Heart Rate Variability, Insulin Resistance, and Insulin Sensitivity in Japanese Adults: The Toon Health Study.
Heart Rate Variability, Insulin Resistance, and Insulin Sensitivity in Japanese Adults: The Toon Health Study.
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DOI：
10.2188/jea.je20140254
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发表时间：
2015
影响因子：
4.7
通讯作者：
Tanigawa T
中科院分区：
文献类型：
--
作者：
Saito I;Hitsumoto S;Maruyama K;Nishida W;Eguchi E;Kato T;Kawamura R;Takata Y;Onuma H;Osawa H;Tanigawa T
虽然心脏自主神经功能受损与高加索人2型糖尿病风险增加有关，但在亚洲人群中的证据有限。在2009年至2012年期间，Toon健康研究招募了1899名年龄在30-79岁之间的人，他们没有服用糖尿病药物。采用75克口服葡萄糖耐量试验诊断2型糖尿病，并测量空腹和2小时后血糖和胰岛素浓度。采用胰岛素抵抗稳态模型评价指数（HOMA-IR）和Gutt胰岛素敏感指数（ISI）进行评价。记录脉搏5 min，计算时域心率变异性（HRV）指标：正常-正常间期标准差（SDNN）和连续差值均方根（RMSSD）。功率谱分析提供了HRV的频域测量：高频（HF）功率、低频（LF）功率和LF：HF比。多因素Logistic回归分析显示，SDNN、RMSSD和HF降低，LF：HF比值升高与HOMA-IR升高和ISI降低显著相关。当按超重状态分层时，RMSSD、HF和LF：HF比值与ISI降低的相关性在非超重个体中也很明显。LF：HF比值与超重个体ISI下降之间的相互作用显著，非超重个体LF：HF比值最高四分位数ISI下降的比值比为2.09（95%置信区间，1.41-3.10）。HRV降低与胰岛素抵抗和胰岛素敏感性降低有关。ISI降低与副交感神经功能障碍有关，主要发生在非超重个体中。
Although impaired cardiac autonomic function is associated with an increased risk of type 2 diabetes in Caucasians, evidence in Asian populations with a lower body mass index is limited. Between 2009–2012, the Toon Health Study recruited 1899 individuals aged 30–79 years who were not taking medication for diabetes. A 75-g oral glucose tolerance test was used to diagnose type 2 diabetes, and fasting and 2-h-postload glucose and insulin concentrations were measured. We assessed the homeostasis model assessment index for insulin resistance (HOMA-IR) and Gutt’s insulin sensitivity index (ISI). Pulse was recorded for 5 min, and time-domain heart rate variability (HRV) indices were calculated: the standard deviation of normal-to-normal intervals (SDNN) and the root mean square of successive difference (RMSSD). Power spectral analysis provided frequency domain measures of HRV: high frequency (HF) power, low frequency (LF) power, and the LF:HF ratio. Multivariate-adjusted logistic regression models showed decreased SDNN, RMSSD, and HF, and increased LF:HF ratio were associated significantly with increased HOMA-IR and decreased ISI. When stratified by overweight status, the association of RMSSD, HF, and LF:HF ratio with decreased ISI was also apparent in non-overweight individuals. The interaction between LF:HF ratio and decreased ISI in overweight individuals was significant, with the odds ratio for decreased ISI in the highest quartile of LF:HF ratio in non-overweight individuals being 2.09 (95% confidence interval, 1.41–3.10). Reduced HRV was associated with insulin resistance and lower insulin sensitivity. Decreased ISI was linked with parasympathetic dysfunction, primarily in non-overweight individuals.