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Circ J. 2017 Sep 25;81(10):1447-1453. doi: 10.1253/circj.CJ-17-0192. Epub 2017 May 30.

Low Heart Rate Variability and Sympathetic Dominance Modifies the Association Between Insulin Resistance and Metabolic Syndrome - The Toon Health Study.

Author information

1
Department of Community Health Systems Nursing, Ehime University Graduate School of Medicine.
2
Department of Public Health, Juntendo University Graduate School of Medicine.
3
Department of Public Health, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences.
4
Center for Education and Educational Research, Faculty of Education, Ehime University.
5
Department of Diabetes and Molecular Genetics, Ehime University Graduate School of Medicine.

Abstract

BACKGROUND:

Insulin resistance is strongly associated with metabolic syndrome (MetS), but it is not known how this association is influenced by the autonomic nervous system, which controls insulin secretion.Methods and Results:The subjects were 2,016 individuals aged 30-79 years enrolled between 2009 and 2012. MetS was determined using the harmonized MetS definition, which includes waist circumference, blood pressure, triglycerides, high-density lipoprotein cholesterol, and fasting glucose. The homeostasis model assessment index for insulin resistance (HOMA-IR) and Gutt's insulin sensitivity index (ISI) were calculated based on fasting and 2 h-post-load glucose and insulin concentrations in a 75-g oral glucose tolerance test. The 5-min heart rate variability (HRV) was evaluated using time-domain indices of standard deviations of NN intervals (SDNN) and root mean square of successive differences (RMSSD). Power spectral analysis yielded frequency-domain measures for HRV: high-frequency (HF) power, low-frequency (LF) power and LF/HF. Multivariable adjusted logistic models showed that the highest quartiles for SDNN, RMSSD, LF, and HF vs. the lowest quartiles had a significant association with MetS. RMSSD, HF, and LF/HF remained significantly associated with MetS after adjustment for HOMA-IR (or ISI). Additive interactions between the levels of high LF/HF and high HOMA-IR (or low ISI) were significantly positive.

CONCLUSIONS:

Sympathovagal imbalance as evidenced by low HF and high LF/HF modified the association of insulin resistance or low insulin sensitivity with MetS.

KEYWORDS:

Epidemiology; Heart rate variability; Insulin sensitivity; Metabolic syndrome

PMID:
28566656
DOI:
10.1253/circj.CJ-17-0192
[Indexed for MEDLINE]
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