Altered Cardiac Autonomic Function May Precede Insulin Resistance in Metabolic Syndrome

Chang, Chih Jen; Yang, Yi Ching; Lu, Feng Hwa; Lin, Tzu-Wei; Chen, Jia Jin; Yeh, Tzung Lieh; Wu, Chih Hsing; Wu, Jin Shang

doi:10.1016/j.amjmed.2009.07.031

Cited by 57 publications

(58 citation statements)

References 31 publications

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“…6 On the basis of this evidence, our findings suggest that cardiac autonomic dysfunction, which reflects an imbalance of overall autonomic function, might be the underlying cause of an unfavorable CVD risk profile. 14,26 Physiologically, the parasympathetic nervous system controls the direct secretion of insulin from beta cells, while the autonomic nervous system regulates glucose concentrations in the body. Diabetic autonomic neuropathy, which includes cardiac autonomic neuropathy, is a complication of type 1 and type 2 diabetes.…”

Section: Discussionmentioning

confidence: 99%

“…9 Although autonomic dysfunction is frequently recognized in patients with advanced diabetes as a form of autonomic neuropathy, it has been hypothesized that the action of insulin itself may be related to autonomic dysfunction in the early stage of glucose intolerance. [10][11][12][13][14] In addition, autonomic dysfunction is associated closely with physical activity, 15,16 behavioral factors, 17 and psychosocial factors, such as social hierarchy, 18 which can be explained in part by the hypothalamic-pituitary-adrenal axis.…”

Section: Introductionmentioning

confidence: 99%

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Heart Rate Variability, Insulin Resistance and Insulin Sensitivity in Japanese Adults: The Toon Health Study.

Saito

Maruyama

Nishida

et al. 2015

International Journal of Epidemiology

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Background: Although impaired cardiac autonomic function is associated with an increased risk of type 2 diabetes in Caucasians, evidence in Asian populations with a lower body mass index is limited. Methods: Between 2009-2012, the Toon Health Study recruited 1899 individuals aged 30-79 years who were not taking medication for diabetes. A 75-g oral glucose tolerance test was used to diagnose type 2 diabetes, and fasting and 2-h-postload glucose and insulin concentrations were measured. We assessed the homeostasis model assessment index for insulin resistance (HOMA-IR) and Gutt's insulin sensitivity index (ISI). Pulse was recorded for 5 min, and time-domain heart rate variability (HRV) indices were calculated: the standard deviation of normal-to-normal intervals (SDNN) and the root mean square of successive difference (RMSSD). Power spectral analysis provided frequency domain measures of HRV: high frequency (HF) power, low frequency (LF) power, and the LF:HF ratio. Results: Multivariate-adjusted logistic regression models showed decreased SDNN, RMSSD, and HF, and increased LF:HF ratio were associated significantly with increased HOMA-IR and decreased ISI. When stratified by overweight status, the association of RMSSD, HF, and LF:HF ratio with decreased ISI was also apparent in nonoverweight individuals. The interaction between LF:HF ratio and decreased ISI in overweight individuals was significant, with the odds ratio for decreased ISI in the highest quartile of LF:HF ratio in non-overweight individuals being 2.09 (95% confidence interval, 1.41-3.10). Conclusions: Reduced HRV was associated with insulin resistance and lower insulin sensitivity. Decreased ISI was linked with parasympathetic dysfunction, primarily in non-overweight individuals.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Heart Rate Variability, Insulin Resistance and Insulin Sensitivity in Japanese Adults: The Toon Health Study.

Saito

Maruyama

Nishida

et al. 2015

International Journal of Epidemiology

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“…In both conditions circadian regulation of cardiac autonomic function is compromised. In lean normotensive individuals [56], demonstrated that 2-day hyperinsulinemia reduced heart rate variability during night and blunted the nocturnal lowering of the arterial blood pressure.…”

Section: Autonomic Imbalance Associated With Cardiovascular Risk Metmentioning

confidence: 96%

“…In a study involving more than 1000 subjects, an impaired function of the ANS seemed to be already present in subjects showing only one of the abnormalities of the MetS, even before the appearance of insulin resistance [56].…”

Section: Autonomic Imbalance Associated With Cardiovascular Risk Metmentioning

confidence: 98%

Links between Autonomic Dysfunction and Metabolic Syndrome

Giampetruzzi¹,

Garruti²

2016

J Metabolic Synd

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The autonomic nervous system (ANS) plays a key role in the control of a number of vital functions including cardiovascular, endocrine/neurovascular, gastrointestinal, genitourinary, pupil and thermoregulatory functions. Its abnormalities have been associated with early mortality, sudden death, silent myocardial infarction, gastrointestinal diseases.The manifestation of the ANS dysfunction in several human diseases is underestimated. Evidences exist on the important role of ANS dysfunctions in different clinically relevant conditions, including diabetes mellitus, chronic functional constipation, scleroderma, thalassemia major.Beside the classical evaluation in patients with diabetes mellitus, little is known about the effects of metabolic factors on ANS dysfunction. The metabolic syndrome (MetS) includes a cluster of frequent abnormalities (impaired fasting glycaemia, dyslipidemia, arterial hypertension and increased visceral adiposity) predisposing to the atherosclerotic changes and increased cardiovascular mortality. Early signs of autonomic dysfunction are often found in subjects with MetS even in the absence of diabetes. Epidemiological studies demonstrated that diabetics display a cardiovascular risk which is twice that of sex-and age-matched non-diabetic population. Manifestations of such a high cardiovascular risk of subjects with DM are the frequent silent myocardial infarctions (MI)s of diabetics which are often due to impaired cardiovascular autonomic function. Only recently major attention has been given to the interactions between impaired glucose tolerance (IGT) and cardiovascular autonomic dysfunctions. When increased waist circumference (one of the features of the MetS) and IGT are both present, cardiovascular autonomic dysfunction also occurs. Some adipokines (e.g. adiponectin) seem to play a role in cardiovascular risk and autonomic dysfunction. This review will therefore focus on some subtle aspects linking ANS dysfunction and MetS.

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“…Проспективное исследование, в котором на протяжении 5 лет наблюдали 433 взрослых людей с исходно нор-мальными весом и параметрами АД, подтвердило, что повышенная активность симпатического отдела ВНС способствует развитию метаболических расстройств [26,27]. Избыточный симпатический тонус предшеству-ет манифестации инсулинорезистентности, развиваю-щейся в рамках метаболического синдрома, и коррели-рует со степенью выраженности таких компонентов метаболического синдрома, как ожирение и артериаль-ная гипертензия [28,30].…”

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Autonomic Dysfunction and Cardiovascular Diseases in Children

2017

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Т.М. ТВОРОГОВА, к.м.н., И.Н. ЗАХАРОВА, д.м.н., профессор, И.И. ПШЕНИЧНИКОВА Российская медицинская академия непрерывного профессионального образования Минздрава России, Москва ВЕГЕТАТИВНАЯ ДИСФУНКЦИЯ И ЗАБОЛЕВАНИЯ СЕРДЕЧНО-СОСУДИСТОЙ СИСТЕМЫ У ДЕТЕЙ В основе развития большинства кардиологических заболеваний, являющихся лидирующей причиной инвалидности и смертности во всем мире, лежит дисфункция вегетативной нервной системы. Вегетативная дизрегуляция является основ-ным патогенетическим звеном синдромов ортостатической дизрегуляции, нейромедиаторных синкопальных состояний. Гиперактивность симпатоадреналового отдела вегетативной нервной системы способствует формированию сахарного диабета второго типа, метаболического синдрома и обструктивных нарушений дыхания во время сна, которые тесно ассо-циированы с развитием сердечно-сосудистых заболеваний.

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Altered Cardiac Autonomic Function May Precede Insulin Resistance in Metabolic Syndrome

Cited by 57 publications

References 31 publications

Heart Rate Variability, Insulin Resistance and Insulin Sensitivity in Japanese Adults: The Toon Health Study.

Heart Rate Variability, Insulin Resistance and Insulin Sensitivity in Japanese Adults: The Toon Health Study.

Links between Autonomic Dysfunction and Metabolic Syndrome

Autonomic Dysfunction and Cardiovascular Diseases in Children

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