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Impaired cardiac autonomic function in women with prior gestational diabetes mellitus.
Eur J Clin Invest. 2007 Jan; 37(1):42-7.EJ

Abstract

BACKGROUND

Cardiac autonomic neuropathy is a common dysfunction in manifest diabetes mellitus and is associated with duration of diabetes and/or an inadequate glycaemic control. Heart rate variability (HRV) reflects autonomic heart function. The aim of the present study was to investigate whether in women with prior gestational diabetes (GD; pre-type 2 diabetes) alterations of cardiac autonomic function can be observed after delivery in relation to insulin sensitivity and glycaemic control.

MATERIALS AND METHODS

Forty-eight healthy women with prior GD were consecutively admitted to the study. HRV was analysed by both time, as well as frequency, domain methods using 24-h Holter monitoring. In addition, 20 women with normal glucose tolerance during and after pregnancy were investigated as control subjects. All women underwent a frequently sampled intravenous glucose tolerance test (FSIGT) for measurement of insulin sensitivity.

RESULTS

Time domain analysis (standard deviation of normal RR intervals; SDNN) showed a reduced HRV in 25 out of the 48 (52%) women with prior GD. Frequency domain analysis revealed that in these 25 subjects both low and high frequency components of power spectral density (reflecting mainly sympathetic respectively parasympathetic activity) were reduced, indicating that sympathetic as well as parasympathetic functional impairment may be assumed. However, a relative predominance of the sympathetic over parasympathetic cardiac function was observed. The impairment of cardiac autonomic function (reduced SDNN) was correlated with HbA1c values and the 2-h blood glucose concentration (oral glucose tolerance test) but not with insulin sensitivity.

CONCLUSION

The present results demonstrate that in 52% of the women examined who had prior GD, an impairment of cardiac sympathetic as well as parasympathetic function was present, which related to glycaemic control, but not to insulin sensitivity. This infers that functional autonomic changes could be an early prognostic indicator in pre-type 2 diabetes.

Authors+Show Affiliations

Department of Internal Medicine III, Medical University of Vienna, Austria.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Controlled Clinical Trial
Journal Article

Language

eng

PubMed ID

17181566

Citation

Gasic, S, et al. "Impaired Cardiac Autonomic Function in Women With Prior Gestational Diabetes Mellitus." European Journal of Clinical Investigation, vol. 37, no. 1, 2007, pp. 42-7.
Gasic S, Winzer Ch, Bayerle-Eder M, et al. Impaired cardiac autonomic function in women with prior gestational diabetes mellitus. Eur J Clin Invest. 2007;37(1):42-7.
Gasic, S., Winzer, C. h., Bayerle-Eder, M., Roden, A., Pacini, G., & Kautzky-Willer, A. (2007). Impaired cardiac autonomic function in women with prior gestational diabetes mellitus. European Journal of Clinical Investigation, 37(1), 42-7.
Gasic S, et al. Impaired Cardiac Autonomic Function in Women With Prior Gestational Diabetes Mellitus. Eur J Clin Invest. 2007;37(1):42-7. PubMed PMID: 17181566.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Impaired cardiac autonomic function in women with prior gestational diabetes mellitus. AU - Gasic,S, AU - Winzer,Ch, AU - Bayerle-Eder,M, AU - Roden,A, AU - Pacini,G, AU - Kautzky-Willer,A, PY - 2006/12/22/pubmed PY - 2007/6/30/medline PY - 2006/12/22/entrez SP - 42 EP - 7 JF - European journal of clinical investigation JO - Eur J Clin Invest VL - 37 IS - 1 N2 - BACKGROUND: Cardiac autonomic neuropathy is a common dysfunction in manifest diabetes mellitus and is associated with duration of diabetes and/or an inadequate glycaemic control. Heart rate variability (HRV) reflects autonomic heart function. The aim of the present study was to investigate whether in women with prior gestational diabetes (GD; pre-type 2 diabetes) alterations of cardiac autonomic function can be observed after delivery in relation to insulin sensitivity and glycaemic control. MATERIALS AND METHODS: Forty-eight healthy women with prior GD were consecutively admitted to the study. HRV was analysed by both time, as well as frequency, domain methods using 24-h Holter monitoring. In addition, 20 women with normal glucose tolerance during and after pregnancy were investigated as control subjects. All women underwent a frequently sampled intravenous glucose tolerance test (FSIGT) for measurement of insulin sensitivity. RESULTS: Time domain analysis (standard deviation of normal RR intervals; SDNN) showed a reduced HRV in 25 out of the 48 (52%) women with prior GD. Frequency domain analysis revealed that in these 25 subjects both low and high frequency components of power spectral density (reflecting mainly sympathetic respectively parasympathetic activity) were reduced, indicating that sympathetic as well as parasympathetic functional impairment may be assumed. However, a relative predominance of the sympathetic over parasympathetic cardiac function was observed. The impairment of cardiac autonomic function (reduced SDNN) was correlated with HbA1c values and the 2-h blood glucose concentration (oral glucose tolerance test) but not with insulin sensitivity. CONCLUSION: The present results demonstrate that in 52% of the women examined who had prior GD, an impairment of cardiac sympathetic as well as parasympathetic function was present, which related to glycaemic control, but not to insulin sensitivity. This infers that functional autonomic changes could be an early prognostic indicator in pre-type 2 diabetes. SN - 0014-2972 UR - https://www.unboundmedicine.com/medline/citation/17181566/Impaired_cardiac_autonomic_function_in_women_with_prior_gestational_diabetes_mellitus_ L2 - https://doi.org/10.1111/j.1365-2362.2007.01752.x DB - PRIME DP - Unbound Medicine ER -