Influence of Insulin Resistance on the Association Between Physical Activity and Heart Rate Variability: The Toon Health Study

Background: Autonomic activity is possibly influenced by physical activity (PA). However, it remains unclear whether this association is modified by insulin resistance. Methods: This population-based study between 2009 and 2012 included 2016 men and women aged 30–79 years. The PA was assessed using a validated questionnaire based on sleep, occupation, transportation, household characteristics, and leisure-time PA. Heart rate (HR) and heart rate variability (HRV) in the sitting position were determined from 5-minute recordings of pulse waves detected by a fingertip sensor. The HRV was calculated as frequency (standard deviation of normal-to-normal [NN] intervals [SDNN]), root mean square of successive differences (RMSSD), and percentage differences between normal NN intervals >50 milliseconds [pNN50]) and time domains. Insulin resistance was evaluated using the homeostasis model assessment index (HOMA-IR). Results: HR, RMSSD, and pNN50 were related to the total and moderate/vigorous PA tertiles in models that included HOMA-IR. The partial regression coefficient of total PA per 1-SD increase was .05 (P = .019) for log-transformed RMSSD and 1.86 (P = .001) for pNN50. No interactive associations were observed between PA and HOMA-IR. Conclusions: Low total PA was associated with increased HR and low levels of RMSSD and pNN50, reflecting parasympathetic modulation that was not modified by insulin resistance.

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Sex differences in associations between insulin resistance, heart rate variability, and arterial stiffness in healthy women and men: a physiology study

Canadian Journal of Physiology and Pharmacology ◽

10.1139/cjpp-2016-0122 ◽

2017 ◽

Vol 95 (4) ◽

pp. 349-355 ◽

Cited By ~ 6

Author(s):

Luke Anthony Rannelli ◽

Jennifer M. MacRae ◽

Michelle C. Mann ◽

Sharanya Ramesh ◽

Brenda R. Hemmelgarn ◽

...

Keyword(s):

Insulin Resistance ◽

Heart Rate ◽

Heart Rate Variability ◽

Sex Differences ◽

Arterial Stiffness ◽

Spectral Power ◽

Applanation Tonometry ◽

Healthy Population ◽

Model Assessment ◽

Healthy Women

Diabetes confers greater cardiovascular risk to women than to men. Whether insulin-resistance-mediated risk extends to the healthy population is unknown. Measures of insulin resistance (fasting insulin, homeostatic model assessment, hemoglobin A1c, quantitative insulin sensitivity check index, glucose) were determined in 48 (56% female) healthy subjects. Heart rate variability (HRV) was calculated by spectral power analysis and arterial stiffness was determined using noninvasive applanation tonometry. Both were measured at baseline and in response to angiotensin II infusion. In women, there was a non-statistically significant trend towards increasing insulin resistance being associated with an overall unfavourable HRV response and increased arterial stiffness to the stressor, while men demonstrated the opposite response. Significant differences in the associations between insulin resistance and cardiovascular physiological profile exist between healthy women and men. Further studies investigating the sex differences in the pathophysiology of insulin resistance in cardiovascular disease are warranted.

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Distribution of HOMA-IR in a population-based cohort and proposal for reference intervals

Clinical Chemistry and Laboratory Medicine (CCLM) ◽

10.1515/cclm-2021-0643 ◽

2021 ◽

Vol 0 (0) ◽

Author(s):

Bassel Matli ◽

Andreas Schulz ◽

Thomas Koeck ◽

Tanja Falter ◽

Johannes Lotz ◽

...

Keyword(s):

Insulin Resistance ◽

Fasting Glucose ◽

Reference Group ◽

Reference Interval ◽

Population Based ◽

Reference Intervals ◽

Health Study ◽

Specific Reference ◽

Model Assessment ◽

Significant Difference

Abstract Objectives Insulin resistance (IR) is a hallmark of type 2 diabetes mellitus (DM). The homeostatic model assessment of insulin resistance (HOMA-IR) provides an estimate for IR from fasting glucose and insulin serum concentrations. The aim of this study was to obtain a reference interval for HOMA-IR for a specific insulin immunoassay. Methods The Gutenberg Health Study (GHS) is a population-based, prospective, single-center cohort study in Germany with 15,030 participants aged 35–74 years. Fasting glucose, insulin, and C-peptide were available in 10,340 participants. HOMA-IR was calculated in this group and three reference subgroups with increasingly more stringent inclusion criteria. Age- and sex-dependent distributions of HOMA-IR and reference intervals were obtained. In a substudy three insulin assays were compared and HOMA-IR estimated for each assay. Results Among the 10,340 participants analyzed there were 6,590 non-diabetic, 2,901 prediabetic, and 849 diabetic individuals. Median (interquartile range [IQR]) HOMA-IR was 1.54 (1.13/2.19), 2.00 (1.39/2.99), and 4.00 (2.52/6.51), respectively. The most stringently selected reference group consisted of 1,065 persons. Median (IQR) HOMA-IR was 1.09 (0.85/1.42) with no significant difference between men and women. The 97.5th percentile was 2.35. There was a non-significant trend towards higher values with older age. Comparison of three immunoassays for insulin showed an unsatisfactory correlation among the assays and systematic differences in calculated HOMA-IR. Conclusions We present HOMA-IR reference intervals for adults derived by more or less stringent selection criteria for the reference cohort. In addition we show that assay specific reference intervals for HOMA-IR are required.

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Response to Letter Regarding Article, “Physical Activity and Heart Rate Variability in Older Adults: The Cardiovascular Health Study”

Circulation ◽

10.1161/circulationaha.114.012825 ◽

2015 ◽

Vol 131 (7) ◽

Cited By ~ 1

Author(s):

Luisa Soares-Miranda ◽

Jacob Sattelmair ◽

Paulo Chaves ◽

Glen Duncan ◽

David S. Siscovick ◽

...

Keyword(s):

Physical Activity ◽

Older Adults ◽

Heart Rate ◽

Heart Rate Variability ◽

Cardiovascular Health ◽

Health Study ◽

Cardiovascular Health Study

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Comparison of Heart Rate Variability Measurement Methods in Panels of Older Adults from the Outdoor Physical Activity and Health Study

ISEE Conference Abstracts ◽

10.1289/isesisee.2018.p02.0640 ◽

2018 ◽

Vol 2018 (1) ◽

Author(s):

Lisa Marie Kauri ◽

Robin Shutt ◽

Marie Mulholland ◽

Martin S Green ◽

Dave Stieb

Keyword(s):

Physical Activity ◽

Older Adults ◽

Heart Rate ◽

Heart Rate Variability ◽

Measurement Methods ◽

Health Study ◽

Heart Rate Variability Measurement

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Associations between heart rate variability, metabolic syndrome risk factors, and insulin resistance

Applied Physiology Nutrition and Metabolism ◽

10.1139/apnm-2014-0528 ◽

2015 ◽

Vol 40 (7) ◽

pp. 734-740 ◽

Cited By ~ 13

Author(s):

Melanie I. Stuckey ◽

Antti Kiviniemi ◽

Dawn P. Gill ◽

J. Kevin Shoemaker ◽

Robert J. Petrella

Keyword(s):

Risk Factors ◽

Insulin Resistance ◽

Metabolic Syndrome ◽

Heart Rate ◽

Heart Rate Variability ◽

Standard Deviation ◽

Waist Circumference ◽

Frequency Domain ◽

Model Assessment ◽

Poincaré Plot

The purpose of this study was to examine differences in heart rate variability (HRV) in metabolic syndrome (MetS) and to determine associations between HRV parameters, MetS risk factors, and insulin resistance (homeostasis model assessment for insulin resistance (HOMA-IR)). Participants (n = 220; aged 23–70 years) were assessed for MetS risk factors (waist circumference, blood pressure, fasting plasma glucose, triglycerides, and high-density lipoprotein cholesterol) and 5-min supine HRV (time and frequency domain and nonlinear). HRV was compared between those with 3 or more (MetS+) and those with 2 or fewer MetS risk factors (MetS–). Multiple linear regression models were built for each HRV parameter to investigate associations with MetS risk factors and HOMA-IR. Data with normal distribution are presented as means ± SD and those without as median [interquartile range]. In women, standard deviation of R–R intervals 38.0 [27.0] ms, 44.5 [29.3] ms; p = 0.020), low-frequency power (5.73 ± 1.06 ln ms2, 6.13 ± 1.05 ln ms2; p = 0.022), and the standard deviation of the length of the Poincaré plot (46.8 [31.6] ms, 58.4 [29.9] ms; p = 0.014) were lower and heart rate was higher (68 [13] beats/min, 64 [12] beats/min; p = 0. 018) in MetS+ compared with MetS–, with no differences in men. Waist circumference was most commonly associated with HRV, especially frequency domain parameters. HOMA-IR was associated with heart rate. In conclusion, MetS+ women had a less favourable HRV profile than MetS– women, but there were no differences in men. HOMA-IR was associated with heart rate, not HRV.

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