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Association of glucose homeostasis measures with heart rate variability among Hispanic/Latino adults without diabetes: the Hispanic Community Health Study/Study of Latinos (HCHS/SOL).
Cardiovasc Diabetol. 2016 Mar 16; 15:45.CD

Abstract

BACKGROUND

Reduced heart rate variability (HRV), a measure of cardiac autonomic function, is associated with an increased risk of cardiovascular disease (CVD) and mortality. Glucose homeostasis measures are associated with reduced cardiac autonomic function among those with diabetes, but inconsistent associations have been reported among those without diabetes. This study aimed to examine the association of glucose homeostasis measures with cardiac autonomic function among diverse Hispanic/Latino adults without diabetes.

METHODS

The Hispanic community Health Study/Study of Latinos (HCHS/SOL; 2008-2011) used two-stage area probability sampling of households to enroll 16,415 self-identified Hispanics/Latinos aged 18-74 years from four USA communities. Resting, standard 12-lead electrocardiogram recordings were used to estimate the following ultrashort-term measures of HRV: RR interval (RR), standard deviation of all normal to normal RR (SDNN) and root mean square of successive differences in RR intervals (RMSSD). Multivariable regression analysis was used to estimate associations between glucose homeostasis measures with HRV using data from 11,994 adults without diabetes (mean age 39 years; 52 % women).

RESULTS

Higher fasting glucose was associated with lower RR, SDNN, and RMSSD. Fasting insulin and the homeostasis model assessment of insulin resistance was negatively associated with RR, SDNN, and RMSSD, and the association was stronger among men compared with women. RMSSD was, on average, 26 % lower in men with higher fasting insulin and 29 % lower in men with lower insulin resistance; for women, the corresponding estimates were smaller at 4 and 9 %, respectively. Higher glycated hemoglobin was associated with lower RR, SDNN, and RMSSD in those with abdominal adiposity, defined by sex-specific cut-points for waist circumference, after adjusting for demographics and medication use. There were no associations between glycated hemoglobin and HRV measures among those without abdominal adiposity.

CONCLUSIONS

Impairment in glucose homeostasis was associated with lower HRV in Hispanic/Latino adults without diabetes, most prominently in men and individuals with abdominal adiposity. These results suggest that reduced cardiac autonomic function is associated with metabolic impairments before onset of overt diabetes in certain subgroups, offering clues for the pathophysiologic processes involved as well as opportunity for identification of those at high risk before autonomic control is manifestly impaired.

Authors+Show Affiliations

University of North Carolina at Chapel Hill, 137 E. Franklin St, Suite 306, Chapel Hill, NC, 27514, USA. mlmeyer@unc.edu.University of North Carolina at Chapel Hill, 137 E. Franklin St, Suite 306, Chapel Hill, NC, 27514, USA.Wake Forest School of Medicine, Winston Salem, NC, USA.University of North Carolina at Chapel Hill, 137 E. Franklin St, Suite 306, Chapel Hill, NC, 27514, USA.Division of Respiratory and Sleep Medicine, The Children's Hospital at Montefiore, Albert Einstein College of Medicine, Bronx, NY, USA.University of North Carolina at Chapel Hill, 137 E. Franklin St, Suite 306, Chapel Hill, NC, 27514, USA.University of Illinois at Chicago College of Medicine, Chicago, IL, USA.Northwestern University, Chicago, IL, USA.Michigan State University, East Lansing, MI, USA.University of Miami, Coral Gables, FL, USA.San Diego State University, San Diego, CA, USA.University of North Carolina at Chapel Hill, 137 E. Franklin St, Suite 306, Chapel Hill, NC, 27514, USA.

Pub Type(s)

Journal Article
Multicenter Study
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

26983644

Citation

Meyer, Michelle L., et al. "Association of Glucose Homeostasis Measures With Heart Rate Variability Among Hispanic/Latino Adults Without Diabetes: the Hispanic Community Health Study/Study of Latinos (HCHS/SOL)." Cardiovascular Diabetology, vol. 15, 2016, p. 45.
Meyer ML, Gotman NM, Soliman EZ, et al. Association of glucose homeostasis measures with heart rate variability among Hispanic/Latino adults without diabetes: the Hispanic Community Health Study/Study of Latinos (HCHS/SOL). Cardiovasc Diabetol. 2016;15:45.
Meyer, M. L., Gotman, N. M., Soliman, E. Z., Whitsel, E. A., Arens, R., Cai, J., Daviglus, M. L., Denes, P., González, H. M., Moreiras, J., Talavera, G. A., & Heiss, G. (2016). Association of glucose homeostasis measures with heart rate variability among Hispanic/Latino adults without diabetes: the Hispanic Community Health Study/Study of Latinos (HCHS/SOL). Cardiovascular Diabetology, 15, 45. https://doi.org/10.1186/s12933-016-0364-y
Meyer ML, et al. Association of Glucose Homeostasis Measures With Heart Rate Variability Among Hispanic/Latino Adults Without Diabetes: the Hispanic Community Health Study/Study of Latinos (HCHS/SOL). Cardiovasc Diabetol. 2016 Mar 16;15:45. PubMed PMID: 26983644.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Association of glucose homeostasis measures with heart rate variability among Hispanic/Latino adults without diabetes: the Hispanic Community Health Study/Study of Latinos (HCHS/SOL). AU - Meyer,Michelle L, AU - Gotman,Nathan M, AU - Soliman,Elsayed Z, AU - Whitsel,Eric A, AU - Arens,Raanan, AU - Cai,Jianwen, AU - Daviglus,Martha L, AU - Denes,Pablo, AU - González,Hector M, AU - Moreiras,Juan, AU - Talavera,Gregory A, AU - Heiss,Gerardo, Y1 - 2016/03/16/ PY - 2015/12/31/received PY - 2016/03/09/accepted PY - 2016/3/18/entrez PY - 2016/3/18/pubmed PY - 2016/10/12/medline KW - Autonomic function KW - Cohort study KW - Insulin resistance KW - Parasympathetic and sympathetic nervous system KW - Type 2 diabetes mellitus SP - 45 EP - 45 JF - Cardiovascular diabetology JO - Cardiovasc Diabetol VL - 15 N2 - BACKGROUND: Reduced heart rate variability (HRV), a measure of cardiac autonomic function, is associated with an increased risk of cardiovascular disease (CVD) and mortality. Glucose homeostasis measures are associated with reduced cardiac autonomic function among those with diabetes, but inconsistent associations have been reported among those without diabetes. This study aimed to examine the association of glucose homeostasis measures with cardiac autonomic function among diverse Hispanic/Latino adults without diabetes. METHODS: The Hispanic community Health Study/Study of Latinos (HCHS/SOL; 2008-2011) used two-stage area probability sampling of households to enroll 16,415 self-identified Hispanics/Latinos aged 18-74 years from four USA communities. Resting, standard 12-lead electrocardiogram recordings were used to estimate the following ultrashort-term measures of HRV: RR interval (RR), standard deviation of all normal to normal RR (SDNN) and root mean square of successive differences in RR intervals (RMSSD). Multivariable regression analysis was used to estimate associations between glucose homeostasis measures with HRV using data from 11,994 adults without diabetes (mean age 39 years; 52 % women). RESULTS: Higher fasting glucose was associated with lower RR, SDNN, and RMSSD. Fasting insulin and the homeostasis model assessment of insulin resistance was negatively associated with RR, SDNN, and RMSSD, and the association was stronger among men compared with women. RMSSD was, on average, 26 % lower in men with higher fasting insulin and 29 % lower in men with lower insulin resistance; for women, the corresponding estimates were smaller at 4 and 9 %, respectively. Higher glycated hemoglobin was associated with lower RR, SDNN, and RMSSD in those with abdominal adiposity, defined by sex-specific cut-points for waist circumference, after adjusting for demographics and medication use. There were no associations between glycated hemoglobin and HRV measures among those without abdominal adiposity. CONCLUSIONS: Impairment in glucose homeostasis was associated with lower HRV in Hispanic/Latino adults without diabetes, most prominently in men and individuals with abdominal adiposity. These results suggest that reduced cardiac autonomic function is associated with metabolic impairments before onset of overt diabetes in certain subgroups, offering clues for the pathophysiologic processes involved as well as opportunity for identification of those at high risk before autonomic control is manifestly impaired. SN - 1475-2840 UR - https://www.unboundmedicine.com/medline/citation/26983644/Association_of_glucose_homeostasis_measures_with_heart_rate_variability_among_Hispanic/Latino_adults_without_diabetes:_the_Hispanic_Community_Health_Study/Study_of_Latinos__HCHS/SOL__ L2 - https://cardiab.biomedcentral.com/articles/10.1186/s12933-016-0364-y DB - PRIME DP - Unbound Medicine ER -