Association of Sympathovagal Imbalance With Cognitive Impairment in Type 2 Diabetes in Adults

Pal, Auroprajna; Naik, Basanta Manjari; Sahoo, Jaya Prakash; Keerthi, Gorantla Shravya; Pavanya, Manohar; Pal, Gopal Krushna

doi:10.1016/j.jcjd.2017.01.008

Cited by 12 publications

(8 citation statements)

References 46 publications

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“…In our study, patients with diabetes had significantly increased LF/HF ratio compared to the participants without diabetes, suggesting the presence of considerable sympathovagal imbalance with increased sympathetic drive in diabetic patients. These findings are in agreement with our previous reports of autonomic imbalance and decreased parasympathetic modulation in T2DM [39,40], which also corroborates with the report by others [38]. However, in previous report by Sucharita et al [41], the authors did not measure SDNN and RMSSD, the primary HRV indices of cardiovagal modulation.…”

Section: Discussionsupporting

confidence: 93%

Increased osteoprotegerin level is associated with impaired cardiovagal modulation in type-2 diabetic patients treated with oral antidiabetic drugs

Malhotra

Nanda

Sahoo

et al. 2020

BMC Cardiovasc Disord

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Background An increased osteoprotegerin (OPG) level has been reported in both type-2 diabetes mellitus (T2DM) and cardiovascular diease (CVD) that are linked to sympathovagal imbalance (SVI). We explored the link of osteoprotegerin with cardiovagal modulation in T2DM. Methods We assessed fasting serum OPG, high-sensitive C-reactive protein (hsCRP), glucose, insulin and lipid profile in patients having T2DM receiving oral antidiabetic drugs (OAD) (n = 42) compared with age, gender and body composition-matched healthy participants without diabetes (n = 42). Rate pressure product (RPP), spectral indices of heart rate variability (HRV) and body composition were recorded in both the groups. Association of HOMA-IR and OPG with various parameters were assessed. Results Osteoprotegerin, HOMA-IR, hsCRP, coronary lipid risk factor were significantly increased, markers of cardiovagal modulation (TP, SDNN, RMSSD) were considerably decreased, ratio of low-frequency to high-frequency (LH-HF ratio), the indicator of SVI, and RPP, the marker of myocardial work stress were significantly higher in patients with diabetes, suggesting an overall elevated CVD risks in them. HOMA-IR was correlated with RMSSD, lipid risk factors and OPG. Rise in OPG was correlated with decreased cardiovagal modulation in patients with diabetes. There was significant contribution of OPG in decreasing TP, suggesting impaired cardiovagal modulation. Conclusion T2DM patients receiving OAD had higher cardiometabolic risks compared to age, gender and body composition-matched healthy individuals. Increased level of OPG is linked to decreased cardiovagal modulation in T2DM patients.

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Section: Discussionsupporting

confidence: 93%

Increased osteoprotegerin level is associated with impaired cardiovagal modulation in type-2 diabetic patients treated with oral antidiabetic drugs

Malhotra

Nanda

Sahoo

et al. 2020

BMC Cardiovasc Disord

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“…Experimental studies in animal models indicate that ROS can affect HRV and other cardiovascular endpoints [32,33]. Moreover, studies in rat models have shown that obesity-related insulin resistance is a risk factor for developing cardiac sympathovagal dysregulation, as indicated by an increase in the LF/HF ratio [34], whereas MDA is significantly correlated with the LF/HF ratio in humans with diabetes [35]. Studies have also shown that obesity causes an increase in oxidative stress and insulin resistance which strongly affects cardiac autonomic regulation, causes cardiac systolic dysfunction, and induces cardiovascular diseases [32,33,35,36].…”

Section: Introductionmentioning

confidence: 99%

“…Moreover, studies in rat models have shown that obesity-related insulin resistance is a risk factor for developing cardiac sympathovagal dysregulation, as indicated by an increase in the LF/HF ratio [34], whereas MDA is significantly correlated with the LF/HF ratio in humans with diabetes [35]. Studies have also shown that obesity causes an increase in oxidative stress and insulin resistance which strongly affects cardiac autonomic regulation, causes cardiac systolic dysfunction, and induces cardiovascular diseases [32,33,35,36]. Thus, whether the observations are made in humans or in animals, evaluation of HRV and oxidative stress can provide information about cardiac function and can help predict diseases that can occur in obese dogs.…”

Section: Introductionmentioning

confidence: 99%

Obesity-Induced Heart Rate Variability Impairment and Decreased Systolic Function in Obese Male Dogs

Pongkan

Jitnapakarn

Phetnoi

et al. 2020

Animals

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Obesity can induce cardiovascular diseases in both humans and animals. Heart rate variability (HRV) is an indicator of sympathovagal balance and is used to identify cardiovascular diseases in humans. However, HRV and cardiac function have rarely been investigated in obese dogs. This study investigated the effect of obesity on oxidative stress, HRV, and cardiac function in obese and non-obese dogs. The nine-scale body condition score (BCS) system was used to determine obesity. Thirty small breed dogs were divided into a normal weight group (n = 15) and an obese group (n = 15). All dogs underwent physical examination, plasma malondialdehyde (MDA) measurement, electrocardiography, echocardiography, and two hours of Holter monitoring. This study found that obese dogs had increased plasma MDA and sympathovagal imbalance, which was indicated by impaired time and frequency domains compared to normal weight dogs. Although cardiac function was within normal limits, the echocardiographic study found that the obese dogs had reduced cardiac wall thickness and lower systolic function, as indicated by a reduction in %ejection fraction, %fractional shortening, increased left ventricular (LV) internal diameter during systole, and LV end-systolic volume compared to normal weight dogs. This study concluded that obesity in dogs can induce increased plasma oxidative stress, impaired HRV, and reduced cardiac systolic function compared to non-obese dogs.

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“…Further studies conducted in diabetes, obesity, and anemia shows that RPP was increased in study group compared to the control group. 7,12,17,19,20 Therefore, in the present study, authors have attempted to compare the difference in RPP among normal pregnant woman and pregnant woman with anaemia in different trimesters of pregnancy. The results of the present study have shown that RPP was significantly higher in pregnant woman with anaemia in all the three trimesters of pregnancy, but this significant increase was more in the third trimester of pregnancy.…”

Section: Discussionmentioning

confidence: 99%

A study on rate pressure product in south Indian pregnant women with anaemia

2018

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Background: Anaemia is a cause of serious concern and contributes to a significantly higher maternal mortality. Rate Pressure Product (RPP) is a major determinant of myocardial oxygen consumption and blood flow. There is an increase in oxygen demand in anemia. Thus, in the present study, we have compared the difference in RPP between a normal pregnant women and pregnant women with anemia.Methods: A total of 180 pregnant women (normal pregnant woman - 90 and pregnant woman with anaemia - 90) belonging to different trimesters of pregnancy were included in the study. Age, height, and weight were recorded, and their body mass index was calculated. The systolic blood pressure, diastolic blood pressure, heart rate was recorded and RPP was calculated.Results: There was a significant increase in RPP in pregnant woman with anaemia in all three trimesters of pregnancy, but the significant increase was more in the third trimester.Conclusions: The present study shows that there is an increase in RPP in pregnant woman with anaemia and they are more prone to hemodynamic stress and cardiovascular risks, especially in their third trimester of pregnancy. This hemodynamic change may be taken into account to prevent the cardiovascular complications associated with anemia in pregnancy. Thus, RPP can be used as a sensitive non-invasive simple marker for early diagnosis of cardiovascular disease in pregnant woman.

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Association of Sympathovagal Imbalance With Cognitive Impairment in Type 2 Diabetes in Adults

Abstract: Treatment-naïve patients with type 2 diabetes have SVI and considerable cognitive impairment. Insulin resistance and oxidative stress contribute to cognitive impairment, and SVI could be the physiologic link to cognitive impairment in treatment-naïve patients with type 2 diabetes.

Cited by 12 publications

References 46 publications

Increased osteoprotegerin level is associated with impaired cardiovagal modulation in type-2 diabetic patients treated with oral antidiabetic drugs

Increased osteoprotegerin level is associated with impaired cardiovagal modulation in type-2 diabetic patients treated with oral antidiabetic drugs

Obesity-Induced Heart Rate Variability Impairment and Decreased Systolic Function in Obese Male Dogs

A study on rate pressure product in south Indian pregnant women with anaemia

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