Abstract
References
- Fisher VL, Tahrani AA. Cardiac autonomic neuropathy in patients with diabetes mellitus: current perspectives. Diabetes Metab Syndr Obes 2017;10:419-34. doi:10.2147/DMSO. S129797
- Vinik AI, Ziegler D. Diabetic cardiovascular autonomic neuropathy. Circulation 2007;115:387-97. doi:10.1161/ CIRCULATIONAHA.106.634949
- Wu L, Jiang Z, Li C, Shu M. Prediction of heart rate variability on cardiac sudden death in heart failure patients: a systematic review. Int J Cardiol 2014;174:857-60. doi:10.1016/j. ijcard.2014.04.176
- Almeida-Santos MA, Barreto-Filho JA, Oliveira JL, Reis FP, da Cunha Oliveira CC, Sousa AC. Aging, heart rate variability and patterns of autonomic regulation of the heart. Arch Gerontol Geriatr 2016;63:1-8. doi:10.1016/j.archger.2015.11.011
- Greiser KH, Kluttig A, Schumann B, et al. Cardiovascular diseases, risk factors and short-term heart rate variability in an elderly general population: the CARLA study 2002-2006. Eur J Epidemiol 2009;24:123-42. doi:10.1007/s10654.009.9317-z
- Chrysohoou C, Skoumas J, Oikonomou E, et al. Aortic artery distensibility shows inverse correlation with heart rate variability in elderly non-hypertensive, cardiovascular diseasefree individuals: the Ikaria Study. Heart Vessels 2013;28:467-2. doi:10.1007/s00380.012.0267-0
- Assoumou HG, Pichot V, Barthelemy JC, et al. Metabolic syndrome and short-term and long-term heart rate variability in elderly free of clinical cardiovascular disease: the PROOF study. Rejuvenation Res 2010;13:653-63. doi:10.1089/ rej.2010.1019
- Cha SA, Park YM, Yun JS, et al. Time – and frequency-domain measures of heart rate variability predict cardiovascular outcome in patients with type 2 diabetes. Diabetes Res Clin Pract 2018;143:159-69. doi:10.1016/j.diabres.2018.07.001
- May O, Arildsen H. Long-term predictive power of heart rate variability on all-cause mortality in the diabetic population. Acta Diabetologica 2011;48:55-9. doi:10.1007/ s00592.010.0222-4
- American Diabetes Association 2. Classification and diagnosis of diabetes: standards of medical care in diabetes-2021. Diabetes Care 2021;44 (Suppl 1):S15–S33. doi:10.2337/ dc21-S002
- Malik M, Bigger JT, Camm AJ, et al. Heart rate variability: standards of measurement, physiological interpretation, and clinical use. Eur Heart J 1996;17:354-81. doi:10.1093/ oxfordjournals.eurheartj.a014868
- Kudat H, Akkaya V, Sozen AB, et al. Heart rate variability in diabetes patients. J Int Med Res 2006;34:291-6. doi:10.1177/1 47.323.000603400308
- Schroeder EB, Chambless LE, Liao D, et al. Diabetes, glucose, insulin, and heart rate variability: the Atherosclerosis Risk in Communities (ARIC) study. Diabetes Care 2005;28:668-74. doi:10.2337/diacare.28.3.668
- Cardoso CR, Moraes RA, Leite NC, Salles GF. Relationships between reduced heart rate variability and pre-clinical cardiovascular disease in patients with type 2 diabetes. Diabetes Res Clin Pract 2014;106:110-7. doi:10.1016/j. diabres.2014.07.005
- Nicholls SJ, Tuzcu EM, Sipahi I, et al. Statins, highdensity lipoprotein cholesterol, and regression of coronary atherosclerosis. JAMA 2007;297:499-508. doi:10.1001/ jama.297.5.499
- Jensen-Urstad M, Jensen-Urstad K, Ericson M, Johansson J. Heart rate variability is related to leucocyte count in men and to blood lipoproteins in women in a healthy population of 35-year-old subjects. J Intern Med 1998;243:33-40. doi:10.1046/joim.1998.243.1.33
- Sajadieh A, Nielsen OW, Rasmussen V, Hein HO, Abedini S, Hansen JF. Increased heart rate and reduced heart-rate variability are associated with subclinical inflammation in middle-aged and elderly subjects with no apparent heart disease. Eur Heart J 2004;25:363-70. doi:10.1016/j. ehj.2003.12.003
- Aeschbacher S, Schoen T, Dörig L, et al. Heart rate, heart rate variability and inflammatory biomarkers among young and healthy adults. Ann Med 2017;49:32-41. doi:10.1080/07853.8 90.2016.1226512
- Vinik AI, Erbas T, Casellini CM. Diabetic cardiac autonomic neuropathy, inflammation and cardiovascular disease. J Diabetes Investig 2013;4:4-18.: doi: 10.1111/jdi.12042.
Abstract
Objective: Cardiac autonomic neuropathy (CAN) is a prevalent complication of type 2 diabetes mellitus (DM) and is associated with
elevated cardiovascular risk. The objective of this study was to evaluate changes in heart rate variability (HRV) in elderly patients with
type 2 DM and to investigate its relationship with laboratory findings.
Patients and Methods: The present retrospective study comprised 182 subjects aged ≥65 years who underwent 24-hour Holter ECG
monitoring. Patients were divided into two groups: a DM group (n=72) and a control group (n=110). HRV parameters in both time
and frequency domains were analyzed, and their correlations with laboratory markers were evaluated.
Results: Heart rate variability parameters, including standard deviation of SDNN (p=0.004), SDANN (p=0.008) and SDNN index
(p=0.015), were found to be significantly lower in DM. Furthermore, a decline in frequency domain parameters, including POWER
(p=0.004), VLF (p=0.006), LF (p =0.007) and HF (p=0.049), was observed. In addition, a negative correlation was identified between
HRV and inflammatory markers, such as white blood cell (WBC) count (p <0.001).
Conclusion: Reduced HRV in elderly diabetic patients suggests autonomic dysfunction and increased cardiovascular risk. The inverse
correlation between HRV and inflammatory markers highlights the potential role of systemic inflammation in autonomic impairment.
Keywords
Heart rate variability Diabetes mellitus Diabetic neuropathies Aged Heart disease risk factors Autonomic nervous system
References
- Fisher VL, Tahrani AA. Cardiac autonomic neuropathy in patients with diabetes mellitus: current perspectives. Diabetes Metab Syndr Obes 2017;10:419-34. doi:10.2147/DMSO. S129797
- Vinik AI, Ziegler D. Diabetic cardiovascular autonomic neuropathy. Circulation 2007;115:387-97. doi:10.1161/ CIRCULATIONAHA.106.634949
- Wu L, Jiang Z, Li C, Shu M. Prediction of heart rate variability on cardiac sudden death in heart failure patients: a systematic review. Int J Cardiol 2014;174:857-60. doi:10.1016/j. ijcard.2014.04.176
- Almeida-Santos MA, Barreto-Filho JA, Oliveira JL, Reis FP, da Cunha Oliveira CC, Sousa AC. Aging, heart rate variability and patterns of autonomic regulation of the heart. Arch Gerontol Geriatr 2016;63:1-8. doi:10.1016/j.archger.2015.11.011
- Greiser KH, Kluttig A, Schumann B, et al. Cardiovascular diseases, risk factors and short-term heart rate variability in an elderly general population: the CARLA study 2002-2006. Eur J Epidemiol 2009;24:123-42. doi:10.1007/s10654.009.9317-z
- Chrysohoou C, Skoumas J, Oikonomou E, et al. Aortic artery distensibility shows inverse correlation with heart rate variability in elderly non-hypertensive, cardiovascular diseasefree individuals: the Ikaria Study. Heart Vessels 2013;28:467-2. doi:10.1007/s00380.012.0267-0
- Assoumou HG, Pichot V, Barthelemy JC, et al. Metabolic syndrome and short-term and long-term heart rate variability in elderly free of clinical cardiovascular disease: the PROOF study. Rejuvenation Res 2010;13:653-63. doi:10.1089/ rej.2010.1019
- Cha SA, Park YM, Yun JS, et al. Time – and frequency-domain measures of heart rate variability predict cardiovascular outcome in patients with type 2 diabetes. Diabetes Res Clin Pract 2018;143:159-69. doi:10.1016/j.diabres.2018.07.001
- May O, Arildsen H. Long-term predictive power of heart rate variability on all-cause mortality in the diabetic population. Acta Diabetologica 2011;48:55-9. doi:10.1007/ s00592.010.0222-4
- American Diabetes Association 2. Classification and diagnosis of diabetes: standards of medical care in diabetes-2021. Diabetes Care 2021;44 (Suppl 1):S15–S33. doi:10.2337/ dc21-S002
- Malik M, Bigger JT, Camm AJ, et al. Heart rate variability: standards of measurement, physiological interpretation, and clinical use. Eur Heart J 1996;17:354-81. doi:10.1093/ oxfordjournals.eurheartj.a014868
- Kudat H, Akkaya V, Sozen AB, et al. Heart rate variability in diabetes patients. J Int Med Res 2006;34:291-6. doi:10.1177/1 47.323.000603400308
- Schroeder EB, Chambless LE, Liao D, et al. Diabetes, glucose, insulin, and heart rate variability: the Atherosclerosis Risk in Communities (ARIC) study. Diabetes Care 2005;28:668-74. doi:10.2337/diacare.28.3.668
- Cardoso CR, Moraes RA, Leite NC, Salles GF. Relationships between reduced heart rate variability and pre-clinical cardiovascular disease in patients with type 2 diabetes. Diabetes Res Clin Pract 2014;106:110-7. doi:10.1016/j. diabres.2014.07.005
- Nicholls SJ, Tuzcu EM, Sipahi I, et al. Statins, highdensity lipoprotein cholesterol, and regression of coronary atherosclerosis. JAMA 2007;297:499-508. doi:10.1001/ jama.297.5.499
- Jensen-Urstad M, Jensen-Urstad K, Ericson M, Johansson J. Heart rate variability is related to leucocyte count in men and to blood lipoproteins in women in a healthy population of 35-year-old subjects. J Intern Med 1998;243:33-40. doi:10.1046/joim.1998.243.1.33
- Sajadieh A, Nielsen OW, Rasmussen V, Hein HO, Abedini S, Hansen JF. Increased heart rate and reduced heart-rate variability are associated with subclinical inflammation in middle-aged and elderly subjects with no apparent heart disease. Eur Heart J 2004;25:363-70. doi:10.1016/j. ehj.2003.12.003
- Aeschbacher S, Schoen T, Dörig L, et al. Heart rate, heart rate variability and inflammatory biomarkers among young and healthy adults. Ann Med 2017;49:32-41. doi:10.1080/07853.8 90.2016.1226512
- Vinik AI, Erbas T, Casellini CM. Diabetic cardiac autonomic neuropathy, inflammation and cardiovascular disease. J Diabetes Investig 2013;4:4-18.: doi: 10.1111/jdi.12042.
Details
| Primary Language | English |
|---|---|
| Subjects | Surgery (Other) |
| Journal Section | Original Research |
| Authors | |
| Publication Date | May 30, 2025 |
| Submission Date | February 19, 2025 |
| Acceptance Date | March 24, 2025 |
| Published in Issue | Year 2025 Volume: 38 Issue: 2 |
