This Article Full Text Full Text (PDF) Submit a related Letter to the Editor View responses Purchase Article View Shopping Cart Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Copyright Permission Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Wu, J.-S. Articles by Chang, C.-J. Search for Related Content PubMed PubMed Citation Articles by Wu, J.-S. Articles by Chang, C.-J. Related Collections Cardiovascular Endocrinology Diabetes and Insulin

Epidemiological Evidence of Altered Cardiac Autonomic Function in Subjects with Impaired Glucose Tolerance But Not Isolated Impaired Fasting Glucose

Departments of Family Medicine (J.-S.W., Y.-C.Y., F.-H.L., C.-J.C.) and Neurology (T.-S.L.), College of Medicine; and Institute of Biomedical Engineering (J.-J.C.), Department of Family Medicine, National Cheng Kung University Hospital (J.-S.W., Y.-C.Y., Y.-H.H., F.-H.L., C.-H.W., C.-J.C.), National Cheng Kung University, 70441 Taiwan, Republic of China

Address all correspondence and requests for reprints to: Chih-Jen Chang, Department of Family Medicine, National Cheng Kung University Hospital, 138, Sheng Li Road, Tainan, 70441, Taiwan, Republic of China. E-mail: em75210{at}email.ncku.edu.tw.

Context: Autonomic dysfunction is present in diabetes mellitus (DM), but no study is available on alteration in cardiac autonomic function (CAF) across different glycemic statuses including normal glucose tolerance (NGT), isolated impaired fasting glucose (IFG), impaired glucose tolerance (IGT), and DM.

Objective: Our objective was to examine whether CAF is altered in subjects with IGT and isolated IFG.

Design and Setting: The study was a stratified systematic cluster sampling design within the general community.

Participants: A total of 1440 subjects were classified as NGT (n = 983), isolated IFG (n = 163), IGT (n = 188), and DM (n = 106).

Main Outcome Measure: CAF was determined by 1) standard deviation of normal-to-normal (SDNN) or RR interval, power spectrum in low and high frequency (LF, 0.04–0.15 Hz; HF, 0.15–0.40 Hz), and LF/HF ratio in supine position for 5 min; 2) ratio between 30th and 15th RR interval after standing from supine position (30/15 ratio); and 3) average heart rate change during breathing of six deep breaths for 1 min (HR_DB).

Results: Univariate analysis showed significant differences in SDNN, 30/15 ratio, HR_DB, HF power, and LF/HF ratio among subjects with NGT, isolated IFG, IGT, and DM. In multivariate analysis, none of the indices of CAF was related to isolated IFG in the reference group of NGT. IGT and DM were negatively associated with 30/15 ratio and HF power but positively associated with LF/HF ratio. In addition, DM was also related to a lower SDNN.

Conclusions: DM and IGT subjects had an impaired CAF independent of other cardiovascular risk factors. The risk of altered CAF is not apparent in subjects with isolated IFG.

This article has been cited by other articles:

				Z. T. Bloomgarden American College of Endocrinology Pre-Diabetes Consensus Conference: Part One Diabetes Care, October 1, 2008; 31(10): 2062 - 2069. [Full Text] [PDF]

eLetters: