664-2392
DOI:10.3389/fendo.2014.00130