Key result
Male first-degree relatives of type 2 diabetics exhibited significantly more intense sympathovagal imbalance and increased cardiovascular risk markers compared with women.
Why the study?
Is male gender associated with increased sympathovagal imbalance and cardiovascular risk in first-degree relatives of type 2 diabetics?
Cross-Sectional (n=226)
Is male gender associated with increased sympathovagal imbalance and cardiovascular risk in first-degree relatives of type 2 diabetics?
Male first-degree relatives of type 2 diabetics exhibit more intense sympathovagal imbalance and higher cardiovascular risk markers than their female counterparts.
May support sex-specific risk monitoring in relatives of type 2 diabetics; hypothesis-generating and requires prospective validation.
BACKGROUND: Although cardiovascular (CV) risks are reported in first-degree relatives (FDRs) of type 2 diabetics, effects of gender on sympathovagal imbalance (SVI) and CV risks in these subjects have not been investigated. METHODS: Body mass index (BMI), blood pressure variability parameters including baroreflex sensitivity (BRS), spectral indices of heart rate variability, autonomic function tests, insulin resistance, lipid profile, inflammatory markers (interleukin 6, high-sensitivity C-reactive protein, tumor necrosis factor α) and oxidative stress (OS) marker were measured and analyzed in control group (without family history of diabetes; 65 women, 60 men) and study group (FDRs of type 2 diabetics; 52 women, 49 men) subjects. RESULTS: BMI, heart rate, blood pressure, rate-pressure product, stroke volume, left-ventricular ejection time, cardiac output, total peripheral resistance, homeostatic model of insulin resistance, lipid profile, inflammatory and OS markers, and ratio of low-frequency to high-frequency power of heart rate variability (LF-HF ratio), a sensitive marker of SVI, were significantly increased, and BRS was significantly decreased in study group men compared with women. SVI was more intense in men and was due to concomitant sympathetic activation and vagal inhibition. There was no SVI in control subjects. Multiple regression analysis demonstrated independent contribution of BMI, homeostatic model of insulin resistance, atherogenic index, inflammatory and OS markers, and BRS to LF-HF ratio. Logistic regression analysis demonstrated significant prediction of prehypertension status and rate-pressure product (markers of CV risk) by LF-HF, which was more prominent in men. CONCLUSIONS: SVI is more intense in male FDRs of type 2 diabetics, and SVI is associated with increased CV risk due to insulin resistance, dyslipidemia, inflammation, and oxidative stress in these subjects.
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Pal et al. (2013) conducted a cross-sectional in First-degree relatives of type 2 diabetics (n=226). Male gender vs. Female gender was evaluated on Sympathovagal imbalance (LF-HF ratio) and cardiovascular risk markers. Male first-degree relatives of type 2 diabetics exhibited significantly more intense sympathovagal imbalance and increased cardiovascular risk markers compared with women.
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