Key result
Metabolic syndrome and diabetes linked to ~28% lower SDNN versus healthy controls.
Why the study?
DM and MetS are associated with autonomic neuropathy, and this study aims to investigate differences in HRV across healthy, MetS, and diabetic populations.
Does the number of metabolic syndrome components correlate with reduced heart rate variability in a general population?
Cross-Sectional (n=7,880)
No
Does the number of metabolic syndrome components correlate with reduced heart rate variability in a general population?
Heart rate variability decreases progressively with the accumulation of up to three metabolic syndrome components, plateauing thereafter and showing similar impairment to manifest diabetes.
Answers are grounded in this paper and cite their sources.
Association with lower HRV in metabolic syndrome should not alter practice; leaves open prospective validation of autonomic markers for risk prediction.
Both diabetes mellitus (DM) and the metabolic syndrome (MetS) are associated with autonomic neuropathy, which predisposes to cardiac events and death. Measures of heart rate variability (HRV) can be used to monitor the activity of the autonomic nervous system (ANS), and there are strong indications that HRV can be used to study the progression of ANS-related diabetes complications. This study aims to investigate differences in HRV in healthy, MetS and diabetic populations. Based on 7880 participants from the sixth health survey in Tromsø (Tromsø 6, 2007-2008), we found a significant negative association between the number of MetS components and HRV as estimated from short-term pulse wave signals (PRV). This decrease in PRV did not appear to be linear, instead it leveled off after the third component, with no significant difference in PRV between the MetS and DM populations. There was a significant negative association between HbA1c and PRV, showing a decrease in PRV occurring already within the normal HbA1c range. The MetS and DM populations are different from healthy controls with respect to PRV, indicating impaired ANS in both conditions. In the future, a study with assessment of PRV measurements in relation to prospective cardiovascular events seems justified.
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Azulay et al. (2022) conducted a cross-sectional in Metabolic Syndrome and Diabetes Mellitus (n=7,880). Metabolic syndrome components and manifest diabetes vs. Healthy controls (0 metabolic syndrome components) was evaluated on Pre-CPT SDNN (ms) (p=<0.001). Increasing number of metabolic syndrome components and manifest diabetes were significantly associated with reduced heart rate variability, with SDNN decreasing from 44.6 ms in healthy controls to 32.0 ms in patients with diabetes.
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