The association and predictive value analysis of metabolic syndrome combined with resting heart rate on cardiovascular autonomic neuropathy in the general Chinese population

Abstract Diabetic cardiovascular autonomic neuropathy (CAN) encompasses damage to the autonomic nerve fibers innervating the heart and blood vessels, resulting in abnormalities in heart rate control and vascular dynamics. Clinical symptoms associated with CAN include resting tachycardia, postural hypotension, dizziness, syncope, exercise intolerance, silent myocardial infarction. The earliest finding of CAN, even at the subclinical stage, is a decrease in heart rate variability (HRV) Purpose To study CAN prevalence and understand the diagnostic capabilities of HRV - tests of diabetic cardiovascular autonomic neuropathy in children with type 1 diabetes. Methods 100 children with type 1 diabetes were assessed for CAN (age 15.2 yrs [9.0–17.8], duration 6.5 yrs [4.0–10.6], HbA1c 8.1% 6.3–9.7]). The degree of compensation of diabetes was estimated according to criteria ISPAD Consensus Guidelines, 2018. Optimal level (HbA1c <7.0%) of compensation was revealed in 62% of children (group I) and nonoptimal in 38% of children (group II). For evaluation of the CAN we used HRV - tests: RR 30:15 ratio, ΔRR quiet breath, ΔRR deep breath, BP response to standing. Results Diabetic cardiovascular autonomic neuropathy was diagnosed in 41 children: in group I – in 6 (29%) and in group II – 35 (71%) children (p=0.00001). The prevalence of DCN correlated with HbA1c level in children and adolescents (groups I and II): ΔRR quiet breath r=−0.47 & r=−0.9; ΔRR deep breath r=−0.65 & r=−0.85; RR30:15 r=−0.77 & r=−0.88 respectively. Prevalence of CAN increased parallel to type 1 diabetes duration (p<0.01). Conclusions Diabetic cardiovascular autonomic neuropathy in children with type 1 diabetes was diagnosed in 41%. Prevalence of diabetic cardiovascular autonomic neuropathy increases parallel to type 1 diabetes duration (p<0.01). In this study we found an association between HRV indexes and HbA1c level. This provides support for HRV - testing to assess diabetic cardiovascular autonomic neuropathy in children. Funding Acknowledgement Type of funding source: None

Download Full-text

Resting heart rate is associated with the risk of metabolic syndrome and its components among Dong adults in southwest China: The China Multi-Ethnic Cohort (CMEC) Study

10.21203/rs.3.rs-144449/v1 ◽

2021 ◽

Author(s):

Xiao Zhang ◽

Feng Hong ◽

Zixiu Qin ◽

Leilei Liu ◽

Jun Yang ◽

...

Keyword(s):

Metabolic Syndrome ◽

Heart Rate ◽

Dose Response ◽

Southwest China ◽

Positive Association ◽

Metabolic Risk ◽

Resting Heart Rate ◽

Response Relationship ◽

Dose Response Relationship ◽

Restricted Cubic Splines

Abstract Background High resting heart rate (RHR), one abnormal manifestation of autonomic nervous system, was associated with metabolic disorders. However, the association between RHR and metabolic syndrome (MetS) and its components remains controversial. This study aimed to explore the link between RHR and MetS and its components. Methods The study included 6,589 Dong adults (1,434 patients) from the China Multi-Ethnic Cohort (CMEC) Study. Logistic regression model was used to calculate odds ratios (ORs) and 95% confidence intervals (CIs) and assess the association between RHR and MetS, clustered metabolic risk, and MetS components. Restricted cubic splines model was used to evaluate the dose–response relationship between RHR and MetS and its components. Results A positive association existed between RHR and MetS, and people in the highest RHR quartile had a higher MetS risk (OR 1.75 [95% CI 1.42–2.15]) than those in the lowest quartile. The clustered metabolic risk associated with RHR (P < 0.05). Furthermore, RHR was related to elevated blood pressure (BP), elevated triglycerides (TG), and elevated fasting plasma glucose (FPG), the ORs (95% CIs) for the highest versus lowest RHR quartile were 2.06 (1.75–2.43), 1.37 (1.17–1.62), and 2.53 (2.04–3.14), respectively. Similar results were found in sensitivity and subgroup analyses. Also, non-linear dose-response relationship existed between RHR and MetS and elevated levels of BP, TG, and FPG (P < 0.001). Conclusions RHR was related to the risk of MetS and three MetS components (elevated BP, elevated TG, and elevated FPG). RHR may be a useful indicator for MetS.

Download Full-text