Assessment of Cardiovascular Autonomic Function in Prediabetes and its Correlation with Metabolic and Inflammatory Markers
Issue: 4/2015
Author: Dimova, Rumyana B., Tankova, Tzvetalina Iv., Chakarova, Nevena Y., Groseva, Greta G., Dakovska, Lilia N.
Department of Diabetology, Clinical Centre of Endocrinology, Medical University, Sofia
Materials and methods: A total of 148 subjects – 91 females and 57 males (mean age 50,4±13,6 years, mean BMI 32,4±8,8 kg/m2) with pre diabetes were divided into 3 groups according to their glucose tolerance: 83 with impaired fasting glucose (IFG), 29 with impaired glucose tolerance (IGT) and 36 with IFG+IGT, into 5 groups according to BMI: 15 normal weight, 43 overweight, 48 obesity class I, 25 class II, and 17 class III and into 2 groups according to the presence of Metabolic syndrome (MetS) – 118 with MetS and 30 controls were enrolled in a cross-sectional study. Glucose tolerance was studied during OGTT applying 2006 WHO criteria. Anthropometric indices, blood pressure, serum lipids and hsCRP were measured. Body composition was estimated by impedance analysis (InBody 720). CAF was assessed by ANX-3.0 using frequency-domain analysis during standard clinical tests – deep breathing, Valsalva and standing from a seated position. Statistical analysis was performed using SPSS v.20.0.
Results: There was no significant difference in both sympathetic nervous system (SNS) and parasympathetic nervous system (PSNS) activity between the groups according to their glucose tolerance. A trend toward decreased PSNS function during deep breathing with the progression of obesity stage was observed (P=0,039). PSNS tone during deep breathing was diminished in the group with MetS as compared to controls (P=0,031) as well. A moderate to strong negative correlation between SNS and PSNS activity and age, visceral fat area, HbA1c, and glycemia was established. No significant correlation between autonomic tone and hsCRP was found.
Conclusion: Obesity and the presence of MetS might be associated with PSNS function deterioration in prediabetes. Central obesity, age, HbA1c, and glycemia significantly influence CAF alterations in prediabetes.
