Insulin resistance and circadian rhythm of cardiac autonomic modulation

Cardiovascular Diabetology

Original Investigation

Jianwen Cai¹  Sol M Rodríguez-Colón²  Duanping Liao²  Xian Li²  Fan He²  Michele L Shaffer²  Alexandros N Vgontzas³  Edward O Bixler³ 

[1] Department of Biostatistics, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA;Department of Public Health Sciences, Penn State University College of Medicine, 600 Centerview Dr. Suite 2200, A210, Hershey, PA, USA;Sleep Research & Treatment Center, Department of Psychiatry, Penn State University College of Medicine, 500 University Drive, Hershey, PA, USA;

关键词: Insulin Resistance;    Heart Rate Variability;    Circadian Pattern;    Heart Rate Variability Analysis;    Heart Rate Variability Index;   

DOI  :  10.1186/1475-2840-9-85

 received in 2010-09-30, accepted in 2010-12-06,  发布年份 2010

来源: Springer

【 摘 要 】

BackgroundInsulin resistance (IR) has been associated with cardiovascular diseases (CVD). Heart rate variability (HRV), an index of cardiac autonomic modulation (CAM), is also associated with CVD mortality and CVD morbidity. Currently, there are limited data about the impairment of IR on the circadian pattern of CAM. Therefore, we conducted this investigation to exam the association between IR and the circadian oscillations of CAM in a community-dwelling middle-aged sample.MethodHomeostasis models of IR (HOMA-IR), insulin, and glucose were used to assess IR. CAM was measured by HRV analysis from a 24-hour electrocardiogram. Two stage modeling was used in the analysis. In stage one, for each individual we fit a cosine periodic model based on the 48 segments of HRV data. We obtained three individual-level cosine parameters that quantity the circadian pattern: mean (M), measures the overall average of a HRV index; amplitude (Â), measures the amplitude of the oscillation of a HRV index; and acrophase time (θ), measures the timing of the highest oscillation. At the second stage, we used a random-effects-meta-analysis to summarize the effects of IR variables on the three circadian parameters of HRV indices obtained in stage one of the analysis.ResultsIn persons without type diabetes, the multivariate adjusted β (SE) of log HOMA-IR and M variable for HRV were -0.251 (0.093), -0.245 (0.078), -0.19 (0.06), -4.89 (1.76), -3.35 (1.31), and 2.14 (0.995), for log HF, log LF, log VLF, SDNN, RMSSD and HR, respectively (all P < 0.05). None of the IR variables were significantly associated with  or θ of the HRV indices. However, in eight type 2 diabetics, the magnitude of effect due to higher HOMA-IR on M, Â, and θ are much larger.ConclusionElevated IR, among non-diabetics significantly impairs the overall mean levels of CAM. However, the  or θ of CAM were not significantly affected by IR, suggesting that the circadian mechanisms of CAM are not impaired. However, among persons with type 2 diabetes, a group clinically has more severe form of IR, the adverse effects of increased IR on all three HRV circadian parameters are much larger.

【 授权许可】

Unknown   
© Rodríguez-Colón et al; licensee BioMed Central Ltd. 2010. This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.