Heart rate variability and the metabolic syndrome: a systematic review of the literature

Stuckey, Melanie I.; Tulppo, Mikko P.; Kiviniemi, Antti M.; Petrella, Robert J.

doi:10.1002/dmrr.2555

Cited by 90 publications

(94 citation statements)

References 37 publications

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“…Indeed, the i-IGT group somewhat differed from the other glucose intolerant groups inasmuch as it included a higher number of women and lower number of regular smokers, persons with the metabolic syndrome and those with previous hospitalisation due to myocardial infarction. For example, a recent meta-analysis reported that HRV is reduced in women with the metabolic syndrome compared with those without [42]. Taken together, we cannot rule out the possibility that these differences may have contributed to the relatively low percentage of abnormal HRV measures in the i-IGT group.…”

Section: Discussionmentioning

confidence: 79%

Increased prevalence of cardiac autonomic dysfunction at different degrees of glucose intolerance in the general population: the KORA S4 survey

Ziegler

Voss

Rathmann³

et al. 2015

Diabetologia

102

107

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Aims/hypothesis Cardiac autonomic nervous dysfunction (CAND) raises the risk of mortality, but the glycaemic threshold at which it develops is unclear. We aimed to determine the prevalence of, risk factors for and impact of CAND in glucose intolerance and diabetes. Methods Among 1,332 eligible participants aged 55-74 years in the population-based cross-sectional KORA S4 study, 130 had known diabetes mellitus (k-DM), and the remaining 1,202 underwent an OGTT. Heart rate variability (HRV) and QT variability were computed from supine 5 min ECGs. Results In all, 565 individuals had normal glucose tolerance (NGT), 336 had isolated impaired fasting glucose (i-IFG), 72 had isolated impaired glucose tolerance (i-IGT), 151 had combined IFG-IGT (IFG-IGT) and 78 had newly detected diabetes mellitus (n-DM). Adjusted normal HRV limits were defined in the NGT population (5th and 95th percentiles). Three HRV measures were more frequently abnormal in those with k-DM, n-DM, IFG-IGT and i-IFG than in those with NGT (p<0.05). The rates of CAND (≥2 of 4 HRV indices abnormal) were: NGT, 4.5%; i-IFG, 8.1%; i-IGT, 5.9%; IFG-IGT, 11.4%; n-DM, 11.7%; and k-DM, 17.5% (p<0.05 vs NGT, except for i-IGT). Reduced HRV was associated with cardiovascular risk factors used to construct a simple screening score for CAND. Mortality was higher in participants with reduced HRV (p<0.05 vs normal HRV). Conclusions/interpretation In the general population aged 55-74 years, the prevalence of CAND is increased not only in individuals with diabetes, but also in those with IFG-IGT and, to a lesser degree, in those with i-IFG. It is associated with mortality and modifiable cardiovascular risk factors which may be used to screen for diminished HRV in clinical practice.

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Section: Discussionmentioning

confidence: 79%

Increased prevalence of cardiac autonomic dysfunction at different degrees of glucose intolerance in the general population: the KORA S4 survey

Ziegler

Voss

Rathmann³

et al. 2015

Diabetologia

102

107

View full text Add to dashboard Cite

show abstract

“…While MetS is linked to increasing age, there is evidence to suggest that associations with job stress could be more prominent among younger employees [3,23,24]. In addition, there are established gender differences in work stress perception, in occupational trajectories, and in biological stress responses, and distinct analyses of gender would therefore seem appropriate [25,26].…”

Section: Introductionmentioning

confidence: 93%

Effort–reward imbalance is associated with the metabolic syndrome — Findings from the Mannheim Industrial Cohort Study (MICS)

Schmidt

Bosch

Jarczok

et al. 2015

International Journal of Cardiology

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“…Obesity alters autonomic nervous system (ANS) activity, and HRV generally diminishes with increasing waist circumference (3). The sympathetic nervous system is a key player linking the development and progression of cardiovascular disease with obesity (5).…”

mentioning

confidence: 99%

Effect of Low-Energy Diets Differing in Fiber, Red Meat, and Coffee Intake on Cardiac Autonomic Function in Obese Individuals With Type 2 Diabetes

et al. 2015

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OBJECTIVEThe autonomic nervous system (ANS) regulates both the cardiovascular system and energy balance and is disturbed in diabetes and obesity. The effect of different approaches of caloric restriction on ANS function has not been assessed in individuals with diabetes. Thus, we sought to determine whether low-energy diets differing in fiber, red meat, and coffee intake exert differential effects on cardiac autonomic function. RESEARCH DESIGN AND METHODSIn this randomized parallel-group pilot trial, obese patients with type 2 diabetes were randomly allocated to consume either a diet high in cereal fiber, free of red meat, and high in coffee (n = 13) or a diet low in fiber, high in red meat, and coffee free (n = 15) over 8 weeks. Eight measures of heart rate variability (HRV) indicating vagal and/or sympathetic modulation over 3 h and inflammatory markers were determined during a hyperinsulinemic-euglycemic clamp. RESULTSAfter 8 weeks, both dietary interventions resulted in a mean weight loss of 5-6 kg, a mean decline in heart rate of 4-6 bpm, and improvement in vagally mediated HRV. However, the changes in HRV parameters from baseline to 8 weeks did not differ between the groups. In the entire study cohort, incremental HRV from baseline to 8 weeks was associated with enhanced oxidative glucose utilization (P < 0.05), but not with insulin sensitivity and inflammatory markers. CONCLUSIONSIn obese patients with type 2 diabetes, energy restriction per se over 8 weeks contributed to improved cardiac vagal function in relation to improved oxidative glucose utilization. This preliminary finding should be verified in a confirmatory trial. Cardiovascular autonomic neuropathy detected by reduced heart rate variability (HRV) affects ;20% of individuals with diabetes (1). HRV measures the fluctuations in autonomic inputs to the heart (2) and is considered a prognostic marker in various conditions including diabetes (1), metabolic syndrome (3), and cardiovascular disease (2). Spectral analysis of HRV indicates that efferent vagal activity is a major contributor to the high-frequency component, while the low-frequency component

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Heart rate variability and the metabolic syndrome: a systematic review of the literature

Abstract: Heart rate variability is altered differently in men and women with metabolic syndrome. Future studies should follow consistent heart rate variability analysis protocols and metabolic syndrome definitions and include more comprehensive analyses to investigate potential mechanisms.

Cited by 90 publications

References 37 publications

Increased prevalence of cardiac autonomic dysfunction at different degrees of glucose intolerance in the general population: the KORA S4 survey

Increased prevalence of cardiac autonomic dysfunction at different degrees of glucose intolerance in the general population: the KORA S4 survey

Effort–reward imbalance is associated with the metabolic syndrome — Findings from the Mannheim Industrial Cohort Study (MICS)

Effect of Low-Energy Diets Differing in Fiber, Red Meat, and Coffee Intake on Cardiac Autonomic Function in Obese Individuals With Type 2 Diabetes

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