Journal Article

Compromised cardiac autonomic function in non-diabetic subjects with 1 h post-load hyperglycemia: a cross-sectional study

Succurro, Elena, Rubino, Mariangela, Monea, Giuseppe, Mannino, Gaia Chiara, Jiritano, Raffaele, Massimino, Mattia, Andreozzi, Francesco, Perticone, Maria, Fiorentino, Teresa Vanessa, Salerno, Luca, Sciacqua, Angela

2024

Overview

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.

• Publisher: BioMed Central,Springer Nature B.V,BMC
• Subject: 1 h post-load glucose / Adult / Angiology / Autonomic nervous system / Autonomic Nervous System - physiopathology / Autonomic Nervous System Diseases - blood / Autonomic Nervous System Diseases - diagnosis / Autonomic Nervous System Diseases - physiopathology / Biomarkers - blood / Blood Glucose - metabolism / Blood pressure / Body mass index / Cardiac autonomic dysfunction / Cardiology / Cardiovascular diseases / Cardiovascular system / Cross-Sectional Studies / Diabetes / Diabetes mellitus (non-insulin dependent) / Diabetic neuropathy / EKG / Electrocardiography / Electrocardiography, Ambulatory / Exercise / Female / Glucose / Glucose Intolerance - blood / Glucose Intolerance - diagnosis / Glucose Intolerance - physiopathology / Glucose tolerance / Glucose Tolerance Test / Heart - innervation / Heart - physiopathology / Heart Rate / Heart rate variability / Homeostasis / Humans / Hyperglycemia / Hyperglycemia - blood / Hyperglycemia - diagnosis / Hyperglycemia - physiopathology / Insulin / Insulin resistance / Male / Medicine / Medicine & Public Health / Metabolic disorders / Metabolism / Middle Aged / Neuropathy / Plasma / Prediabetes / Prediabetic State - blood / Prediabetic State - diagnosis / Prediabetic State - physiopathology / Regression analysis / Risk Factors / Standard deviation / Time Factors / Triglycerides