Determinants of the heart rate variability in type 1 diabetes mellitus

Frontiers in Endocrinology

Endocrinology

Gergő Attila Molnár¹  István Wittmann¹  Vivien Vértes²  Réka Faludi²  Konstandia Garmpis²  László Hejjel²  Máté Hajdu²  Noémi Vorobcsuk-Varga³ 

[1] 2nd Department of Internal Medicine and Nephrological Center, Medical School, University of Pécs, Pécs, Hungary;Heart Institute, Medical School, University of Pécs, Pécs, Hungary;Medicover Clinic, Pécs, Hungary;

关键词: type 1 diabetes mellitus;    heart rate variability;    cardiac autonomic neuropathy;    glycemic control;    cardiovascular risk factor;   

DOI  :  10.3389/fendo.2023.1247054

 received in 2023-06-27, accepted in 2023-09-04,  发布年份 2023

来源: Frontiers

【 摘 要 】

BackgroundEvaluation of heart rate variability (HRV) detects the early subclinical alterations of the autonomic nervous system. Thus, impaired HRV is the earliest subclinical marker of cardiac autonomic neuropathy (CAN) in type 1 diabetes mellitus (T1DM).ObjectivesWe aimed to explore the HRV parameters in asymptomatic T1DM patients and compare them with the results obtained in healthy subjects. Potential associations between HRV parameters and the established risk factors for CAN and cardiovascular diseases were also investigated.MethodsSeventy T1DM patients (38 ± 12 years, 46 females) and 30 healthy subjects were enrolled into the study. For HRV analysis, beat-to-beat heart rate was recorded for 30 min. The less noisy 5-min segment of the recording was analyzed by Bittium Cardiac Navigator HRV analysis software. Time domain, frequency domain, and nonlinear indices were calculated.ResultsRegarding ratio of low to high frequency component (LF/HF), no differences were found between the two populations (p = 0.227). All the further, time domain, frequency domain, and nonlinear HRV indices were significantly lower in T1DM patients (each p < 0.001). In multiple linear models, disease duration remained the only independent predictor of LF/HF ratio (p = 0.019). HbA1c was found to be significant independent predictor of all further time domain (SDNN, p < 0.001; rMSSD, p < 0.001), frequency domain (VLF, p < 0.001; LF, p = 0.002; HF, p = 0.006; Total Power, p = 0.002), and nonlinear indices (SD1, p = 0.006; SD2, p = 0.007), alone, or in combination with other factors, such as age or body mass index.ConclusionAsymptomatic T1DM patients have significantly reduced overall HRV as compared with healthy subjects, indicating subclinical CAN. Quality of the glycemic control is important determinant of HRV among T1DM patients. This relationship is independent of other risk factors for CAN or cardiovascular diseases.

【 授权许可】

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Copyright © 2023 Hajdu, Garmpis, Vértes, Vorobcsuk-Varga, Molnár, Hejjel, Wittmann and Faludi