Key result
Higher SUA is linked to greater HRV reduction in diabetes versus prediabetes.
Why the study?
Heart rate variability tends to decrease in people with type 2 diabetes, but the underlying mechanisms remain incompletely understood.
Does serum uric acid correlate with heart rate variability in prediabetic and diabetic individuals?
Observational (n=56)
No
Does serum uric acid correlate with heart rate variability in prediabetic and diabetic individuals?
Effect estimate: Positive correlation between SUA and HRV parameters in diabetes group; reduced HRV more pronounced in diabetes vs prediabetes; normal SUA but reduced HRV in prediabetes
p-value: p=<0.0001 for HbA1c and SUA differences
Serum uric acid levels correlate with reduced heart rate variability in diabetic and prediabetic individuals, suggesting its potential utility as an early marker for cardiac autonomic dysfunction.
SUA-HRV association in diabetes is hypothesis-generating; leaves open causality and any role in prediabetes.
Objectives: Heart rate variability (HRV) tends to decrease in people with type 2 diabetes, but exactly why this happens is not yet fully understood. The aim of the study was to study the correlation of serum uric acid (SUA) with heart rate variability (HRV) in prediabetic individuals and patients with diabetes mellitus and also among male and females in the respective groups. Materials and Methods: In this study, we included a total of 56 participants, which comprised 28 individuals diagnosed with diabetes mellitus and 28 who were prediabetic. We conducted the HRV analysis using Power Lab from AD Instruments based in Australia. To determine the P -values, we employed a Student t -test. We also examined the correlations between SUA levels and HRV among the prediabetic group and diabetes mellitus patients, as well as between male and female subjects within these groups, using Pearson’s correlation. Results: The autonomic functions are deranged both in patients with diabetes and prediabetic group but the reduction in HRV is more pronounced in patients with diabetes. Males have more reduced HRV as compared to females in both the groups. The comparative analysis among the prediabetic males and females revealed that the total frequency was decreased in both the groups and moderate autonomic dysfunction was observed. The low frequency/high frequency ratio in pre-diabetic individuals was lower in males than females; though reduced in both the group, signifying symatho vagal imbalance in both males and females. Conclusion: There is a positive link between HRV and SUA levels in patients with diabetes. Prediabetic individuals having normal uric acid levels also exhibit a reduction in HRV. Earlier identification of cardiac autonomic dysfunction on HRV in pre-diabetic individuals and patients with diabetes mellitus will help prevent further cardiovascular complications.
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John et al. (2026) conducted an observational in Adults with prediabetes (HbA1c 5.7%-6.4%) or type 2 diabetes mellitus (HbA1c ≥6.5%), without hyperuricemia in prediabetics and excluding those on certain medications or with comorbid conditions, from India (n=56). Measurement of serum uric acid and heart rate variability vs. Comparison between prediabetes and diabetes groups; also by sex within groups was evaluated on Correlation between serum uric acid (SUA) levels and heart rate variability (HRV) parameters in prediabetic and diabetic patients (Positive correlation between SUA and HRV parameters in diabetes group; reduced HRV more pronounced in diabetes vs prediabetes; normal SUA but reduced HRV in prediabetes, p=<0.0001 for HbA1c and SUA differences). Serum uric acid was significantly higher (9.48±2.83 vs 5.61±1.73 mg/dL, p<0.0001) and heart rate variability was more reduced (TF 484.74±485.79 vs 812.5±871.3 ms², p=0.0878) in diabetes mellitus than in prediabetes, showing a positive link between SUA and HRV in diabetes, while prediabetics with normal uric acid also exhibited reduced HRV.
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