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Insulin resistance and circadian rhythm of cardiac autonomic modulation.
Cardiovasc Diabetol. 2010 Dec 06; 9:85.CD

Abstract

BACKGROUND

Insulin resistance (IR) has been associated with cardiovascular diseases (CVD). Heart rate variability (HRV), an index of cardiac autonomic modulation (CAM), is also associated with CVD mortality and CVD morbidity. Currently, there are limited data about the impairment of IR on the circadian pattern of CAM. Therefore, we conducted this investigation to exam the association between IR and the circadian oscillations of CAM in a community-dwelling middle-aged sample.

METHOD

Homeostasis models of IR (HOMA-IR), insulin, and glucose were used to assess IR. CAM was measured by HRV analysis from a 24-hour electrocardiogram. Two stage modeling was used in the analysis. In stage one, for each individual we fit a cosine periodic model based on the 48 segments of HRV data. We obtained three individual-level cosine parameters that quantity the circadian pattern: mean (M), measures the overall average of a HRV index; amplitude (Â), measures the amplitude of the oscillation of a HRV index; and acrophase time (θ), measures the timing of the highest oscillation. At the second stage, we used a random-effects-meta-analysis to summarize the effects of IR variables on the three circadian parameters of HRV indices obtained in stage one of the analysis.

RESULTS

In persons without type diabetes, the multivariate adjusted β (SE) of log HOMA-IR and M variable for HRV were -0.251 (0.093), -0.245 (0.078), -0.19 (0.06), -4.89 (1.76), -3.35 (1.31), and 2.14 (0.995), for log HF, log LF, log VLF, SDNN, RMSSD and HR, respectively (all P < 0.05). None of the IR variables were significantly associated with  or θ of the HRV indices. However, in eight type 2 diabetics, the magnitude of effect due to higher HOMA-IR on M, Â, and θ are much larger.

CONCLUSION

Elevated IR, among non-diabetics significantly impairs the overall mean levels of CAM. However, the  or θ of CAM were not significantly affected by IR, suggesting that the circadian mechanisms of CAM are not impaired. However, among persons with type 2 diabetes, a group clinically has more severe form of IR, the adverse effects of increased IR on all three HRV circadian parameters are much larger.

Authors+Show Affiliations

Department of Public Health Sciences, Penn State University College of Medicine, 600 Centerview Dr, Suite 2200, A210, Hershey, PA, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, N.I.H., Extramural

Language

eng

PubMed ID

21134267

Citation

Rodríguez-Colón, Sol M., et al. "Insulin Resistance and Circadian Rhythm of Cardiac Autonomic Modulation." Cardiovascular Diabetology, vol. 9, 2010, p. 85.
Rodríguez-Colón SM, Li X, Shaffer ML, et al. Insulin resistance and circadian rhythm of cardiac autonomic modulation. Cardiovasc Diabetol. 2010;9:85.
Rodríguez-Colón, S. M., Li, X., Shaffer, M. L., He, F., Bixler, E. O., Vgontzas, A. N., Cai, J., & Liao, D. (2010). Insulin resistance and circadian rhythm of cardiac autonomic modulation. Cardiovascular Diabetology, 9, 85. https://doi.org/10.1186/1475-2840-9-85
Rodríguez-Colón SM, et al. Insulin Resistance and Circadian Rhythm of Cardiac Autonomic Modulation. Cardiovasc Diabetol. 2010 Dec 6;9:85. PubMed PMID: 21134267.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Insulin resistance and circadian rhythm of cardiac autonomic modulation. AU - Rodríguez-Colón,Sol M, AU - Li,Xian, AU - Shaffer,Michele L, AU - He,Fan, AU - Bixler,Edward O, AU - Vgontzas,Alexandros N, AU - Cai,Jianwen, AU - Liao,Duanping, Y1 - 2010/12/06/ PY - 2010/09/30/received PY - 2010/12/06/accepted PY - 2010/12/8/entrez PY - 2010/12/8/pubmed PY - 2011/4/19/medline SP - 85 EP - 85 JF - Cardiovascular diabetology JO - Cardiovasc Diabetol VL - 9 N2 - BACKGROUND: Insulin resistance (IR) has been associated with cardiovascular diseases (CVD). Heart rate variability (HRV), an index of cardiac autonomic modulation (CAM), is also associated with CVD mortality and CVD morbidity. Currently, there are limited data about the impairment of IR on the circadian pattern of CAM. Therefore, we conducted this investigation to exam the association between IR and the circadian oscillations of CAM in a community-dwelling middle-aged sample. METHOD: Homeostasis models of IR (HOMA-IR), insulin, and glucose were used to assess IR. CAM was measured by HRV analysis from a 24-hour electrocardiogram. Two stage modeling was used in the analysis. In stage one, for each individual we fit a cosine periodic model based on the 48 segments of HRV data. We obtained three individual-level cosine parameters that quantity the circadian pattern: mean (M), measures the overall average of a HRV index; amplitude (Â), measures the amplitude of the oscillation of a HRV index; and acrophase time (θ), measures the timing of the highest oscillation. At the second stage, we used a random-effects-meta-analysis to summarize the effects of IR variables on the three circadian parameters of HRV indices obtained in stage one of the analysis. RESULTS: In persons without type diabetes, the multivariate adjusted β (SE) of log HOMA-IR and M variable for HRV were -0.251 (0.093), -0.245 (0.078), -0.19 (0.06), -4.89 (1.76), -3.35 (1.31), and 2.14 (0.995), for log HF, log LF, log VLF, SDNN, RMSSD and HR, respectively (all P < 0.05). None of the IR variables were significantly associated with  or θ of the HRV indices. However, in eight type 2 diabetics, the magnitude of effect due to higher HOMA-IR on M, Â, and θ are much larger. CONCLUSION: Elevated IR, among non-diabetics significantly impairs the overall mean levels of CAM. However, the  or θ of CAM were not significantly affected by IR, suggesting that the circadian mechanisms of CAM are not impaired. However, among persons with type 2 diabetes, a group clinically has more severe form of IR, the adverse effects of increased IR on all three HRV circadian parameters are much larger. SN - 1475-2840 UR - https://www.unboundmedicine.com/medline/citation/21134267/Insulin_resistance_and_circadian_rhythm_of_cardiac_autonomic_modulation_ L2 - https://cardiab.biomedcentral.com/articles/10.1186/1475-2840-9-85 DB - PRIME DP - Unbound Medicine ER -