Associations of age‐adjusted coefficient of variation of R‐R intervals with autonomic and peripheral nerve function in non‐elderly persons with diabetes

Abstract

Aims/IntroductionEarly diagnosis of diabetes‐associated cardiac autonomic neuropathy using the coefficient of variation of R‐R intervals (CVRR) may improve outcomes for individuals with diabetes. The present study examined the associations of decreased CVRR at rest and during deep breathing (DB) with other autonomic nerve function parameters.Materials and MethodsThe electronic records of 141 inpatients with diabetes (22–65 years) admitted to our hospital between March 2015 and March 2019 were analyzed retrospectively. After assessment by exclusion criteria, 51 inpatients were included. All inpatients were assessed for peripheral and autonomic nerve function, clinical characteristics, and physical abilities.ResultsInpatients with decreased CVRR at rest (n = 9 (17.6%)) and during DB (n = 12 (23.5%)) had a longer duration of known diabetes, a higher prevalence of diabetic retinopathy, lower body mass index (BMI), skeletal mass index (SMI), and knee extension strength, and a higher proportion of impaired standing balance. Decreased CVRR at rest was associated with a greater fall in diastolic BP from supine to standing, higher resting HR, longer QTc, longer time of voiding, and sensory symptoms.ConclusionsDecreased CVRR at rest and during deep breathing was associated with lower BMI, SMI, and knee strength and a higher proportion of impaired standing balance among non‐elderly inpatients with diabetes. Decreased CVRR at rest appeared more strongly associated with a greater orthostatic BP decline, higher resting heart rate, longer QTc, lower urinary tract dysfunction, and sensory symptoms than a decreased CVRR during deep breathing.

Advances in diagnostic methods for early‐stage diabetic polyneuropathy

“…Age‐adjusted CVRR might be a more perceptive indicator for autonomic neuropathy. Age‐adjusted CVRRs are calculated as follows: CVRR at rest 3.87–0.05 × age (years) and CVRR during deep breathing 8.55–0.09 × age (years) 11 . It is interesting that age‐adjusted CVRR at rest is more strongly associated with other autonomic parameters and sensory symptoms than CVRR during deep breathing.…”