PMID- 35846280 OWN - NLM STAT- MEDLINE DCOM- 20220719 LR - 20220729 IS - 1664-2392 (Print) IS - 1664-2392 (Electronic) IS - 1664-2392 (Linking) VI - 13 DP - 2022 TI - Cardiac Autonomic Dysfunction Is Associated With Risk of Diabetic Kidney Disease Progression in Type 2 Diabetes Mellitus. PG - 900465 LID - 10.3389/fendo.2022.900465 [doi] LID - 900465 AB - BACKGROUND: Evidence on the relationship between heart rate variability (HRV) and albumin-to-creatinine ratio (ACR) combined with estimated glomerular filtration rate (eGFR) in patients with type 2 diabetes mellitus (T2DM) is rare. Thus, this study aimed to investigate the relationship between heart rate variability and the risk of diabetic kidney disease (DKD) progression in diabetes patients. METHOD: Overall, 747 T2DM patients who were admitted to the Second Affiliated Hospital of Nanchang University underwent 24-hour dynamic electrocardiograms for HRV analysis. Time-domain HRV measures included mean heart rate, standard deviation of the R-R interval (SDNN), SDNN index, root mean squared difference of successive RR intervals (RMSSD), and percent of adjacent RR intervals with a difference greater than 50 ms (PNN50). Frequency-domain measures included low frequency (LF), very low frequency (VLF), high frequency (HF) components and LF-to-HF ratio. The risk of DKD progression was determined by combining ACR and eGFR and stratified as low risk (Group A), moderately increased risk (Group B), high risk (Group C), and very high risk (Group D) based on the Kidney Disease: Improving Global Outcomes guidelines. RESULT: There were significant differences in HRV parameters among the four risk groups (SDNN: 113 ms vs 109 ms vs 101 ms vs 81 ms, P<0.01; LF: 240.2 ms(2) vs 241.1 ms(2) vs 155.2 ms(2) vs 141.9 ms(2), P<0.01; LF-to-HF ratio: 1.70 vs 1.24 vs 1.12 vs 0.93, P<0.01; VLF: 723.7 ms(2) vs 601.1 ms(2) vs 446.4 ms(2) vs 356.3 ms(2), P<0.01). A very high risk of DKD progression was significantly associated with a lower SDNN (beta=-19.5, 95% CI: -30.0 to -10.0, P<0.01), and moderately increased, high, and very high risks were associated with lower LF-to-HF ratio and VLF (P<0.05). Logistic regression analysis showed that group D had a higher risk of reduced SDNN, LF-to-HF ratio, and VLF compared with group A after adjusting for systolic blood pressure, glycated haemoglobin, haemoglobin, high-density lipoprotein cholesterol, and age (odds ratio (95% CI): 0.989 (0. 983-0.996), 0.674 (0.498-0.913), and 0.999 (0.999-1.000), respectively). CONCLUSION: Cardiac autonomic dysfunction is associated with a risk of DKD progression in adults with T2DM, and reduced heart rate variability increased such risk. Thus, HRV screening may be necessary in patients with T2DM, especially those with high proteinuria. CI - Copyright (c) 2022 Zeng, Liu, Chen, Yu and Liu. FAU - Zeng, Haixia AU - Zeng H AD - Department of Endocrinology and Metabolism, The Second Affiliated Hospital of Nanchang University, Nanchang, China. FAU - Liu, Jianmo AU - Liu J AD - Department of Endocrinology and Metabolism, The Second Affiliated Hospital of Nanchang University, Nanchang, China. FAU - Chen, Zheng AU - Chen Z AD - Department of Endocrinology and Metabolism, The Second Affiliated Hospital of Nanchang University, Nanchang, China. FAU - Yu, Peng AU - Yu P AD - Department of Endocrinology and Metabolism, The Second Affiliated Hospital of Nanchang University, Nanchang, China. FAU - Liu, Jianping AU - Liu J AD - Department of Endocrinology and Metabolism, The Second Affiliated Hospital of Nanchang University, Nanchang, China. LA - eng PT - Journal Article DEP - 20220701 PL - Switzerland TA - Front Endocrinol (Lausanne) JT - Frontiers in endocrinology JID - 101555782 SB - IM MH - Adult MH - Autonomic Nervous System MH - *Autonomic Nervous System Diseases MH - *Diabetes Mellitus, Type 2/complications MH - *Diabetic Nephropathies/diagnosis/etiology MH - Heart Rate/physiology MH - Humans PMC - PMC9283697 OTO - NOTNLM OT - ACR OT - DKD OT - HRV OT - T2DM OT - eGFR 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- 2022/07/19 06:00 MHDA- 2022/07/20 06:00 PMCR- 2022/01/01 CRDT- 2022/07/18 04:00 PHST- 2022/03/20 00:00 [received] PHST- 2022/06/06 00:00 [accepted] PHST- 2022/07/18 04:00 [entrez] PHST- 2022/07/19 06:00 [pubmed] PHST- 2022/07/20 06:00 [medline] PHST- 2022/01/01 00:00 [pmc-release] AID - 10.3389/fendo.2022.900465 [doi] PST - epublish SO - Front Endocrinol (Lausanne). 2022 Jul 1;13:900465. doi: 10.3389/fendo.2022.900465. eCollection 2022.