Circadian rhythm of autonomic activity in non diabetic offsprings of type 2 diabetic patients

Q: What is the clinical evidence from this study?

Study design: Cross-Sectional. Population: Offspring of type 2 diabetic patients (n=75). Intervention: Familiarity for type 2 diabetes (offspring of type 2 diabetic patients) vs. Healthy subjects without familiarity for type 2 diabetes. Primary outcome: Total low frequency (LF) power (n.u.) in insulin-resistant offspring (p=<0.001).

Key Result

Offspring of type 2 diabetic patients demonstrated sympathetic overactivity, evidenced by significantly higher total low frequency power in both insulin-resistant (70.88 n.u.) and non-insulin-resistant (67.59 n.u.) groups compared to controls (55.46 n.u.).

Study Design

Type

Cross-Sectional (n=75)

Multicenter

PICO

Population

75 Caucasian adults, comprising 50 non-diabetic offspring of type 2 diabetic patients and 25 healthy controls, evaluated for circadian autonomic activity via 24-hour ECG Holter monitoring.

Exposure / Comparator

Familiarity for type 2 diabetes (offspring of type 2 diabetic patients) vs Healthy subjects without familiarity for type 2 diabetes

Primary Outcome

Total low frequency (LF) power (n.u.) in insulin-resistant offspring, p=<0.001

Main Result

Absolute Event Rate: 70.88% vs 55.46%

p-value: p=<0.001

Limitations

Use of the HOMA index as a conventional indicator of insulin resistance instead of the gold-standard glucose clamp technique
Cross-sectional design cannot determine whether autonomic abnormality precedes the occurrence of insulin resistance

Abstract

UNLABELLED: The aim of the present study was to evaluate, by heart rate variability (HRV) with 24-hours ECG Holter (HRV), the circadian autonomic activity in offspring of type 2 diabetic subjects and the relation with insulin-resistance. METHODS: 50 Caucasian offsprings of type 2 diabetic subjects were divided in two groups: insulin-resistant offsprings (IR) and non insulin-resistant offsprings (NIR). Autonomic nervous activity was studied by HRV. Time domain and spectral analysis (low frequency, LF, and high frequency, HF, provide markers of sympathetic and parasympathetic modulation when assessed in normalized units) were evaluated. RESULTS: Time domain showed a reduction of total SDNN in IR (p < 0.001) and NIR (p 0.047) versus controls. Spectral analysis showed a total and night LF higher in IR and NIR than in control group (all p < 0.001). CONCLUSION: In frequency domain, the analysis of sympathetic (LF) and parasympathetic (HF) component evidenced an association between the offspring of type 2 diabetic subjects and a sympathetic overactivity. A global reduction and alteration of circadian rhythm of autonomic activity are present in offspring of type 2 diabetic patients with and without insulin resistance. The data of our study suggested that an autonomic impairment is associated with the familiarity for type 2 diabetes independently to insulin resistance and that an impairment of autonomic system activity could precede the insulin resistance.

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Cite This Study

Fiorentini et al. (Sat,) conducted a cross-sectional in Offspring of type 2 diabetic patients (n=75). Familiarity for type 2 diabetes (offspring of type 2 diabetic patients) vs. Healthy subjects without familiarity for type 2 diabetes was evaluated on Total low frequency (LF) power (n.u.) in insulin-resistant offspring (p=<0.001). Offspring of type 2 diabetic patients demonstrated sympathetic overactivity, evidenced by significantly higher total low frequency power in both insulin-resistant (70.88 n.u.) and non-insulin-resistant (67.59 n.u.) groups compared to controls (55.46 n.u.).

synapsesocial.com/papers/6a22215f1b095894fc4ecd3e https://doi.org/https://doi.org/10.1186/1475-2840-4-15

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