Hyperglycemia: A determinant of cardiac autonomic dysfunction in youth with obesity across the spectrum of glycemic regulation.
Hyperglycemia: A determinant of cardiac autonomic dysfunction in youth with obesity across the spectrum of glycemic regulation.
复制标题
高血糖：肥胖青年心脏自主神经功能障碍的决定因素，涵盖整个血糖调节范围。
DOI：
10.1111/ijpo.13063
复制
发表时间：
2023
影响因子：
3.8
通讯作者：
Bacha,Fida
中科院分区：
文献类型：
--
作者：
El-Ayash,Heba;Puyau,Maurice;Bacha,Fida
ObjectivesTo characterize the determinants of heart rate variability (HRV) in youth with obesity across the glycemia spectrum.MethodsA total of 94 adolescents, 15 ± 2.1 years (21 with normal weight, 23 with overweight‐normal glucose tolerance, 26 with prediabetes and 24 with type 2 diabetes [T2D]) underwent an assessment of body composition (dual‐energy x‐ray absorptiometry), 2‐h oral glucose tolerance test with the calculation of indices of glycemia and insulin sensitivity (IS), inflammatory markers (high‐sensitivity C‐reactive protein [hs‐CRP] and tumour necrosis factor‐α [TNF‐α]), and HRV by peripheral arterial tonometry.ResultsThe HRV frequency‐domain index (low‐frequency to high‐frequency ratio [LF/HF]), an estimate of the ratio between sympathetic and parasympathetic activity, increased across the glycemic spectrum, and was highest in T2D compared with the other three groups (p= 0.004). LF/HF correlated with %body fat (r= 0.22,p= 0.04); fasting (r= 0.39,p< 0.001), 2‐h (r= 0.31,p= 0.004), and area under the curve glucose (r= 0.32,p= 0.003); hs‐CRP (r= 0.33,p= 0.002) and TNF‐α (r= 0.38,p= 0.006). In a linear regression model, fasting glucose (β= 0.39,p= 0.003) and hs‐CRP (β= 0.21,p= 0.09) contributed to the variance in Ln LF/HF independent of IS, %body fat, age, sex, race‐ethnicity and Tanner stage (R2= 0.23,p= 0.013).ConclusionsYouth with impaired glucose regulation have evidence of cardiac autonomic dysfunction with decreased HRV, and sympathetic overdrive (increased LF/HF). This dysfunction is mainly related to glycemia and systemic inflammation.
