PMID- 36289393
OWN - NLM
STAT- MEDLINE
DCOM- 20221028
LR  - 20230123
IS  - 2045-2322 (Electronic)
IS  - 2045-2322 (Linking)
VI  - 12
IP  - 1
DP  - 2022 Oct 26
TI  - Parasympathetic tonus in type 2 diabetes and pre-diabetes and its clinical 
      implications.
PG  - 18020
LID - 10.1038/s41598-022-22675-2 [doi]
LID - 18020
AB  - Autonomic imbalance reflected by higher resting heart rate and reduced 
      parasympathetic tone may be driven by low-grade inflammation (LGI) and impaired 
      glycemic control in type 2 diabetes mellitus (T2DM) and pre-diabetes. We examined 
      the interaction of parasympathetic components of heart rate variability (HRV), 
      variables of LGI, and glucose metabolism in people with T2DM, pre-diabetes, and 
      normal glucose metabolism (NGM). We recorded HRV by Holter (48 h) in 633 
      community-dwelling people of whom T2DM n = 131, pre-diabetes n = 372, and NGM 
      n = 130 and mean HbA1c of 7.2, 6.0 and 5.3%, respectively. Age was 55-75 years 
      and all were without known cardiovascular disease except from hypertension. 
      Fasting plasma glucose, fasting insulin, HOMA-IR, HbA1c and LGI (CRP, 
      Interleukin-18 (IL-18), and white blood cells) were measured. 
      Root-mean-square-of-normal-to-normal-beats (RMSSD), and proportion of 
      normal-to-normal complexes differing by more than 50 ms (pNN50) are accepted 
      measures of parasympathetic activity. In univariate analyses, RMSSD and pNN50 
      were significantly inversely correlated with level of HbA1c and CRP among people 
      with T2DM and pre-diabetes, but not among NGM. RMSSD and pNN50 remained 
      significantly inversely associated with level of HbA1c after adjusting for age, 
      sex, smoking, and BMI among people with T2DM (beta = - 0.22) and pre-diabetes 
      (beta = - 0.11); adjustment for LGI, HOMA-IR, and FPG did not attenuate these 
      associations. In backward elimination models, age and level of HbA1c remained 
      associated with RMSSD and pNN50. In people with well controlled diabetes and 
      pre-diabetes, a lower parasympathetic activity was more related to age and HbA1c 
      than to markers of LGI. Thus, this study shows that the driver of parasympathetic 
      tonus may be more the level of glycemic control than inflammation in people with 
      prediabetes and well controlled diabetes.
CI  - (c) 2022. The Author(s).
FAU - Hadad, Rakin
AU  - Hadad R
AD  - Department of Cardiology, Copenhagen University Hospital of Bispebjerg, 
      Bispebjerg Bakke 23, 2400, Copenhagen NV, Denmark. rakin@live.dk.
FAU - Akobe, Sarah F
AU  - Akobe SF
AD  - Department of Cardiology, Copenhagen University Hospital of Bispebjerg, 
      Bispebjerg Bakke 23, 2400, Copenhagen NV, Denmark.
FAU - Weber, Philip
AU  - Weber P
AD  - Department of Endocrinology, Copenhagen University Hospital of Bispebjerg, 
      Bispebjerg Bakke 23, 2400, Copenhagen NV, Denmark.
FAU - Madsen, Christoffer V
AU  - Madsen CV
AD  - Department of Cardiology, Copenhagen University Hospital of Bispebjerg, 
      Bispebjerg Bakke 23, 2400, Copenhagen NV, Denmark.
FAU - Larsen, Bjorn Stroier
AU  - Larsen BS
AD  - Department of Cardiology, Copenhagen University Hospital of Bispebjerg, 
      Bispebjerg Bakke 23, 2400, Copenhagen NV, Denmark.
FAU - Madsbad, Sten
AU  - Madsbad S
AD  - Department of Endocrinology, Copenhagen University of Hvidovre, Kettegard Alle 
      30, 2650, Hvidovre, Denmark.
AD  - Institute of Clinical Medicine, Faculty of Health and Medical Sciences, 
      University of Copenhagen, Copenhagen, Denmark.
FAU - Nielsen, Olav W
AU  - Nielsen OW
AD  - Department of Cardiology, Copenhagen University Hospital of Bispebjerg, 
      Bispebjerg Bakke 23, 2400, Copenhagen NV, Denmark.
FAU - Dominguez, Maria Helena
AU  - Dominguez MH
AD  - Department of Cardiology, Copenhagen University Hospital of Bispebjerg, 
      Bispebjerg Bakke 23, 2400, Copenhagen NV, Denmark.
AD  - Institute of Clinical Medicine, Faculty of Health and Medical Sciences, 
      University of Copenhagen, Copenhagen, Denmark.
FAU - Haugaard, Steen B
AU  - Haugaard SB
AD  - Department of Endocrinology, Copenhagen University Hospital of Bispebjerg, 
      Bispebjerg Bakke 23, 2400, Copenhagen NV, Denmark.
AD  - Institute of Clinical Medicine, Faculty of Health and Medical Sciences, 
      University of Copenhagen, Copenhagen, Denmark.
FAU - Sajadieh, Ahmad
AU  - Sajadieh A
AD  - Department of Cardiology, Copenhagen University Hospital of Bispebjerg, 
      Bispebjerg Bakke 23, 2400, Copenhagen NV, Denmark.
AD  - Institute of Clinical Medicine, Faculty of Health and Medical Sciences, 
      University of Copenhagen, Copenhagen, Denmark.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20221026
PL  - England
TA  - Sci Rep
JT  - Scientific reports
JID - 101563288
RN  - 0 (Interleukin-18)
RN  - 0 (Glycated Hemoglobin A)
RN  - 0 (Blood Glucose)
RN  - 0 (Insulin)
SB  - IM
MH  - Humans
MH  - Middle Aged
MH  - Aged
MH  - *Diabetes Mellitus, Type 2/complications
MH  - Interleukin-18
MH  - Glycated Hemoglobin/metabolism
MH  - *Prediabetic State/complications
MH  - Blood Glucose/metabolism
MH  - Insulin
MH  - Heart Rate/physiology
MH  - Inflammation/complications
PMC - PMC9605979
COIS- The authors declare no competing interests.
EDAT- 2022/10/28 06:00
MHDA- 2022/10/29 06:00
PMCR- 2022/10/26
CRDT- 2022/10/27 00:00
PHST- 2022/06/21 00:00 [received]
PHST- 2022/10/18 00:00 [accepted]
PHST- 2022/10/27 00:00 [entrez]
PHST- 2022/10/28 06:00 [pubmed]
PHST- 2022/10/29 06:00 [medline]
PHST- 2022/10/26 00:00 [pmc-release]
AID - 10.1038/s41598-022-22675-2 [pii]
AID - 22675 [pii]
AID - 10.1038/s41598-022-22675-2 [doi]
PST - epublish
SO  - Sci Rep. 2022 Oct 26;12(1):18020. doi: 10.1038/s41598-022-22675-2.