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Alterations in heart rate variability during everyday life are linked to insulin resistance. A role of dominating sympathetic over parasympathetic nerve activity?
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Clinical diabetology and metabolism.
Umea Univ Hosp, Dept Med, Umea, Sweden..
Umea Univ Hosp, Dept Biomed Engn & Informat, Umea, Sweden..
Orebro Univ Hosp, Dept Clin Physiol, Orebro, Sweden..
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2016 (English)In: Cardiovascular Diabetology, ISSN 1475-2840, E-ISSN 1475-2840, Vol. 15, 91Article in journal (Refereed) Published
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Text
Abstract [en]

Aims: To evaluate the role of the autonomic nervous system (ANS) in the development of insulin resistance (IR) and assess the relationship between IR and activity of ANS using power spectrum analysis of heart rate variability (HRV). Subjects and methods: Twenty-three healthy first-degree relatives of patients with type 2 diabetes (R) and 24 control subjects without family history of diabetes (C) group-matched for age, BMI and sex were included. Insulin sensitivity (M value) was assessed by hyperinsulinemic (56 mU/m(2)/min) euglycemic clamp. Activity of the ANS was assessed using power spectrum analysis of HRV in long-term recordings, i.e., 24-h ECG monitoring, and in short-term recordings during manoeuvres activating the ANS. Computed tomography was performed to estimate the amount and distribution of abdominal adipose tissue. Results: Insulin sensitivity (M value, mg/kg lbm/min) did not differ significantly between the R and C groups. Total spectral power (P-tot) and very low-frequency (P-VLF) power was lower in R than C during 24 h ECG-recordings (p = 0.02 and p = 0.03). The best fit multiple variable linear regression model (r(2) = 0.37, p < 0.001 for model) indicated that body composition (BMI) and long-term low to high frequency (LF/HF) power ratio (std beta = -0.46, p = 0.001 and std beta = -0.28, p = 0.003, respectively) were significantly and independently associated with the M value. Conclusion: Altered heart rate variability, assessed by power spectrum analysis, during everyday life is linked to insulin resistance. The data suggest that an increased ratio of sympathetic to parasympathetic nerve activity, occurring via both inherited and acquired mechanisms, could potentially contribute to the development of type 2 diabetes.

Place, publisher, year, edition, pages
2016. Vol. 15, 91
Keyword [en]
Heart rate variability, Spectral analysis, Autonomic nervous system, Insulin sensitivity, Type 2 diabetes
National Category
Endocrinology and Diabetes Cardiac and Cardiovascular Systems
Identifiers
URN: urn:nbn:se:uu:diva-299869DOI: 10.1186/s12933-016-0411-8ISI: 000378876100002PubMedID: 27352833OAI: oai:DiVA.org:uu-299869DiVA: diva2:950241
Funder
Swedish Society of MedicineSwedish Research Council, 14287Swedish Diabetes Association
Available from: 2016-07-28 Created: 2016-07-28 Last updated: 2017-11-28Bibliographically approved

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Svensson, Maria K.Kullberg, JoelJohansson, LarsEriksson, Jan W.

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