scholarly journals Unreliability of Approximate Entropy to Locate Optimal Complexity in Diabetes Mellitus via Heart Rate Variability

2020 ◽  
Vol 2 (2) ◽  
pp. 32-40
Author(s):  
David M Garner ◽  

Introduction: Approximate Entropy (ApEn) is a widely enforced metric to evaluate the chaotic response and irregularities of RR intervals from an electrocardiogram. We applied the metric to estimate these responses in subjects with type 1 diabetes mellitus (DM1). So far, as a technique it has one key problem – the accurate choices of the tolerance (r) and embedding dimension (M). So, we attempted to overcome this drawback by applying different groupings to detect the optimum. Methods: We studied 46 subjects split into two equal groups: DM1 and control. To evaluate autonomic modulation the heart rate was measured for 30 min in a supine position without any physical, sensory, or pharmacological stimuli. For the time-series, the ApEn was applied with set values for r (0.1→0.5 in intervals of 0.1) and M (1→5 in intervals of 1) and the differences between the two groups and their effect size by two measures (Cohen’s ds and Hedges’s gs) were computed. Results: The highest value of statistical significance accomplished for the effect sizes (ES) for any of the combinations performed was -0.7137 for Cohen’s ds and -0.7015 for Hedges’s gs with M = 2 and r = 0.08. Conclusion: ApEn was able to identify the reduction in chaotic response in DM1 subjects. Still, ApEn is relatively unreliable as a mathematical marker to determine this.

2018 ◽  
Vol 25 (3) ◽  
pp. 289-295 ◽  
Author(s):  
David M. Garner ◽  
Naiara Maria de Souza ◽  
Luiz Carlos M. Vanderlei

Abstract Background and aims: Statistical markers are valuable when assessing physiological status over periods of time and in certain disease states. We assess if type 1 diabetes mellitus promote modification in the autonomic nervous system using the main two types of algorithms to estimate a Fractal Dimension: Higuchi and Katz. Material and methods: 46 adults were divided into two equal groups. The autonomic evaluation consisted of recording heart rate variability (HRV) for 30 minutes in supine position in absence of any other stimuli. Fractal dimensions ought then able to determine which series of interbeat intervals are derived from diabetics’ or not. We then equated results to observe which assessment gave the greatest significance by One-way analysis of variance (ANOVA1), Kruskal-Wallis technique and Cohen’s d effect sizes. Results: Katz’s fractal dimension is the most robust algorithm when assisted by a cubic spline interpolation (6 Hz) to increase the number of samples in the dataset. This was categorical after two tests for normality; then, ANOVA1, Kruskal-Wallis and Cohen’s d effect sizes (p≈0.01 and Cohen’s d=0.814143 –medium effect size). Conclusion: Diabetes significantly reduced the chaotic response as measured by Katz’s fractal dimension. Katz’s fractal dimension is a viable statistical marker for subjects with type 1 diabetes mellitus.


2021 ◽  
pp. 1-6
Author(s):  
David M. Garner ◽  
Gláucia S. Barreto ◽  
Vitor E. Valenti ◽  
Franciele M. Vanderlei ◽  
Andrey A. Porto ◽  
...  

Abstract Introduction: Approximate Entropy is an extensively enforced metric to evaluate chaotic responses and irregularities of RR intervals sourced from an eletrocardiogram. However, to estimate their responses, it has one major problem – the accurate determination of tolerances and embedding dimensions. So, we aimed to overt this potential hazard by calculating numerous alternatives to detect their optimality in malnourished children. Materials and methods: We evaluated 70 subjects split equally: malnourished children and controls. To estimate autonomic modulation, the heart rate was measured lacking any physical, sensory or pharmacologic stimuli. In the time series attained, Approximate Entropy was computed for tolerance (0.1→0.5 in intervals of 0.1) and embedding dimension (1→5 in intervals of 1) and the statistical significances between the groups by their Cohen’s ds and Hedges’s gs were totalled. Results: The uppermost value of statistical significance accomplished for the effect sizes for any of the combinations was −0.2897 (Cohen’s ds) and −0.2865 (Hedges’s gs). This was achieved with embedding dimension = 5 and tolerance = 0.3. Conclusions: Approximate Entropy was able to identify a reduction in chaotic response via malnourished children. The best values of embedding dimension and tolerance of the Approximate Entropy to identify malnourished children were, respectively, embedding dimension = 5 and embedding tolerance = 0.3. Nevertheless, Approximate Entropy is still an unreliable mathematical marker to regulate this.


2020 ◽  
Vol 33 (10) ◽  
pp. 1299-1305
Author(s):  
Daniel Zamanfar ◽  
Mohsen Aarabi ◽  
Monireh Amini ◽  
Mahila Monajati

AbstractObjectivesType 1 diabetes is an autoimmune disease. Its most important immunologic markers are pancreatic beta-cell autoantibodies. This study aimed to determine diabetes mellitus antibodies frequency among children and adolescents with type 1 diabetes.MethodsThis descriptive study evaluated the frequency of four diabetes autoantibodies (glutamic acid decarboxylase 65 autoantibodies [GADA], islet cell autoantibodies [ICA], insulin autoantibodies [IAA], tyrosine phosphatase–like insulinoma antigen-2 antibodies [IA-2A]) and their serum level in children and adolescents diagnosed with type 1 diabetes mellitus at the diabetes department of Bou-Ali-Sina Hospital and Baghban Clinic, Sari, Iran, from March 2012 to March 2018. The relationship between the level of different antibodies and age, gender, and diabetes duration were determined. A two-sided p value less than 0.05 indicated statistical significance.ResultsOne hundred forty-two eligible patient records were screened. The average age at diabetes diagnosis was 4.2 ± 4.4 years. The median duration of diabetes was 34.0 (12.7–69.7) months. 53.5% of patients were female, and 81.7% of them had at least one positive autoantibody, and ICA in 66.2%, GADA in 56.3%, IA-2A in 40.1%, and IAA in 21.8% were positive. The type of the autoantibodies and their serum level was similar between females and males but there was a higher rate of positive autoantibodies in females. The level of IA-2A and ICA were in positive and weak correlation with age at diagnosis.ConclusionsMore than 80% of pediatric and adolescent patients with type 1 diabetes were autoantibody-positive. ICA and GADA were the most frequently detected autoantibodies. The presence of antibodies was significantly higher in females.


2006 ◽  
Vol 7 (1) ◽  
pp. 45-50 ◽  
Author(s):  
Firat Kardelen ◽  
Gayaz Akcurin ◽  
Halil Ertug ◽  
Sema Akcurin ◽  
Iffet Bircan

Open Medicine ◽  
2009 ◽  
Vol 4 (4) ◽  
pp. 415-422
Author(s):  
Kamile Gul ◽  
Ihsan Ustun ◽  
Yusuf Aydin ◽  
Dilek Berker ◽  
Halil Erol ◽  
...  

AbstractThe aim of the study was to determine the frequency and titers of anti-thyroid peroxidase (Anti-TPO), anti-thyroglobulin (Anti-TG), and anti-glutamic acid decarboxylase (Anti-GAD) antibodies in Turkish patients with type 1 diabetes mellitus (DM), and to compare the frequency of anti-TPO and anti-TG titers in the presence or absence of anti-GAD. A total of 104 patients including 56 males and 48 females with type 1 DM and their age-, gender-, and body mass index-matched control group, including 31 males and 27 females, 58 cases in total with an age range of 15-50 years, were recruited into this study. In patients with type 1 DM, positive anti-GAD was detected in 30.8% (n=32). In patients with positive anti-GAD, rate of positive anti-TPO was 37.5%; however, in patients with negative anti-GAD, the rate of positive anti-TPO was 9.7% and the difference was statistically significant (p=0.001). In patients with positive anti-GAD, the rate of positive anti-TG was 18.8%. In patients with negative anti-GAD, the rate of positive anti-TG was 2.8%, and the difference between them was statistically significant (p=0.005). In patients with positive and negative anti-GAD, rates of both positive anti-TPO and anti-TG were 15.6% and 1.4%, respectively, with the difference showing statistical significance (p=0.004). Thyroid autoimmunity in type 1 DM patients with positive anti-GAD was apparently higher; therefore, these patients should be followed more frequently and carefully.


Author(s):  
Philip Wiffen ◽  
Marc Mitchell ◽  
Melanie Snelling ◽  
Nicola Stoner

Diabetes mellitus 444Monitoring and control 449Thyroid disorders 450Diabetes mellitus (DM) affects approximately 4% of the UK population. In 2009, Diabetes UK reported that 2.6 million people in the UK have diabetes.Type 2 diabetes accounts for 90% of all diabetes and is a result of insulin resistance and pancreatic β-cell dysfunction. Type 1 diabetes results from an absolute insulin deficiency secondary to autoimmune dysfunction....


2014 ◽  
Vol 32 (2) ◽  
pp. 279-285 ◽  
Author(s):  
Camila Balsamo Gardim ◽  
Bruno Affonso P. de Oliveira ◽  
Aline Fernanda B. Bernardo ◽  
Rayana Loch Gomes ◽  
Francis Lopes Pacagnelli ◽  
...  

OBJECTIVE:To gather current information about the effects of type 1 diabetes mellitus on children's cardiac autonomic behavior.DATA SOURCES: The search of articles was conducted on PubMed, Ibecs, Medline, Cochrane, Lilacs, SciELO and PEDro databases using the MeSH terms: "autonomic nervous system", "diabetes mellitus", "child", "type 1 diabetes mellitus", "sympathetic nervous system" and "parasympathetic nervous system", and their respective versions in Portuguese (DeCS). Articles published from January 2003 to February 2013 that enrolled children with 9-12 years old with type 1 diabetes mellitus were included in the review.DATA SYNTHESIS: The electronic search resulted in four articles that approached the heart rate variability in children with type 1 diabetes mellitus, showing that, in general, these children present decreased global heart rate variability and vagal activity. The practice of physical activity promoted benefits for these individuals.CONCLUSIONS: Children with type 1 diabetes mellitus present changes on autonomic modulation, indicating the need for early attention to avoid future complications in this group.


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