Diabetes, glucose, insulin, and heart rate variability: The Atherosclerosis Risk in Communities (ARIC) study

Emily B. Schroeder, Lloyd E. Chambless, Duanping Liao, Ronald J. Prineas, Gregory W. Evans, Wayne D. Rosamond, Gerardo Heiss

Research output: Contribution to journalArticle

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Abstract

OBJECTIVE - To describe the progression of autonomic impairment among individuals with diabetes and pre-diabetic metabolic impairments. RESEARCH DESIGN AND METHODS - We investigated the consequence of diabetes and pre-diabetic metabolic impairments on the 9-year change in heart rate variability (HRV) in a population-based cohort of 6,245 individuals aged 45-64 years at baseline and cross-sectional associations among 9,940 individuals. RESULTS - Diabetic subjects had a more rapid temporal decrease in HRV conditional on baseline HRV than nondiabetic subjects. Adjusted mean annual changes (95% CI) (ms/year) in the SD of all normal-to-normal R-R intervals were -0.65 (-0.69 to -0.61) for those with normal fasting glucose vs. -0.95 (-1.09 to -0.81) for diabetic subjects, in root mean square of successive differences in normal-to-normal R-R intervals -0.35 (-0.39 to -0.30) vs. -0.66 (-0.82 to -0.51), and in R-R interval 6.70 (6.37-7.04) vs. 3.89 (2.72-5.05). While we found cross-sectional associations between decreased HRV and diabetes and nondiabetic hyperinsulinemia and a weak inverse association with fasting glucose, neither impaired fasting glucose nor nondiabetic hyperinsulimenia was associated with a measurably more rapid decline in HRV than normal. CONCLUSIONS - Cardiac autonomic impairment appears to be present at early stages of diabetic metabolic impairment, and progressive worsening of autonomic cardiac function over 9 years was observed in diabetic subjects. The degree to which pre-diabetic metabolic impairments in insulin and glucose metabolism contribute to decreases in cardiac autonomic function remains to be determined.

Original languageEnglish (US)
Pages (from-to)668-674
Number of pages7
JournalDiabetes care
Volume28
Issue number3
DOIs
StatePublished - Mar 1 2005

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Atherosclerosis
Heart Rate
Insulin
Glucose
Fasting
Hyperinsulinism
Research Design
Population

All Science Journal Classification (ASJC) codes

  • Internal Medicine
  • Endocrinology, Diabetes and Metabolism
  • Advanced and Specialized Nursing

Cite this

Schroeder, E. B., Chambless, L. E., Liao, D., Prineas, R. J., Evans, G. W., Rosamond, W. D., & Heiss, G. (2005). Diabetes, glucose, insulin, and heart rate variability: The Atherosclerosis Risk in Communities (ARIC) study. Diabetes care, 28(3), 668-674. https://doi.org/10.2337/diacare.28.3.668
Schroeder, Emily B. ; Chambless, Lloyd E. ; Liao, Duanping ; Prineas, Ronald J. ; Evans, Gregory W. ; Rosamond, Wayne D. ; Heiss, Gerardo. / Diabetes, glucose, insulin, and heart rate variability : The Atherosclerosis Risk in Communities (ARIC) study. In: Diabetes care. 2005 ; Vol. 28, No. 3. pp. 668-674.
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Schroeder, EB, Chambless, LE, Liao, D, Prineas, RJ, Evans, GW, Rosamond, WD & Heiss, G 2005, 'Diabetes, glucose, insulin, and heart rate variability: The Atherosclerosis Risk in Communities (ARIC) study', Diabetes care, vol. 28, no. 3, pp. 668-674. https://doi.org/10.2337/diacare.28.3.668

Diabetes, glucose, insulin, and heart rate variability : The Atherosclerosis Risk in Communities (ARIC) study. / Schroeder, Emily B.; Chambless, Lloyd E.; Liao, Duanping; Prineas, Ronald J.; Evans, Gregory W.; Rosamond, Wayne D.; Heiss, Gerardo.

In: Diabetes care, Vol. 28, No. 3, 01.03.2005, p. 668-674.

Research output: Contribution to journalArticle

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T1 - Diabetes, glucose, insulin, and heart rate variability

T2 - The Atherosclerosis Risk in Communities (ARIC) study

AU - Schroeder, Emily B.

AU - Chambless, Lloyd E.

AU - Liao, Duanping

AU - Prineas, Ronald J.

AU - Evans, Gregory W.

AU - Rosamond, Wayne D.

AU - Heiss, Gerardo

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N2 - OBJECTIVE - To describe the progression of autonomic impairment among individuals with diabetes and pre-diabetic metabolic impairments. RESEARCH DESIGN AND METHODS - We investigated the consequence of diabetes and pre-diabetic metabolic impairments on the 9-year change in heart rate variability (HRV) in a population-based cohort of 6,245 individuals aged 45-64 years at baseline and cross-sectional associations among 9,940 individuals. RESULTS - Diabetic subjects had a more rapid temporal decrease in HRV conditional on baseline HRV than nondiabetic subjects. Adjusted mean annual changes (95% CI) (ms/year) in the SD of all normal-to-normal R-R intervals were -0.65 (-0.69 to -0.61) for those with normal fasting glucose vs. -0.95 (-1.09 to -0.81) for diabetic subjects, in root mean square of successive differences in normal-to-normal R-R intervals -0.35 (-0.39 to -0.30) vs. -0.66 (-0.82 to -0.51), and in R-R interval 6.70 (6.37-7.04) vs. 3.89 (2.72-5.05). While we found cross-sectional associations between decreased HRV and diabetes and nondiabetic hyperinsulinemia and a weak inverse association with fasting glucose, neither impaired fasting glucose nor nondiabetic hyperinsulimenia was associated with a measurably more rapid decline in HRV than normal. CONCLUSIONS - Cardiac autonomic impairment appears to be present at early stages of diabetic metabolic impairment, and progressive worsening of autonomic cardiac function over 9 years was observed in diabetic subjects. The degree to which pre-diabetic metabolic impairments in insulin and glucose metabolism contribute to decreases in cardiac autonomic function remains to be determined.

AB - OBJECTIVE - To describe the progression of autonomic impairment among individuals with diabetes and pre-diabetic metabolic impairments. RESEARCH DESIGN AND METHODS - We investigated the consequence of diabetes and pre-diabetic metabolic impairments on the 9-year change in heart rate variability (HRV) in a population-based cohort of 6,245 individuals aged 45-64 years at baseline and cross-sectional associations among 9,940 individuals. RESULTS - Diabetic subjects had a more rapid temporal decrease in HRV conditional on baseline HRV than nondiabetic subjects. Adjusted mean annual changes (95% CI) (ms/year) in the SD of all normal-to-normal R-R intervals were -0.65 (-0.69 to -0.61) for those with normal fasting glucose vs. -0.95 (-1.09 to -0.81) for diabetic subjects, in root mean square of successive differences in normal-to-normal R-R intervals -0.35 (-0.39 to -0.30) vs. -0.66 (-0.82 to -0.51), and in R-R interval 6.70 (6.37-7.04) vs. 3.89 (2.72-5.05). While we found cross-sectional associations between decreased HRV and diabetes and nondiabetic hyperinsulinemia and a weak inverse association with fasting glucose, neither impaired fasting glucose nor nondiabetic hyperinsulimenia was associated with a measurably more rapid decline in HRV than normal. CONCLUSIONS - Cardiac autonomic impairment appears to be present at early stages of diabetic metabolic impairment, and progressive worsening of autonomic cardiac function over 9 years was observed in diabetic subjects. The degree to which pre-diabetic metabolic impairments in insulin and glucose metabolism contribute to decreases in cardiac autonomic function remains to be determined.

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