Negative Affect-Related Autonomic Arousal Mediates the Association Between Baroreflex Dysfunction and Insulin Resistance in Non-Diabetic Young Adults

Abstract

Abstract. Autonomic dysfunction, in particular under-regulation of heart rate (HR) by the baroreflex, is implicated in development of insulin resistance (IR). According to reactivity hypothesis, sympathetic response to stressors may be more sensitive at predicting IR than baroreceptor sensitivity (BRS), a baseline measure of baroreflex functioning. Using ecological momentary assessment (EMA) of negative affect coupled with minute-to-minute HR and heart-rate variability (HRV) monitoring, we examined whether negative affect (NA)-related autonomic arousal mediates the association of BRS with IR. At baseline, BRS was measured, and fasting serum glucose and insulin levels were collected from 178 young adults (18–39 years old), from which homeostasis model assessment of IR (HOMA-IR) and beta-cell functioning (HOMA %B) were derived. Participants subsequently underwent one day of Holter HR and HRV monitoring while reporting NA levels via EMA. Multilevel modeling was used to assess the associations of momentary NA with HR and low- (LF) and high-frequency (HF) HRV during the 5-minute intervals following each EMA reading. Structural equation modeling was then used to determine whether individual differences in these associations mediated the association of BRS with IR, measured by HOMA-IR, HOMA %B, and insulin levels. As predicted, BRS was negatively associated with the IR (β = −.17, p = .024). However, NA-related autonomic arousal mediated their association, accounting for 56% of the covariance between BRS and IR. Not only do these results provide support for reactivity hypothesis, they reveal a potential point of intervention in the treatment of affective dysregulation.

The association between self-reported stress and cardiovascular measures in daily life: A systematic review

“…Our screening results identified three different types of cardiovascular measures: blood pressure, heart rate, and heart rate variability. Blood pressure was assessed in 19 reports [37][38][39][40][41][42][43][44][45][46][47][48][49][50][51][52][53][54][55] (Table 2), heart rate in 21 studies [37-39, 42, 43, 45-47, 51, 53, 56-66] (Table 3), and heart rate variability in 12 studies [56,58,59,62,64,65,[67][68][69][70][71][72] (Table 4). Specifically, BP was measured as systolic (SBP) or diastolic (DBP) blood pressure, mean arterial pressure (MAP), or pulse pressure (PP).…”

“…Ten different devices were used to measure blood pressure, with the most common device being the Spacelabs model 90207 (N = 5; 31% for SBP and 22% for DBP) [39,40,42,50,53]. Fifteen different devices were used to measure heart rate, with the most common devices being a Holter device in four (19%) studies [56,58,62,74], Spacelabs model 90207 in three studies [39,42,53], and VU-AMS in two (10%) studies [64,65]. For heart rate variability, seven different devices were identified and the most used devices were either a Holter monitor [56,58,62] or a Movisens EcqMove [70][71][72] device in three studies each (25%).…”

Psychophysiology in the digital age

“…A similar pattern is observed for HRV, but with more variability: it is negatively associated with general negative affect (Bacon et al, 2004;Pieper et al, 2007;Conrad et al, 2008;Kimhy et al, 2010), and with negative affect with high arousal (Bacon et al, 2004;Pieper et al, 2007). When arousal is low, HRV has been negatively (Simon et al, 2021, Liu et al, 2022, positively (Kim et al, 2021), or not (Dennis et al, 2018;Määttänen et al, 2021) associated with negative affect. The overall reduction in HRV is also seen during general positive affect (Bacon et al, 2004;Conrad et al, 2008;Kennedy et al, 2015;Simon et al, 2021) and positive affect paired to high arousal (Gerteis & Schwerdtfeger, 2016).…”

“…Studies show that HR was positively associated with negative affect when arousal is high (Pieper et al, 2007;Pollard et al, 2007;Lumley et al, 2014;Kennedy et al, 2015;Ensari et al, 2020;Gordon & Mendes, 2021;Kim et al, 2021;Simon et al, 2021) or low (Kim et al, 2021;Simon et al, 2021;Liu et al, 2022). For general (i.e., not taking arousal levels into account) negative affect mixed results are found, with both positive (Pieper et al, 2007;Ilies et al, 2010), negative (Sloan et al, 1994), and non-significant relationships (Kamarck et al, 1998;Kimhy et al, 2010;Dennis et al, 2018;Määttänen et al, 2021) identified. Furthermore, HR is also positively associated with general positive affect (Ensari et al, 2020;Määttänen et al, 2021;Simon et al, 2021) and with positive affective states characterized by high arousal (Gordon & Mendes, 2021).…”