Evaluation of the relationship between cardiac autonomic function and glucose variability and HOMA-IR in prediabetes

Abstract

Aims: The present study aims to investigate the relationship between cardiac autonomic function (CAF) and glucose variability (GV) and HOMA-IR in subjects with prediabetes and normal glucose tolerance (NGT). Material and methods: Ninety-two subjects (59 with prediabetes and 33 with NGT), of mean age 50.3 ± 11.5 years, mean BMI 30.4 ± 6.0 kg/m2, were included in this cross-sectional study. Glucose tolerance was assessed by OGTT according to WHO 2006 criteria. Glucose, HbA1c, insulin, oxLDL, and 3-Nitrotyrosine were measured. CGM was performed with a blinded sensor (FreeStyle Libre Pro). CAF was assessed by ANX-3.0 technology. Results: GV indices were increased in prediabetes. CAF was suppressed in subjects with any stage of dysglycemia. The prevalence of cardiac autonomic dysfunction was higher in prediabetes −20.3% as compared to NGT −3.0%, p = 0.028. HOMA-IR [OR 1.5 (95% CI: 1.1–2.1), p = 0.010] and time in target range [OR 0.8 (95% CI: 0.67–0.97), p = 0.021] were found to be predictive variables for impaired CAF. Sympathetic and parasympathetic activity negatively correlated with mean glycemia and GV indices and were independently related to JINDEX in prediabetes (F[1, 47] = 5.76, p = 0.021 and F[1, 47] = 5.94, p = 0.019, respectively); and to time above target range in NGT (F[1, 18] = 4.48, p = 0.049 and F[1, 18] = 4.65, p = 0.046, respectively). Conclusion: CAF is declined in prediabetes and seems to be related to GV and HOMA-IR at early stages of dysglycemia.