PMID- 29608603
OWN - NLM
STAT- MEDLINE
DCOM- 20180716
LR  - 20240322
IS  - 1932-6203 (Electronic)
IS  - 1932-6203 (Linking)
VI  - 13
IP  - 4
DP  - 2018
TI  - Heart rate variability in type 2 diabetes mellitus: A systematic review and 
      meta-analysis.
PG  - e0195166
LID - 10.1371/journal.pone.0195166 [doi]
LID - e0195166
AB  - BACKGROUND: Cardiac autonomic neuropathy in type 2 dibetes mellitus (T2DM) 
      patients is frequent and associated with high cardiovascular mortality. Heart 
      rate variability (HRV) is the gold standard to measure cardiac autonomic 
      neuropathy. We aimed to conduct a systematic review and meta-analysis to evaluate 
      the impact of T2DM on HRV parameters. METHODS: The PubMed, Cochrane Library, 
      Embase and Science Direct databases were searched on 1st October 2017 using the 
      keywords "diabetes" AND ("heart rate variability" OR "HRV"). Included articles 
      had to report HRV parameters in T2DM patients and healthy controls measured 
      during 24 hours with a Holter-electrocardiogram. Measurements of HRV retieved 
      were: RR-intervals (or Normal to Normal intervals-NN), standard deviation of RR 
      intervals (SDNN), percetange of adjacent NN intervals differing by more than 50 
      milliseconds (pNN50), square root of the mean squared difference of successive RR 
      intervals (RMSSD), total power, Low Frequency (LF), High Frequency (HF) and LF/HF 
      ratio, as per Task Force recommendations. RESULTS: We included twenty-five 
      case-control studies with 2,932 patients: 1,356 with T2DM and 1,576 healthy 
      controls. T2DM patients had significantly (P<0.01) lower RR-intervals (effect 
      size = -0.61; 95%CI -1.21 to -0.01), lower SDNN (-0.65; -0.83 to -0.47), lower 
      RMSSD (-0.92; -1.37 to -0.47), lower pNN50 (-0.46; -0.84 to -0.09), lower total 
      power (-1.52; -2.13 to -0.91), lower LF (-1.08; -1.46 to -0.69]), and lower HF 
      (-0.79; -1.09 to -0.50). LF/HF did not differ between groups. Levels of blood 
      glucose and HbA1c were associated with several HRV parameters, as well as Time 
      from diagnosis of T2DM. CONCLUSIONS: T2DM was associated with an overall decrease 
      in the HRV of T2DM patients. Both sympathetic and parasympathetic activity were 
      decreased, which can be explained by the deleterious effects of altered glucose 
      metabolism on HRV, leading to cardiac autonomic neuropathy.
FAU - Benichou, Thomas
AU  - Benichou T
AD  - University Hospital of Clermont-Ferrand, CHU Clermont-Ferrand, Endocrinology, 
      Clermont-Ferrand, France.
FAU - Pereira, Bruno
AU  - Pereira B
AD  - University Hospital of Clermont-Ferrand, CHU Clermont-Ferrand, Clinical Research 
      Direction, Clermont-Ferrand, France.
FAU - Mermillod, Martial
AU  - Mermillod M
AD  - Univ. Grenoble Alpes, LPNC & CNRS, LPNC, Grenoble, France.
AD  - Institut Universitaire de France, Paris, France.
FAU - Tauveron, Igor
AU  - Tauveron I
AD  - Universite Clermont Auvergne, CNRS, GReD, Inserm, University Hospital of 
      Clermont-Ferrand, CHU Clermont-Ferrand, Endocrinology, Clermont-Ferrand, France.
FAU - Pfabigan, Daniela
AU  - Pfabigan D
AD  - Peking University, Culture and Social Cognitive Neuroscience Laboratory, School 
      of Psychological and Cognitive Sciences, Beijing, China.
FAU - Maqdasy, Salwan
AU  - Maqdasy S
AD  - Universite Clermont Auvergne, CNRS, GReD, Inserm, University Hospital of 
      Clermont-Ferrand, CHU Clermont-Ferrand, Endocrinology, Clermont-Ferrand, France.
FAU - Dutheil, Frederic
AU  - Dutheil F
AUID- ORCID: 0000-0002-1468-6029
AD  - Universite Clermont Auvergne, CNRS, LaPSCo, Physiological and Psychosocial 
      Stress, University Hospital of Clermont-Ferrand, CHU Clermont-Ferrand, Preventive 
      and Occupational Medicine, WittyFit, Clermont-Ferrand, France.
AD  - Australian Catholic University, Faculty of Health, School of Exercise Science, 
      Melbourne, Victoria, Australia.
LA  - eng
PT  - Journal Article
PT  - Meta-Analysis
PT  - Research Support, Non-U.S. Gov't
PT  - Review
PT  - Systematic Review
DEP - 20180402
PL  - United States
TA  - PLoS One
JT  - PloS one
JID - 101285081
SB  - IM
MH  - Adult
MH  - Aged
MH  - Body Mass Index
MH  - Case-Control Studies
MH  - Diabetes Mellitus, Type 2/epidemiology/*physiopathology
MH  - Female
MH  - *Heart Rate
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Regression Analysis
MH  - Risk Factors
PMC - PMC5880391
COIS- Competing Interests: The authors have declared that no competing interests exist.
EDAT- 2018/04/03 06:00
MHDA- 2018/07/17 06:00
PMCR- 2018/04/02
CRDT- 2018/04/03 06:00
PHST- 2018/01/21 00:00 [received]
PHST- 2018/03/16 00:00 [accepted]
PHST- 2018/04/03 06:00 [entrez]
PHST- 2018/04/03 06:00 [pubmed]
PHST- 2018/07/17 06:00 [medline]
PHST- 2018/04/02 00:00 [pmc-release]
AID - PONE-D-18-02165 [pii]
AID - 10.1371/journal.pone.0195166 [doi]
PST - epublish
SO  - PLoS One. 2018 Apr 2;13(4):e0195166. doi: 10.1371/journal.pone.0195166. 
      eCollection 2018.