Key result
Elevated baseline fasting plasma glucose and diabetes were significantly associated with reduced heart rate variability over 6 years, indicating they precede autonomic nervous system dysfunction.
Why the study?
The potential causal pathways and temporal relationships of glucose metabolism and diabetes with heart rate variability were not established.
Does impaired glucose metabolism and diabetes reduce heart rate variability over time in Chinese adults?
Cohort (n=3,858)
Yes
Does impaired glucose metabolism and diabetes reduce heart rate variability over time in Chinese adults?
Elevated fasting plasma glucose and diabetes precede and may cause reductions in heart rate variability over time, indicating progressive autonomic nervous system dysfunction.
Should not yet change practice; leaves open whether glycemic control preserves heart rate variability.
Objective To investigate potential causal pathways and temporal relationships of glucose metabolism and diabetes with heart rate variability (HRV). Methods The cohort study was developed in 3858 Chinese adults. At baseline and 6 years follow-up, participants underwent HRV measurement (low frequency [LF], high frequency [HF], total power [TP], standard deviation of all normal-to-normal intervals [SDNN], and square root of the mean squared difference between adjacent normal-to-normal intervals [r-MSSD]) and determination of glucose homeostasis (fasting plasma glucose [FPG] and insulin [FPI], homeostatic model assessment for insulin resistance [HOMA-IR]). Cross-lagged panel analysis was used to examine the temporal relationships of glucose metabolism and diabetes with HRV. Results FPG, FPI, HOMA-IR, and diabetes were cross-sectionally negatively associated with HRV indices at baseline and follow-up (P <0.05). Cross-lagged panel analyses showed significant unidirectional paths from baseline FPG to follow-up LF (β=-0.06), and baseline diabetes to follow-up low TP group (β=0.08), low SDNN group (β=0.05), and low r-MSSD group (β=0.10) (P <0.05). No significant path coefficient from baseline HRV to follow-up impaired glucose homeostasis or diabetes was observed. The results were still statistically significant after excluding participants taking antidiabetics. Conclusions The findings provide strong evidence that elevated FPG and diabetes may be the causes rather than the consequences of HRV reduction over time.
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Yu et al. (2023) conducted a cohort in Impaired glucose metabolism and diabetes (n=3,858). Elevated fasting plasma glucose and diabetes vs. Normal glucose homeostasis / non-diabetic was evaluated on Heart rate variability indices (LF, TP, SDNN, r-MSSD) (β=-0.06, p=<0.05). Elevated baseline fasting plasma glucose and diabetes were significantly associated with reduced heart rate variability over 6 years, indicating they precede autonomic nervous system dysfunction.
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