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Circadian rhythm of the autonomic nervous system in insulin resistant subjects with normoglycemia, impaired fasting glycemia, impaired glucose tolerance, type 2 diabetes mellitus.
BMC Cardiovasc Disord. 2006 May 02; 6:19.BC

Abstract

BACKGROUND

In type 2 diabetes mellitus both insulin resistance and hyperglycemia are considered responsible for autonomic dysfunction. The relation between the autonomic activity, impaired fasting glycemia and impaired glucose tolerance is, however, unclear. The purpose of this study was to evaluate and compare the circadian autonomic activity expressed as heart rate variability (HRV) measured by 24-hours ECG recording in insulin resistant subjects (IR) with characteristics as follow: IR subjects with normal oral glucose tolerance test results, IR subjects with impaired fasting glucose, IR subjects with impaired glucose tolerance and subjects with type 2 diabetes mellitus.

METHODS

Eighty Caucasian insulin resistant subjects (IR) and twenty five control subjects were recruited for the study. IR subjects were divided into four groups according to the outcoming results of oral glucose tests (OGTTs): IR subjects with normal glucose regulation (NGR), IR subjects with impaired fasting glycemia (IFG), IR subjects with impaired glucose tolerance (IGT) and subjects with type 2 diabetes mellitus (DM). Autonomic nervous activity was studied by 24-hours ECG recording. Heart rate variability analysis was performed in time and frequency domains: SDNN, RMS-SD, low frequency (LF) and high frequency (HF) were calculated.

RESULTS

The total SDNN showed statistically significant reduction in all four groups with insulin resistant subjects (IR) when compared to the control group (p <0,001). During night LF normalized units (n.u.) were found to be higher in all four groups including IR subjects than in the control group (all p < 0,001) and subjects with normal glucose regulation (NGR), with impaired fasting glycemia (IFG) and with impaired glucose tolerance (IGT) were found to have higher LF n.u. than those in the type 2 diabetes mellitus group. The linear regression model demonstrated direct association between LF values and the homeostasis model assessment-index (HOMA-I), in the insulin resistant group (r = 0,715, p <0,0001).

CONCLUSION

The results of our study suggest that insulin resistance might cause global autonomic dysfunction which increases along with worsening glucose metabolic impairment. The analysis of sympathetic and parasympathetic components and the sympathovagal balance demonstrated an association between insulin resistance and sympathetic over-activity, especially during night. The results indicated that the sympathetic over-activity is directly correlated to the grade of insulin resistance calculated according to the HOMA-I. Since increased sympathetic activity is related to major cardiovascular accidents, early diagnosis of all insulin resistant patients should be contemplated.

Authors+Show Affiliations

III Clinica Medica, Department of Clinical Medicine, University La Sapienza, Rome, Italy. antonioperciaccante@libero.itNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

16670002

Citation

Perciaccante, Antonio, et al. "Circadian Rhythm of the Autonomic Nervous System in Insulin Resistant Subjects With Normoglycemia, Impaired Fasting Glycemia, Impaired Glucose Tolerance, Type 2 Diabetes Mellitus." BMC Cardiovascular Disorders, vol. 6, 2006, p. 19.
Perciaccante A, Fiorentini A, Paris A, et al. Circadian rhythm of the autonomic nervous system in insulin resistant subjects with normoglycemia, impaired fasting glycemia, impaired glucose tolerance, type 2 diabetes mellitus. BMC Cardiovasc Disord. 2006;6:19.
Perciaccante, A., Fiorentini, A., Paris, A., Serra, P., & Tubani, L. (2006). Circadian rhythm of the autonomic nervous system in insulin resistant subjects with normoglycemia, impaired fasting glycemia, impaired glucose tolerance, type 2 diabetes mellitus. BMC Cardiovascular Disorders, 6, 19.
Perciaccante A, et al. Circadian Rhythm of the Autonomic Nervous System in Insulin Resistant Subjects With Normoglycemia, Impaired Fasting Glycemia, Impaired Glucose Tolerance, Type 2 Diabetes Mellitus. BMC Cardiovasc Disord. 2006 May 2;6:19. PubMed PMID: 16670002.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Circadian rhythm of the autonomic nervous system in insulin resistant subjects with normoglycemia, impaired fasting glycemia, impaired glucose tolerance, type 2 diabetes mellitus. AU - Perciaccante,Antonio, AU - Fiorentini,Alessandra, AU - Paris,Alberto, AU - Serra,Pietro, AU - Tubani,Luigi, Y1 - 2006/05/02/ PY - 2005/09/27/received PY - 2006/05/02/accepted PY - 2006/5/4/pubmed PY - 2006/8/22/medline PY - 2006/5/4/entrez SP - 19 EP - 19 JF - BMC cardiovascular disorders JO - BMC Cardiovasc Disord VL - 6 N2 - BACKGROUND: In type 2 diabetes mellitus both insulin resistance and hyperglycemia are considered responsible for autonomic dysfunction. The relation between the autonomic activity, impaired fasting glycemia and impaired glucose tolerance is, however, unclear. The purpose of this study was to evaluate and compare the circadian autonomic activity expressed as heart rate variability (HRV) measured by 24-hours ECG recording in insulin resistant subjects (IR) with characteristics as follow: IR subjects with normal oral glucose tolerance test results, IR subjects with impaired fasting glucose, IR subjects with impaired glucose tolerance and subjects with type 2 diabetes mellitus. METHODS: Eighty Caucasian insulin resistant subjects (IR) and twenty five control subjects were recruited for the study. IR subjects were divided into four groups according to the outcoming results of oral glucose tests (OGTTs): IR subjects with normal glucose regulation (NGR), IR subjects with impaired fasting glycemia (IFG), IR subjects with impaired glucose tolerance (IGT) and subjects with type 2 diabetes mellitus (DM). Autonomic nervous activity was studied by 24-hours ECG recording. Heart rate variability analysis was performed in time and frequency domains: SDNN, RMS-SD, low frequency (LF) and high frequency (HF) were calculated. RESULTS: The total SDNN showed statistically significant reduction in all four groups with insulin resistant subjects (IR) when compared to the control group (p <0,001). During night LF normalized units (n.u.) were found to be higher in all four groups including IR subjects than in the control group (all p < 0,001) and subjects with normal glucose regulation (NGR), with impaired fasting glycemia (IFG) and with impaired glucose tolerance (IGT) were found to have higher LF n.u. than those in the type 2 diabetes mellitus group. The linear regression model demonstrated direct association between LF values and the homeostasis model assessment-index (HOMA-I), in the insulin resistant group (r = 0,715, p <0,0001). CONCLUSION: The results of our study suggest that insulin resistance might cause global autonomic dysfunction which increases along with worsening glucose metabolic impairment. The analysis of sympathetic and parasympathetic components and the sympathovagal balance demonstrated an association between insulin resistance and sympathetic over-activity, especially during night. The results indicated that the sympathetic over-activity is directly correlated to the grade of insulin resistance calculated according to the HOMA-I. Since increased sympathetic activity is related to major cardiovascular accidents, early diagnosis of all insulin resistant patients should be contemplated. SN - 1471-2261 UR - https://www.unboundmedicine.com/medline/citation/16670002/Circadian_rhythm_of_the_autonomic_nervous_system_in_insulin_resistant_subjects_with_normoglycemia_impaired_fasting_glycemia_impaired_glucose_tolerance_type_2_diabetes_mellitus_ L2 - https://bmccardiovascdisord.biomedcentral.com/articles/10.1186/1471-2261-6-19 DB - PRIME DP - Unbound Medicine ER -