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Imbalance of the autonomic nervous system at night in women with gestational diabetes.
Diabet Med. 2010 Sep; 27(9):988-94.DM

Abstract

AIMS

Autonomic nervous system dysfunction is observed in Type 2 diabetes. As gestational diabetes is a potent risk factor of later Type 2 diabetes, we set out to determine whether autonomic nervous system imbalance could already be observed in women with this condition. Because activity of the sympathetic nervous system tends to be relatively stable in the nocturnal hours, we performed the study at night.

RESEARCH DESIGN AND METHODS

We studied 41 women with gestational diabetes, 22 healthy pregnant controls and 14 non-pregnant controls. We assayed plasma noradrenaline at 24.00, 04.00 and 07.00 h and performed an overnight Holter recording for heart rate variability analysis. In addition, we assayed plasma adrenomedullin, a cardiovascular protective hormone.

RESULTS

Compared with non-pregnant controls, plasma noradrenaline levels were increased at 04.00 and 07.00 h in the gestational diabetic (P = 0.003) and pregnant control (P = 0.002) groups, with no difference between them. Heart rate variability, very-low-frequency and low-frequency power were lower in pregnant groups compared to the non-pregnant controls. Heart rate variability remained unchanged between specified sampling times in the gestational diabetic group, in contrast to fluctuation seen in the control groups.

CONCLUSIONS

Gestational diabetes, compared with normal pregnancy, seems not to be a state of overall sympathetic nervous system activation. At the heart level, however, an inhibitory effect on autonomic nervous system modulation was seen. Plasma noradrenaline and heart rate variability correlated well, supporting the use of this function in future studies of overall sympathetic activity during pregnancy.

Authors+Show Affiliations

Department of Obstetrics and Gynecology, Helsinki University Central Hospital, Helsinki, Finland.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

20722671

Citation

Pöyhönen-Alho, M, et al. "Imbalance of the Autonomic Nervous System at Night in Women With Gestational Diabetes." Diabetic Medicine : a Journal of the British Diabetic Association, vol. 27, no. 9, 2010, pp. 988-94.
Pöyhönen-Alho M, Viitasalo M, Nicholls MG, et al. Imbalance of the autonomic nervous system at night in women with gestational diabetes. Diabet Med. 2010;27(9):988-94.
Pöyhönen-Alho, M., Viitasalo, M., Nicholls, M. G., Lindström, B. M., Väänänen, H., & Kaaja, R. (2010). Imbalance of the autonomic nervous system at night in women with gestational diabetes. Diabetic Medicine : a Journal of the British Diabetic Association, 27(9), 988-94. https://doi.org/10.1111/j.1464-5491.2010.03062.x
Pöyhönen-Alho M, et al. Imbalance of the Autonomic Nervous System at Night in Women With Gestational Diabetes. Diabet Med. 2010;27(9):988-94. PubMed PMID: 20722671.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Imbalance of the autonomic nervous system at night in women with gestational diabetes. AU - Pöyhönen-Alho,M, AU - Viitasalo,M, AU - Nicholls,M G, AU - Lindström,B-M, AU - Väänänen,H, AU - Kaaja,R, PY - 2010/8/21/entrez PY - 2010/8/21/pubmed PY - 2011/3/26/medline SP - 988 EP - 94 JF - Diabetic medicine : a journal of the British Diabetic Association JO - Diabet Med VL - 27 IS - 9 N2 - AIMS: Autonomic nervous system dysfunction is observed in Type 2 diabetes. As gestational diabetes is a potent risk factor of later Type 2 diabetes, we set out to determine whether autonomic nervous system imbalance could already be observed in women with this condition. Because activity of the sympathetic nervous system tends to be relatively stable in the nocturnal hours, we performed the study at night. RESEARCH DESIGN AND METHODS: We studied 41 women with gestational diabetes, 22 healthy pregnant controls and 14 non-pregnant controls. We assayed plasma noradrenaline at 24.00, 04.00 and 07.00 h and performed an overnight Holter recording for heart rate variability analysis. In addition, we assayed plasma adrenomedullin, a cardiovascular protective hormone. RESULTS: Compared with non-pregnant controls, plasma noradrenaline levels were increased at 04.00 and 07.00 h in the gestational diabetic (P = 0.003) and pregnant control (P = 0.002) groups, with no difference between them. Heart rate variability, very-low-frequency and low-frequency power were lower in pregnant groups compared to the non-pregnant controls. Heart rate variability remained unchanged between specified sampling times in the gestational diabetic group, in contrast to fluctuation seen in the control groups. CONCLUSIONS: Gestational diabetes, compared with normal pregnancy, seems not to be a state of overall sympathetic nervous system activation. At the heart level, however, an inhibitory effect on autonomic nervous system modulation was seen. Plasma noradrenaline and heart rate variability correlated well, supporting the use of this function in future studies of overall sympathetic activity during pregnancy. SN - 1464-5491 UR - https://www.unboundmedicine.com/medline/citation/20722671/Imbalance_of_the_autonomic_nervous_system_at_night_in_women_with_gestational_diabetes_ L2 - https://doi.org/10.1111/j.1464-5491.2010.03062.x DB - PRIME DP - Unbound Medicine ER -