Association of glucose homeostasis measures with heart rate variability among Hispanic/Latino adults without diabetes: The Hispanic Community Health Study/Study of Latinos (HCHS/SOL)

Michelle L. Meyer; Nathan M. Gotman; Elsayed Z. Soliman; Eric A. Whitsel; Raanan Arens; Jianwen Cai; Martha L. Daviglus; Pablo Denes; Hector M. González; Juan Moreiras; Gregory A. Talavera; Gerardo Heiss

doi:10.1186/s12933-016-0364-y

Association of glucose homeostasis measures with heart rate variability among Hispanic/Latino adults without diabetes: The Hispanic Community Health Study/Study of Latinos (HCHS/SOL)

Michelle L. Meyer^*, Nathan M. Gotman, Elsayed Z. Soliman, Eric A. Whitsel, Raanan Arens, Jianwen Cai, Martha L. Daviglus, Pablo Denes, Hector M. González, Juan Moreiras, Gregory A. Talavera, Gerardo Heiss

^*Corresponding author for this work

Medicine, Cardiology Division

Research output: Contribution to journal › Article › peer-review

36 Scopus citations

Abstract

Background: Reduced heart rate variability (HRV), a measure of cardiac autonomic function, is associated with an increased risk of cardiovascular disease (CVD) and mortality. Glucose homeostasis measures are associated with reduced cardiac autonomic function among those with diabetes, but inconsistent associations have been reported among those without diabetes. This study aimed to examine the association of glucose homeostasis measures with cardiac autonomic function among diverse Hispanic/Latino adults without diabetes. Methods: The Hispanic community Health Study/Study of Latinos (HCHS/SOL; 2008-2011) used two-stage area probability sampling of households to enroll 16,415 self-identified Hispanics/Latinos aged 18-74years from four USA communities. Resting, standard 12-lead electrocardiogram recordings were used to estimate the following ultrashort-term measures of HRV: RR interval (RR), standard deviation of all normal to normal RR (SDNN) and root mean square of successive differences in RR intervals (RMSSD). Multivariable regression analysis was used to estimate associations between glucose homeostasis measures with HRV using data from 11,994 adults without diabetes (mean age 39years; 52% women). Results: Higher fasting glucose was associated with lower RR, SDNN, and RMSSD. Fasting insulin and the homeostasis model assessment of insulin resistance was negatively associated with RR, SDNN, and RMSSD, and the association was stronger among men compared with women. RMSSD was, on average, 26% lower in men with higher fasting insulin and 29% lower in men with lower insulin resistance; for women, the corresponding estimates were smaller at 4 and 9%, respectively. Higher glycated hemoglobin was associated with lower RR, SDNN, and RMSSD in those with abdominal adiposity, defined by sex-specific cut-points for waist circumference, after adjusting for demographics and medication use. There were no associations between glycated hemoglobin and HRV measures among those without abdominal adiposity. Conclusions: Impairment in glucose homeostasis was associated with lower HRV in Hispanic/Latino adults without diabetes, most prominently in men and individuals with abdominal adiposity. These results suggest that reduced cardiac autonomic function is associated with metabolic impairments before onset of overt diabetes in certain subgroups, offering clues for the pathophysiologic processes involved as well as opportunity for identification of those at high risk before autonomic control is manifestly impaired.

Original language	English (US)
Article number	45
Journal	Cardiovascular Diabetology
Volume	15
Issue number	1
DOIs	https://doi.org/10.1186/s12933-016-0364-y
State	Published - Mar 16 2016

Funding

Funding/Support: The Hispanic Community Health Study/Study of Latinos was carried out as a collaborative study supported by contracts from the National Heart, Lung, and Blood Institute (NHLBI) to the University of North Carolina (N01-HC65233), University of Miami (N01-HC65234), Albert Einstein College of Medicine (N01-HC65235), Northwestern University (N01-HC65236), and San Diego State University (N01-HC65237). The following institutes, centers, or offices contribute to the HCHS/SOL through a transfer of funds to the NHLBI: National Center on Minority Health and Health Disparities, the National Institute on Deafness and Other Communications Disorders, the National Institute of Dental and Craniofacial Research, the National Institute of Diabetes and Digestive and Kidney Diseases, the National Institute of Neurological Disorders and Stroke, and the Office of Dietary Supplements. MLM was supported by the NHLBI T32 training Grant HL-007055. HMG was supported by the National Institute of Aging (AG48642). The authors thank the staff and participants of HCHS/SOL for their important contributions. A complete list of staff and investigators was published in Ann Epidemiol. 2010;20:642-649 and is also available on the study website, http:// www.cscc.unc.edu/hchs/. Role of the Sponsor: The funding agency had a role in the design and conduct of the study; in the collection, analysis, and interpretation of the data; and in the review and approval of the manuscript.

Keywords

Autonomic function
Cohort study
Insulin resistance
Parasympathetic and sympathetic nervous system
Type 2 diabetes mellitus

ASJC Scopus subject areas

Cardiology and Cardiovascular Medicine
Internal Medicine
Endocrinology, Diabetes and Metabolism

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1186/s12933-016-0364-y

Cite this

Meyer, M. L., Gotman, N. M., Soliman, E. Z., Whitsel, E. A., Arens, R., Cai, J., Daviglus, M. L., Denes, P., González, H. M., Moreiras, J., Talavera, G. A., & Heiss, G. (2016). Association of glucose homeostasis measures with heart rate variability among Hispanic/Latino adults without diabetes: The Hispanic Community Health Study/Study of Latinos (HCHS/SOL). Cardiovascular Diabetology, 15(1), Article 45. https://doi.org/10.1186/s12933-016-0364-y

@article{a44d6466df084782a5d7ee9ed23f40f1,

title = "Association of glucose homeostasis measures with heart rate variability among Hispanic/Latino adults without diabetes: The Hispanic Community Health Study/Study of Latinos (HCHS/SOL)",

abstract = "Background: Reduced heart rate variability (HRV), a measure of cardiac autonomic function, is associated with an increased risk of cardiovascular disease (CVD) and mortality. Glucose homeostasis measures are associated with reduced cardiac autonomic function among those with diabetes, but inconsistent associations have been reported among those without diabetes. This study aimed to examine the association of glucose homeostasis measures with cardiac autonomic function among diverse Hispanic/Latino adults without diabetes. Methods: The Hispanic community Health Study/Study of Latinos (HCHS/SOL; 2008-2011) used two-stage area probability sampling of households to enroll 16,415 self-identified Hispanics/Latinos aged 18-74years from four USA communities. Resting, standard 12-lead electrocardiogram recordings were used to estimate the following ultrashort-term measures of HRV: RR interval (RR), standard deviation of all normal to normal RR (SDNN) and root mean square of successive differences in RR intervals (RMSSD). Multivariable regression analysis was used to estimate associations between glucose homeostasis measures with HRV using data from 11,994 adults without diabetes (mean age 39years; 52% women). Results: Higher fasting glucose was associated with lower RR, SDNN, and RMSSD. Fasting insulin and the homeostasis model assessment of insulin resistance was negatively associated with RR, SDNN, and RMSSD, and the association was stronger among men compared with women. RMSSD was, on average, 26% lower in men with higher fasting insulin and 29% lower in men with lower insulin resistance; for women, the corresponding estimates were smaller at 4 and 9%, respectively. Higher glycated hemoglobin was associated with lower RR, SDNN, and RMSSD in those with abdominal adiposity, defined by sex-specific cut-points for waist circumference, after adjusting for demographics and medication use. There were no associations between glycated hemoglobin and HRV measures among those without abdominal adiposity. Conclusions: Impairment in glucose homeostasis was associated with lower HRV in Hispanic/Latino adults without diabetes, most prominently in men and individuals with abdominal adiposity. These results suggest that reduced cardiac autonomic function is associated with metabolic impairments before onset of overt diabetes in certain subgroups, offering clues for the pathophysiologic processes involved as well as opportunity for identification of those at high risk before autonomic control is manifestly impaired.",

keywords = "Autonomic function, Cohort study, Insulin resistance, Parasympathetic and sympathetic nervous system, Type 2 diabetes mellitus",

author = "Meyer, {Michelle L.} and Gotman, {Nathan M.} and Soliman, {Elsayed Z.} and Whitsel, {Eric A.} and Raanan Arens and Jianwen Cai and Daviglus, {Martha L.} and Pablo Denes and Gonz{\'a}lez, {Hector M.} and Juan Moreiras and Talavera, {Gregory A.} and Gerardo Heiss",

note = "Publisher Copyright: {\textcopyright} 2016 Meyer et al.",

year = "2016",

month = mar,

day = "16",

doi = "10.1186/s12933-016-0364-y",

language = "English (US)",

volume = "15",

journal = "Cardiovascular Diabetology",

issn = "1475-2840",

publisher = "BioMed Central",

number = "1",

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Meyer, ML, Gotman, NM, Soliman, EZ, Whitsel, EA, Arens, R, Cai, J, Daviglus, ML, Denes, P, González, HM, Moreiras, J, Talavera, GA & Heiss, G 2016, 'Association of glucose homeostasis measures with heart rate variability among Hispanic/Latino adults without diabetes: The Hispanic Community Health Study/Study of Latinos (HCHS/SOL)', Cardiovascular Diabetology, vol. 15, no. 1, 45. https://doi.org/10.1186/s12933-016-0364-y

Association of glucose homeostasis measures with heart rate variability among Hispanic/Latino adults without diabetes: The Hispanic Community Health Study/Study of Latinos (HCHS/SOL). / Meyer, Michelle L.; Gotman, Nathan M.; Soliman, Elsayed Z. et al.
In: Cardiovascular Diabetology, Vol. 15, No. 1, 45, 16.03.2016.

Research output: Contribution to journal › Article › peer-review

TY - JOUR

T1 - Association of glucose homeostasis measures with heart rate variability among Hispanic/Latino adults without diabetes

T2 - The Hispanic Community Health Study/Study of Latinos (HCHS/SOL)

AU - Meyer, Michelle L.

AU - Gotman, Nathan M.

AU - Soliman, Elsayed Z.

AU - Whitsel, Eric A.

AU - Arens, Raanan

AU - Cai, Jianwen

AU - Daviglus, Martha L.

AU - Denes, Pablo

AU - González, Hector M.

AU - Moreiras, Juan

AU - Talavera, Gregory A.

AU - Heiss, Gerardo

PY - 2016/3/16

Y1 - 2016/3/16

N2 - Background: Reduced heart rate variability (HRV), a measure of cardiac autonomic function, is associated with an increased risk of cardiovascular disease (CVD) and mortality. Glucose homeostasis measures are associated with reduced cardiac autonomic function among those with diabetes, but inconsistent associations have been reported among those without diabetes. This study aimed to examine the association of glucose homeostasis measures with cardiac autonomic function among diverse Hispanic/Latino adults without diabetes. Methods: The Hispanic community Health Study/Study of Latinos (HCHS/SOL; 2008-2011) used two-stage area probability sampling of households to enroll 16,415 self-identified Hispanics/Latinos aged 18-74years from four USA communities. Resting, standard 12-lead electrocardiogram recordings were used to estimate the following ultrashort-term measures of HRV: RR interval (RR), standard deviation of all normal to normal RR (SDNN) and root mean square of successive differences in RR intervals (RMSSD). Multivariable regression analysis was used to estimate associations between glucose homeostasis measures with HRV using data from 11,994 adults without diabetes (mean age 39years; 52% women). Results: Higher fasting glucose was associated with lower RR, SDNN, and RMSSD. Fasting insulin and the homeostasis model assessment of insulin resistance was negatively associated with RR, SDNN, and RMSSD, and the association was stronger among men compared with women. RMSSD was, on average, 26% lower in men with higher fasting insulin and 29% lower in men with lower insulin resistance; for women, the corresponding estimates were smaller at 4 and 9%, respectively. Higher glycated hemoglobin was associated with lower RR, SDNN, and RMSSD in those with abdominal adiposity, defined by sex-specific cut-points for waist circumference, after adjusting for demographics and medication use. There were no associations between glycated hemoglobin and HRV measures among those without abdominal adiposity. Conclusions: Impairment in glucose homeostasis was associated with lower HRV in Hispanic/Latino adults without diabetes, most prominently in men and individuals with abdominal adiposity. These results suggest that reduced cardiac autonomic function is associated with metabolic impairments before onset of overt diabetes in certain subgroups, offering clues for the pathophysiologic processes involved as well as opportunity for identification of those at high risk before autonomic control is manifestly impaired.

AB - Background: Reduced heart rate variability (HRV), a measure of cardiac autonomic function, is associated with an increased risk of cardiovascular disease (CVD) and mortality. Glucose homeostasis measures are associated with reduced cardiac autonomic function among those with diabetes, but inconsistent associations have been reported among those without diabetes. This study aimed to examine the association of glucose homeostasis measures with cardiac autonomic function among diverse Hispanic/Latino adults without diabetes. Methods: The Hispanic community Health Study/Study of Latinos (HCHS/SOL; 2008-2011) used two-stage area probability sampling of households to enroll 16,415 self-identified Hispanics/Latinos aged 18-74years from four USA communities. Resting, standard 12-lead electrocardiogram recordings were used to estimate the following ultrashort-term measures of HRV: RR interval (RR), standard deviation of all normal to normal RR (SDNN) and root mean square of successive differences in RR intervals (RMSSD). Multivariable regression analysis was used to estimate associations between glucose homeostasis measures with HRV using data from 11,994 adults without diabetes (mean age 39years; 52% women). Results: Higher fasting glucose was associated with lower RR, SDNN, and RMSSD. Fasting insulin and the homeostasis model assessment of insulin resistance was negatively associated with RR, SDNN, and RMSSD, and the association was stronger among men compared with women. RMSSD was, on average, 26% lower in men with higher fasting insulin and 29% lower in men with lower insulin resistance; for women, the corresponding estimates were smaller at 4 and 9%, respectively. Higher glycated hemoglobin was associated with lower RR, SDNN, and RMSSD in those with abdominal adiposity, defined by sex-specific cut-points for waist circumference, after adjusting for demographics and medication use. There were no associations between glycated hemoglobin and HRV measures among those without abdominal adiposity. Conclusions: Impairment in glucose homeostasis was associated with lower HRV in Hispanic/Latino adults without diabetes, most prominently in men and individuals with abdominal adiposity. These results suggest that reduced cardiac autonomic function is associated with metabolic impairments before onset of overt diabetes in certain subgroups, offering clues for the pathophysiologic processes involved as well as opportunity for identification of those at high risk before autonomic control is manifestly impaired.

KW - Autonomic function

KW - Cohort study

KW - Insulin resistance

KW - Parasympathetic and sympathetic nervous system

KW - Type 2 diabetes mellitus

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U2 - 10.1186/s12933-016-0364-y

DO - 10.1186/s12933-016-0364-y

M3 - Article

C2 - 26983644

AN - SCOPUS:84962159671

SN - 1475-2840

VL - 15

JO - Cardiovascular Diabetology

JF - Cardiovascular Diabetology

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M1 - 45

ER -

Association of glucose homeostasis measures with heart rate variability among Hispanic/Latino adults without diabetes: The Hispanic Community Health Study/Study of Latinos (HCHS/SOL)

Abstract

Funding

Keywords

ASJC Scopus subject areas

UN SDGs

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