Giuseppe Monea, Raffaele Jiritano, Luca Salerno, Mariangela Rubino, Mattia Massimino, Maria Perticone, Gaia Chiara Mannino, Angela Sciacqua, Elena Succurro, Teresa Vanessa Fiorentino, Francesco Andreozzi
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In this study we explored the relationship between 1 h post-load hyperglycemia and cardiac autonomic dysfunction.</p><p><strong>Methods: </strong>Presence of cardiac autonomic neuropathy (CAN) defined by cardiovascular autonomic reflex tests (CARTs) and heart rate variability (HRV), assessed by 24-h electrocardiography were evaluated in 88 non-diabetic subjects subdivided on the basis of OGTT data in: NGT with 1 h PG < 155 mg/dl (NGT 1 h-low), NGT 1 h-high and IGT.</p><p><strong>Results: </strong>As compared to subjects with NGT 1 h-low, those with NGT 1 h-high and IGT were more likely to have CARTs defined CAN and reduced values of the 24 h time domain HVR parameters including standard deviation of all normal heart cycles (SDNN), standard deviation of the average RR interval for each 5 min segment (SDANN), square root of the differences between adjacent RR intervals (RMSSD), percentage of beats with a consecutive RR interval difference > 50 ms (PNN50) and Triangular index. Univariate analyses showed that 1hPG, but not fasting and 2hPG, was inversely associated with all the explored HVR parameters and positively with CARTs determined presence of CAN. In multivariate regression analysis models including several confounders we found that 1hPG was an independent contributor of HRV and presence of CAN.</p><p><strong>Conclusion: </strong>Subjects with 1hPG ≥ 155 mg/dl have an impaired cardiac autonomic function.</p>","PeriodicalId":9374,"journal":{"name":"Cardiovascular Diabetology","volume":null,"pages":null},"PeriodicalIF":8.5000,"publicationDate":"2024-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11316982/pdf/","citationCount":"0","resultStr":"{\"title\":\"Compromised cardiac autonomic function in non-diabetic subjects with 1 h post-load hyperglycemia: a cross-sectional study.\",\"authors\":\"Giuseppe Monea, Raffaele Jiritano, Luca Salerno, Mariangela Rubino, Mattia Massimino, Maria Perticone, Gaia Chiara Mannino, Angela Sciacqua, Elena Succurro, Teresa Vanessa Fiorentino, Francesco Andreozzi\",\"doi\":\"10.1186/s12933-024-02394-w\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>A compromised cardiac autonomic function has been found in subjects with insulin resistance related disorders such as obesity, impaired glucose tolerance (IGT) and type 2 diabetes and confers an increased risk of adverse cardiovascular outcomes. Growing evidence indicate that 1 h plasma glucose levels (1hPG) during an oral glucose tolerance test (OGTT) ≥ 155 mg/dl identify amongst subjects with normal glucose tolerance (NGT) a new category of prediabetes (NGT 1 h-high), harboring an increased risk of cardiovascular organ damage. 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引用次数: 0
摘要
背景:胰岛素抵抗相关疾病(如肥胖、糖耐量受损(IGT)和 2 型糖尿病)患者的心脏自主神经功能受到损害,会增加心血管不良后果的风险。越来越多的证据表明,在口服葡萄糖耐量试验(OGTT)中,1 小时血浆葡萄糖水平(1hPG)≥ 155 mg/dl 可在正常葡萄糖耐量(NGT)受试者中识别出一类新的糖尿病前期(NGT 1 h-高),其心血管器官受损的风险增加。在这项研究中,我们探讨了负荷后 1 小时高血糖与心脏自主神经功能障碍之间的关系:方法:我们对 88 名非糖尿病受试者进行了心脏自主神经病变(CAN)评估,其定义是心血管自主神经反射测试(CARTs)和心率变异性(HRV),通过 24 小时心电图进行评估:1小时PG的NGT 结果:与 NGT 1 h 低的受试者相比,NGT 1 h 高和 IGT 的受试者更有可能出现 CARTs 定义的 CAN 和 24 h 时域 HVR 参数值降低,这些参数包括所有正常心动周期的标准偏差(SDNN)、每个 5 分钟区段平均 RR 间期的标准偏差(SDANN)、相邻 RR 间期差值的平方根(RMSSD)、连续 RR 间期差值大于 50 ms 的心动百分比(PNN50)和三角指数。单变量分析表明,1hPG(而非空腹和 2hPG)与所有探讨的 HVR 参数成反比关系,而与确定是否存在 CAN 的 CARTs 成正比关系。在包括几个混杂因素的多变量回归分析模型中,我们发现 1hPG 是心率变异和 CAN 存在的一个独立因素:结论:1hPG ≥ 155 mg/dl 的受试者心脏自主神经功能受损。
Compromised cardiac autonomic function in non-diabetic subjects with 1 h post-load hyperglycemia: a cross-sectional study.
Background: A compromised cardiac autonomic function has been found in subjects with insulin resistance related disorders such as obesity, impaired glucose tolerance (IGT) and type 2 diabetes and confers an increased risk of adverse cardiovascular outcomes. Growing evidence indicate that 1 h plasma glucose levels (1hPG) during an oral glucose tolerance test (OGTT) ≥ 155 mg/dl identify amongst subjects with normal glucose tolerance (NGT) a new category of prediabetes (NGT 1 h-high), harboring an increased risk of cardiovascular organ damage. In this study we explored the relationship between 1 h post-load hyperglycemia and cardiac autonomic dysfunction.
Methods: Presence of cardiac autonomic neuropathy (CAN) defined by cardiovascular autonomic reflex tests (CARTs) and heart rate variability (HRV), assessed by 24-h electrocardiography were evaluated in 88 non-diabetic subjects subdivided on the basis of OGTT data in: NGT with 1 h PG < 155 mg/dl (NGT 1 h-low), NGT 1 h-high and IGT.
Results: As compared to subjects with NGT 1 h-low, those with NGT 1 h-high and IGT were more likely to have CARTs defined CAN and reduced values of the 24 h time domain HVR parameters including standard deviation of all normal heart cycles (SDNN), standard deviation of the average RR interval for each 5 min segment (SDANN), square root of the differences between adjacent RR intervals (RMSSD), percentage of beats with a consecutive RR interval difference > 50 ms (PNN50) and Triangular index. Univariate analyses showed that 1hPG, but not fasting and 2hPG, was inversely associated with all the explored HVR parameters and positively with CARTs determined presence of CAN. In multivariate regression analysis models including several confounders we found that 1hPG was an independent contributor of HRV and presence of CAN.
Conclusion: Subjects with 1hPG ≥ 155 mg/dl have an impaired cardiac autonomic function.
期刊介绍:
Cardiovascular Diabetology is a journal that welcomes manuscripts exploring various aspects of the relationship between diabetes, cardiovascular health, and the metabolic syndrome. We invite submissions related to clinical studies, genetic investigations, experimental research, pharmacological studies, epidemiological analyses, and molecular biology research in this field.