Heart rate variability and increased risk for developing type 2 diabetes mellitus

Biljana Penčić- Popović; Vera Ćelić; Zoran Ćosić; Milena Pavlović- Kleut; Zorica Čaparević; Nada Kostić; Branislav Milovanović; Aleksandra Šljivić; Biljana Stojčevski

doi:10.2298/2800

Biljana Penčić- Popović Clinical Hospital Center “Dr Dragiša Mišović-Dedinje”, Faculty of Medicine, University of Belgrade, Belgrade, Serbia
Vera Ćelić Clinical Hospital Center “Dr Dragiša Mišović-Dedinje”, Faculty of Medicine, University of Belgrade, Belgrade, Serbia
Zoran Ćosić Clinical Hospital Center “Dr Dragiša Mišović-Dedinje”, Faculty of Medicine, University of Belgrade, Belgrade, Serbia
Milena Pavlović- Kleut Clinical Hospital Center “Dr Dragiša Mišović-Dedinje”, Faculty of Medicine, University of Belgrade, Belgrade, Serbia
Zorica Čaparević Clinical Hospital Center “Dr Dragiša Mišović-Dedinje”, Faculty of Medicine, University of Belgrade, Belgrade, Serbia
Nada Kostić Clinical Hospital Center “Dr Dragiša Mišović-Dedinje”, Faculty of Medicine, University of Belgrade, Belgrade, Serbia
Branislav Milovanović Clinical Hospital Center “Bežanijska Kosa”, Faculty of Medicine, University of Belgrade, Belgrade, Serbia
Aleksandra Šljivić Clinical Hospital Center “Dr Dragiša Mišović-Dedinje”, Faculty of Medicine, University of Belgrade, Belgrade, Serbia
Biljana Stojčevski Clinical Hospital Center “Dr Dragiša Mišović-Dedinje”, Faculty of Medicine, University of Belgrade, Belgrade, Serbia

DOI: https://doi.org/10.2298/2800

Keywords: heart rate, electrocardiography, ambulatory, diabetes mellitus, type 2, risk factors, predictive value of tests,

Abstract

Background/Aim. To our knowledge there are no data about the relationship between elevated risk for developing type 2 diabetes mellitus (DM2) and altered cardiac autonomic function. The aim of this study was to evaluate the association between heart rate variability (HRV) and slightly increased risk for DM2. Methods. We evaluated 69 subjects (50.0 ± 14.4 years; 30 male) without DM2, coronary artery disease and arrhythmias. The subjects were divided into two groups according to the Finnish Diabetes Risk Score (FINDRISC): group I (n = 39) included subjects with 12 > FINDRISC ≥ 7; group II (n = 30) subjects with FINDRISC < 7. HRV was derived from 24-h electrocardiogram. We used time domain variables and frequency domain analysis performed over the entire 24-h period, during the day (06–22 h) and overnight (22–06 h). Results. Standard deviation of the average normal RR intervals was significantly lower in the group with increased risk for DM2 compared to the group II (127.1 ± 26.6 ms vs 149.6 ± 57.6 ms; p = 0.035). Other time domain measures were similar in both groups. The group I demonstrated significantly reduced frequency domain measures, total power – TP (7.2 ± 0.3 ln/ms² vs 7.3 ± 0.3 ln/ms²; p = 0.029), and low frequency – LF (5.9 ± 0.4 ln/ms² vs 6.3 ± 0.6 ln/ms²; p = 0.006), over entire 24 h, as well as TP (7.1 ± 0.3 ln/ms² vs 7.3 ± 0.3 ln/ms²; p = 0.004), very low frequency (6.2 ± 0.2 ln/ms² vs 6.3 ± 0.2 ln/ms²; p = 0.030), LF (5.9 ± 0.4 ln/ms² vs 6.2 ± 0.3 ln/ms²; p = 0.000) and high frequency (5.7 ± 0.4 ln/ms² vs 5.9 ± 0.4 ln/ms²; p = 0.011) during the daytime compared to the group II. Nocturnal frequency domain analysis was similar between the groups. The low diurnal frequency was independently related to elevated risk for diabetes mellitus (beta = -0,331; p = 0.006). Conclusion. The obtained results suggest that even slightly elevated risk for developing diabetes mellitus may be related to impaired HRV.

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