We examined the association between heart rate variability (HRV) and duration of type 2 diabetes among 155 female and 106 male subjects: mean±SD for duration=49.6±65.6 and 57.3±77.1 months, respectively, p=0.38. Among males, duration of diabetes was independently and inversely associated with vagal-heart rate modulation (high frequency (HF) power, 0.15—0.40 Hz, standardised ß = -0.32, p=0.001; root mean square of successive differences between R-R intervals, ß = -0.26, p=0.006) and total R-R variability (standard deviation of normal R-R intervals, ß = -0.36, p=0.001); but not among females (p≥0.80 for each HRV index). In contrast, HF was inversely associated with age of diabetes diagnosis (ß = -0.16, p=0.04) and 10-year absolute risk for coronary heart disease (ß = -0.16, p=0.04) among female subjects. Longitudinal research is needed to establish whether risk factors for early cardiac autonomic impairment differ among men and women with type 2 diabetes.
Wheeler SG, Ahroni JH, Boyko EJ ( 2002) Prospective study of autonomic neuropathy as a predictor of mortality in patients with diabetes. Diabetes Res Clin Pract58: 131-8.
2.
Vinik AI, Maser RE, Mitchell BD, Freeman, R. ( 2003) Diabetic autonomic neuropathy. Diabetes Care26: 1553-79.
3.
Witte DR, Tesfaye S., Chaturvedi N., et al. (2005) Risk factors for cardiac autonomic neuropathy in type 1 diabetes mellitus. Diabetologia48: 164-71.
4.
Valensi P., Paries J., Attali JR ( 2003) Cardiac autonomic neuropathy in diabetic patients: influence of diabetes duration, obesity, and microangiopathic complications - the French multicenter study. Metabolism52: 815-20.
5.
Stella P., Ellis D., Maser RE, Orchard TJ ( 2000) Cardiovascular autonomic neuropathy (expiration and inspiration ratio) in type 1 diabetes. Incidence and predictors. J Diabetes Complications14: 1-6.
6.
Aaberg ML, Burch DM, Hud ZR, Zacharias MP ( 2008) Gender differences in the onset of diabetic neuropathy . J Diabetes Complications22: 83-7.
Boulton AJ, Vinik AI, Arezzo JC, et al. (2005) Diabetic neuropathies: a statement by the American Diabetes Association. Diabetes Care28: 956-62.
9.
Liao D., Carnethon M., Evans GW, Cascio WE, Heiss G. ( 2002) Lower heart rate variability is associated with the development of coronary heart disease in individuals with diabetes: the atherosclerosis risk in communities (ARIC) study. Diabetes51: 3524-31.
10.
Takebayashi K. , Matsutomo R., Matsumoto S., et al. (2006) Relationships between heart rate variability and urinary albumin excretion in patients with type 2 diabetes. Am J Med Sci331: 72-8.
11.
Meyer C., Milat F., McGrath BP, et al. (2004) Vascular dysfunction and autonomic neuropathy in Type 2 diabetes. Diabet Med21: 746-51.
12.
Chessa M., Butera G., Lanza GA, et al. (2002) Role of heart rate variability in the early diagnosis of diabetic autonomic neuropathy in children. Herz27: 785-90.
13.
Jaffe RS, Aoki TT, Rohatsch PL, Disbrow EA, Fung DL ( 1995) Predicting cardiac autonomic neuropathy in type I (insulin-dependent) diabetes mellitus. Clin Auton Res5: 155-8.
14.
Kida Y. ( 2006) Autonomic neuropathy in type-2 diabetes, lessons from Okamoto Diabetes Study. Rinsho Shinkeigaku46: 871-3.
15.
O’Brien IA, O’Hare JP, Lewin IG, Corrall RJ (1986) The prevalence of autonomic neuropathy in insulin-dependent diabetes mellitus: a controlled study based on heart rate variability. Q J Med61: 957-67.
16.
Schroeder EB , Chambless LE, Liao D., et al. (2005) Diabetes, glucose, insulin, and heart rate variability: the Atherosclerosis Risk in Communities (ARIC) study. Diabetes Care28: 668-74.
17.
The Diabetes Control and Complications Trial Research Group (1998) The effect of intensive diabetes therapy on measures of autonomic nervous system function in the Diabetes Control and Complications Trial (DCCT). Diabetologia41: 416-23.
18.
Yamasaki Y. , Ueda N., Kishimoto M., et al. (1991) Assessment of early stage autonomic nerve dysfunction in diabetic subjects--application of power spectral analysis of heart rate variability. Diabetes Res17: 73-80.
19.
Stein PK, Kleiger RE, Rottman JN ( 1997) Differing effects of age on heart rate variability in men and women. Am J Cardiol80: 302-5.
20.
Umetani K., Singer DH, McCraty R., Atkinson M. ( 1998) Twenty-four hour time domain heart rate variability and heart rate: relations to age and gender over nine decades. J Am Coll Cardiol31: 593-601.
21.
Nolan RP, Upshur REG, Lynn H., et al. (2008) Therapeutic benefit of a standardized telehealth program in the community outreach heart health and risk reduction trial (COHRT): A randomized controlled trial. Eur J Cardiovasc Prevent Rehabil15: S32.
22.
Grundy SM, Pasternak R., Greenland P., Smith S., Jr., Fuster V. ( 1999) Assessment of cardiovascular risk by use of multiple-risk-factor assessment equations: a statement for healthcare professionals from the American Heart Association and the American College of Cardiology. Circulation100: 1481-92.
23.
Task Force of the European Society of Cardiology and the North American Society of Pacing and Electrophysiology ( 1996) Heart rate variability: standards of measurement, physiological interpretation and clinical use. Circulation93: 1043-65.
24.
Stein PK, Kleiger RE ( 1999) Insights from the study of heart rate variability . Annu Rev Med50: 249-61.
25.
Safar ME, Rizzoni D., Blacher J., Muiesan ML, Agabiti-Rosei E. ( 2008) Macro and microvasculature in hypertension: therapeutic aspects. J Hum Hypertens22: 590-5.
26.
Migliaro ER , Contreras P. (2003) Heart rate variability: short-term studies are as useful as holter to differentiate diabetic patients from healthy subjects. Ann Noninvasive Electrocardiol8: 313-20.
27.
Howorka K., Pumprla J., Schabmann A. ( 1998) Optimal parameters of short-term heart rate spectrogram for routine evaluation of diabetic cardiovascular autonomic neuropathy. J Auton Nerv Syst69: 164-72.
28.
Bigger JT, Fleiss JL, Rolnitzky LM, Steinman RC ( 1993) The ability of several short-term measures of RR variability to predict mortality after myocardial infarction. Circulation88: 927-34.
29.
Fei L., Copie X., Malik M., Camm AJ ( 1996) Short- and long-term assessment of heart rate variability for risk stratification after acute myocardial infarction. Am J Cardiol77: 681-4.
30.
Lopez-Lopez R., Huerta R., Malacara JM (1999) Age at menopause in women with type 2 diabetes mellitus. Menopause6: 174-8.
31.
Collins P., Rosano G., Casey C., et al. (2007) Management of cardiovascular risk in the peri-menopausal woman: a consensus statement of European cardiologists and gynaecologists. Eur Heart J28: 2028-40.
32.
Mercuro G., Podda A., Pitzalis L., et al. (2000) Evidence of a role of endogenous estrogen in the modulation of autonomic nervous system. Am J Cardiol85: 787-9, A9.
33.
Kimura T., Matsumoto T., Akiyoshi M., et al. (2006) Body fat and blood lipids in postmenopausal women are related to resting autonomic nervous system activity. Eur J Appl Physiol97: 542-7.
34.
Bertoni AG, Goff DC, Jr., D’Agostino RB, Jr., et al. (2006) Diabetic cardiomyopathy and subclinical cardiovascular disease: the Multi-Ethnic Study of Atherosclerosis (MESA). Diabetes Care29: 588-94.
35.
The Task Force on Diabetes and Cardiovascular Diseases of the European Society of Cardiology (ESC) and of the European Association for the Study of Diabetes (EASD) (2007) Guidelines on diabetes, pre-diabetes, and cardiovascular diseases: full text. Eur Heart J 9 Supplement C: C3-C74.
