PMID- 35498438
OWN - NLM
STAT- MEDLINE
DCOM- 20220503
LR  - 20220728
IS  - 1664-2392 (Print)
IS  - 1664-2392 (Electronic)
IS  - 1664-2392 (Linking)
VI  - 13
DP  - 2022
TI  - The Predictive Value of Serum Calcium on Heart Rate Variability and Cardiac 
      Function in Type 2 Diabetes Patients.
PG  - 864008
LID - 10.3389/fendo.2022.864008 [doi]
LID - 864008
AB  - BACKGROUND: Cardiovascular autonomic neuropathy (CAN) is common in patients with 
      type 2 diabetes mellitus (T2DM), mainly presented as decreased heart rate 
      variability (HRV) which often leads to cardiac death. However, HRV measurement is 
      not convenient in most clinics. Therefore, identifying high-risk patients for CAN 
      in diabetes with easier measurements is crucial for the early intervention and 
      prevention of catastrophic consequences. METHODS: In this cross-sectional study, 
      675 T2DM patients with normocalcemia were selected. Of these, they were divided 
      into two groups: normal HRV group (n = 425, 100 ms</= SDNN </=180 ms) vs. declined 
      HRV group (n = 250, SDNN <100 ms). All patients' clinical data were collected and 
      the correlation of clinical variables with HRV were analyzed by correlation and 
      logistic regression analysis. The area below the ROC curve was used to evaluate 
      the predictive performance of serum calcium on HRV. RESULTS: In this study, 
      declines in HRV were present in 37.0% of T2DM patients. Significant differences 
      in albumin-adjusted serum calcium levels (CaA) (8.86 +/- 0.27 vs. 9.13 +/- 0.39 
      mg/dl, p <0.001) and E/A (0.78 +/- 0.22 vs. 0.83 +/- 0.26, p = 0.029) were observed 
      between declined HRV and normal HRV groups. Bivariate linear correlation analysis 
      showed that CaA and E/A were positively correlated with HRV parameters including 
      SDNN (p < 0.001), SDNN index (p < 0.001), and Triangle index (p < 0.05). The AUC 
      in the ROC curve for the prediction of CaA on HRV was 0.730 (95% CI 
      (0.750-0.815), p < 0.001). The cutoff value of CaA was 8.87 mg/dl (sensitivity 
      0.644, specificity 0.814). The T2DM patients with CaA <8.87 mg/dl had 
      significantly lower HRV parameters (SDNN, SDNN index, rMSSD, and triangle index) 
      than those with CaA >/=8.87 mg/dl (p < 0.01, respectively). Multivariate logistic 
      regression analysis showed a significantly increased risk of declined HRV in 
      subjects with CaA level <8.87 mg/dl [OR (95% CI), 0.049 (0.024-0.099), p < 
      0.001]. CONCLUSIONS: Declined HRV is associated with a lower CaA level and worse 
      cardiac function. The serum calcium level can be used for risk evaluation of 
      declined HRV in T2DM patients even within the normocalcemic range.
CI  - Copyright (c) 2022 Wang, Xu, Lv, Ye, Luo, Wan, Zhou, Yu, Wang, Liu and Gao.
FAU - Wang, Junyi
AU  - Wang J
AD  - Department of Endocrinology & Metabolism, Renmin Hospital of Wuhan University, 
      Wuhan, China.
FAU - Xu, Zihui
AU  - Xu Z
AD  - Department of Endocrinology & Metabolism, Renmin Hospital of Wuhan University, 
      Wuhan, China.
FAU - Lv, Kang
AU  - Lv K
AD  - Shenzhen University, College of Big Data and Internet, Shenzhen, China.
FAU - Ye, Yingchun
AU  - Ye Y
AD  - Department of Endocrinology & Metabolism, Renmin Hospital of Wuhan University, 
      Wuhan, China.
FAU - Luo, Deng
AU  - Luo D
AD  - Department of Endocrinology & Metabolism, Renmin Hospital of Wuhan University, 
      Wuhan, China.
FAU - Wan, Li
AU  - Wan L
AD  - Department of Endocrinology & Metabolism, Renmin Hospital of Wuhan University, 
      Wuhan, China.
FAU - Zhou, Fen
AU  - Zhou F
AD  - Department of Endocrinology & Metabolism, Renmin Hospital of Wuhan University, 
      Wuhan, China.
FAU - Yu, Ailin
AU  - Yu A
AD  - Department of Endocrinology & Metabolism, Renmin Hospital of Wuhan University, 
      Wuhan, China.
FAU - Wang, Shuo
AU  - Wang S
AD  - Department of Endocrinology & Metabolism, Renmin Hospital of Wuhan University, 
      Wuhan, China.
FAU - Liu, Jingcheng
AU  - Liu J
AD  - Department of Endocrinology & Metabolism, Renmin Hospital of Wuhan University, 
      Wuhan, China.
FAU - Gao, Ling
AU  - Gao L
AD  - Department of Endocrinology & Metabolism, Renmin Hospital of Wuhan University, 
      Wuhan, China.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20220414
PL  - Switzerland
TA  - Front Endocrinol (Lausanne)
JT  - Frontiers in endocrinology
JID - 101555782
RN  - SY7Q814VUP (Calcium)
SB  - IM
MH  - Calcium
MH  - Cross-Sectional Studies
MH  - *Diabetes Mellitus, Type 2/complications
MH  - Heart Rate
MH  - Humans
MH  - ROC Curve
PMC - PMC9047897
OTO - NOTNLM
OT  - SDNN
OT  - calcium
OT  - cardiovascular autonomic neuropathy
OT  - heart rate variability
OT  - type 2 diabetes mellitus
COIS- The authors declare that the research was conducted in the absence of any 
      commercial or financial relationships that could be construed as a potential 
      conflict of interest.
EDAT- 2022/05/03 06:00
MHDA- 2022/05/04 06:00
PMCR- 2022/01/01
CRDT- 2022/05/02 07:11
PHST- 2022/01/27 00:00 [received]
PHST- 2022/03/03 00:00 [accepted]
PHST- 2022/05/02 07:11 [entrez]
PHST- 2022/05/03 06:00 [pubmed]
PHST- 2022/05/04 06:00 [medline]
PHST- 2022/01/01 00:00 [pmc-release]
AID - 10.3389/fendo.2022.864008 [doi]
PST - epublish
SO  - Front Endocrinol (Lausanne). 2022 Apr 14;13:864008. doi: 
      10.3389/fendo.2022.864008. eCollection 2022.