Comparison of cardiac autonomic function across complete glycaemic spectrum

Rajathi Rajendran; Vivek Kumar Sharma; Kolar Vishwanath Vinod; Ramesh Ananthakrishnan; Hanumanthappa Nandeesha; Senthil Kumar Subramanian

doi:10.1515/jbcpp-2022-0053

Article

Comparison of cardiac autonomic function across complete glycaemic spectrum

Rajathi Rajendran , Vivek Kumar Sharma , Kolar Vishwanath Vinod , Ramesh Ananthakrishnan , Hanumanthappa Nandeesha and Senthil Kumar Subramanian

Published/Copyright: May 18, 2022

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From the journal Journal of Basic and Clinical Physiology and Pharmacology Volume 34 Issue 3

Abstract

Objectives

Autonomic imbalance is attributed as key mechanism altering metabolic regulation in diabetes mellitus. In view of controversial reports on autonomic function in FDRD and prediabetes, we aimed to assess and compare the autonomic function across the complete glycaemic spectrum in Indian population.

Methods

Short term heart rate variability and cardiac autonomic reactivity tests – blood pressure and heart rate response to orthostatic tolerance and deep breathing exercise, and diastolic response to isometric handgrip exercise were recorded in normoglycemic apparently healthy individual, normoglycemic first degree relatives of diabetes, prediabetes and diabetes individuals.

Results

Resting heart rate is significantly higher in FDRD, prediabetes and diabetes as compared to controls (control < FDRD = prediabetes = diabetes). Total power, LF power (control < FDRD < prediabetes = diabetes) and HF power (control < FDRD < prediabetes < diabetes) decreased along the glycaemic spectrum. Time-domain variables of HRV (SDNN, RMSSD, NN50, pNN50) were reduced as we move along the glycaemic spectrum (control < FDRD < prediabetes = diabetes). Cardiac autonomic function reactivity parameters such as 30:15 ratio and E:I ratio are decreased in prediabetes and diabetes group as compared to control and FDRD group (control = FDRD < prediabetes = diabetes). Diastolic response to isometric hand grip increases along the glycaemic spectrum starting from FDRD (control < FDRD < prediabetes = diabetes).

Conclusions

Autonomic dysfunction is observed even in first degree relatives of diabetes. Autonomic dysfunction increases as we move along the glycaemic spectrum (control < FDRD < prediabetes < diabetes).

Keywords: autonomic function; autonomic reactivity tests; cardiovagal tone; diabetes; first degree relatives of diabetes; glucose; glycaemic spectrum; heart rate variability; prediabetes

Corresponding author: Dr. Vivek Kumar Sharma, Professor-Head, Department of Physiology, AIIMS, Rajkot, Gujarat, India, Phone: +919442529673, E-mail: drvivekphysiology@gmail.com

Funding source: Research Society for the Study of Diabetes in India

Award Identifier / Grant number: JIPMER intramural grant

Award Identifier / Grant number: RSSDI/HQ/Grants/2017/181

Research funding: The study was partially funded by JIPMER intramural funding and extramural funding from Research Society for the Study of Diabetes in India [RSSDI/HQ/Grants/2017/181].
Author contribution: All authors have accepted responsibility for the entire content of this manuscript and approved its submission.
Contribution details of authors:
Competing interests: Authors state no conflict of interest.
Informed consent: Informed consent was obtained from all individuals included in this study.
Ethical approval: The study has been approved by Institute Ethics committee for Human studies.

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Received: 2022-03-16

Accepted: 2022-04-06

Published Online: 2022-05-18

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Articles in the same Issue

https://doi.org/10.1515/jbcpp-2022-0053

Keywords for this article

autonomic function; autonomic reactivity tests; cardiovagal tone; diabetes; first degree relatives of diabetes; glucose; glycaemic spectrum; heart rate variability; prediabetes