GW25-e1580 Impact of blood glucose variability on heart rate variability in patients with type 2 diabetes mellitus

  • Xixiang T
  • Long P
  • Yanming C
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Abstract

Objectives: The atherosclerosis risk in communities (ARIC) study have demonstrated that lower heart rate variability (HRV) is associated with the development of coronary heart disease (CAD) in individuals with diabetes. However, the relationship between blood glucose variability and HRV remains unclear. The present study aimed to explore the impact of glucose variability on HRV in patients with type 2 diabetes mellitus (T2DM). Methods: According to glucose variability, assessed by mean amplitude of glycemic excursions (MAGE) obtained from continuous glucose monitoring system( CGMS), 68 consecutive type 2 diabetic patients without CAD were divided into two groups: subjects with non-glucose fluctuation (MAGE<3.9 mmol/l, n=32) and subjects with glucose fluctuation (MAGE>=3.9mmol/l, n=36). Thirty healthy controls (NC) were also enrolled. HRV was assessed by dynamic electrocardiogram examination. HRV analysis included time domain parameters such as SDNN, SDANN, rMSSD and pNN50, and total spectral power (TP) of HRV, which mainly consists of VLF, LF and HF component along with LF/HF ratio, was also obtained. Results: Compared with NC, all the time domain measures were significantly lower in T2DM (SDNN: 92.2.8 ± 23.1 vs 121.7 ± 27.4, P<0.05; SDANN: 78.7 ± 22.9 vs 106.2 ± 22.5, P<0.05; rMSSD: 27.5 ± 10.2 vs 35.7 ± 10.1, P<0.05; and pNN50: 6.0 ± 7.1 vs 8.8 ± 7.8, P<0.05). For frequency domain, LF and HF were significantly lower in T2DM (LF:300.2 ± 237.8 vs 398.7 ± 277.5, P<0.05; HF: 141.8 ± 121.5 vs 186.5 ± 171.5, P<0.05) whereas VLF and LF/HF ratio were comparable (P>0.05). In cases with glucose fluctuation, SDNN(79.1 ± 22.1 vs 100.8 ± 24.1, P<0.05), SDANN (61.3 ± 23.8 vs 88.7 ± 20.9, P<0.05), rMSSD (23.1 ± 10.5 vs 29.3 ± 11.5, P<0.05), PNN50 (4.9 ± 6.6 vs 6.5 ± 6.1, P<0.05), TP (1290.8 ± 902.3 vs 1727.0 ± 1131.5, P<0.05) and HF (102.1 ± 110.7 vs 139.8 ± 122.4, P<0.05) were all significantly lower than those in non-glucose fluctuation subjects. No significant differences in VLF (1190.4 ± 861.6 vs 1285.6 ± 858.0, P>0.05) and LF (274.9 ± 223.0 vs 280.2 ± 233.7, P>0.05) were found between the two groups, while LF/HF ratio was significantly higher in glucose fluctuation patients than in non-glucose fluctuation subjects (2.7 ± 0.4 vs 2.0 ± 0.5, P<0.01). Negative correlations of MAGE with SDNN, SDANN, and HF (r = -0.611, -0.601, -0.542, respectively, P<0.05) were found in diabetics, while MAGE was positive correlated with LF/HF ratio (r = 0.594, P<0.05). Conclusions: Blood glucose variability could lower the HRV of the patients with T2DM, which relates to impairing the cardiac autonomic nerve function and contributes to the risk of CAD among individuals with diabetes.

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Xixiang, T., Long, P., & Yanming, C. (2014). GW25-e1580 Impact of blood glucose variability on heart rate variability in patients with type 2 diabetes mellitus. Journal of the American College of Cardiology, 64(16), C112–C113. https://doi.org/10.1016/j.jacc.2014.06.522

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