TY - JOUR
T1 - Altered Cardiac Autonomic Function May Precede Insulin Resistance in Metabolic Syndrome
AU - Chang, Chih Jen
AU - Yang, Yi Ching
AU - Lu, Feng Hwa
AU - Lin, Thy Sheng
AU - Chen, Jia Jin
AU - Yeh, Tzung Lieh
AU - Wu, Chih Hsing
AU - Wu, Jin Shang
N1 - Funding Information:
This study was supported by grants from the National Science Council , Taiwan, R.O.C. ( NSC 87-2314-B-006-084 , NSC 89-2314-B-006-043 , and NSC 92-2314-B-006-117 ).
PY - 2010/5
Y1 - 2010/5
N2 - Background: Previous studies on the change of cardiac autonomic function and insulin resistance in metabolic syndrome recruited subjects with cardiovascular-related disease and defined metabolic abnormality with a more severe cutoff. We explored the alteration of cardiac autonomic function and insulin resistance in predisease community dwellers with different numbers of metabolic abnormalities. Methods: A total of 1298 subjects were classified as none (n = 539), one (n = 378), 2 (n = 218), and 3 or more metabolic abnormalities (n = 154). Insulin resistance was calculated by homeostatic model assessment. Cardiac autonomic function included 5-minute standard deviation of R-R interval, low- and high-frequency power spectrum, and low-/high-frequency power spectrum ratio, the ratio of the longest R-R interval around the 30th beat and the shortest R-R interval around the 15th beat after standing, and the ratio of the longest expiratory R-R interval to the shortest inspiratory R-R interval during deep breathing. Results: Subjects with a single metabolic abnormality or more had a lower standard deviation of R-R interval and expiratory/inspiratory ratio than subjects without metabolic abnormality in multivariate analysis. Subjects with 3 or more metabolic abnormalities had a higher low-/high-frequency power spectrum ratio, but a lower high-frequency power. Insulin resistance was higher in groups with 2 metabolic abnormalities or more, but not in the group with one metabolic abnormality, than those without metabolic abnormality. Conclusions: Cardiac autonomic function altered in predisease subjects with one or more metabolic abnormalities, while insulin resistance existed in subjects with 2 or more metabolic abnormalities. Thus, autonomic function change may precede insulin resistance in the initiation of metabolic syndrome.
AB - Background: Previous studies on the change of cardiac autonomic function and insulin resistance in metabolic syndrome recruited subjects with cardiovascular-related disease and defined metabolic abnormality with a more severe cutoff. We explored the alteration of cardiac autonomic function and insulin resistance in predisease community dwellers with different numbers of metabolic abnormalities. Methods: A total of 1298 subjects were classified as none (n = 539), one (n = 378), 2 (n = 218), and 3 or more metabolic abnormalities (n = 154). Insulin resistance was calculated by homeostatic model assessment. Cardiac autonomic function included 5-minute standard deviation of R-R interval, low- and high-frequency power spectrum, and low-/high-frequency power spectrum ratio, the ratio of the longest R-R interval around the 30th beat and the shortest R-R interval around the 15th beat after standing, and the ratio of the longest expiratory R-R interval to the shortest inspiratory R-R interval during deep breathing. Results: Subjects with a single metabolic abnormality or more had a lower standard deviation of R-R interval and expiratory/inspiratory ratio than subjects without metabolic abnormality in multivariate analysis. Subjects with 3 or more metabolic abnormalities had a higher low-/high-frequency power spectrum ratio, but a lower high-frequency power. Insulin resistance was higher in groups with 2 metabolic abnormalities or more, but not in the group with one metabolic abnormality, than those without metabolic abnormality. Conclusions: Cardiac autonomic function altered in predisease subjects with one or more metabolic abnormalities, while insulin resistance existed in subjects with 2 or more metabolic abnormalities. Thus, autonomic function change may precede insulin resistance in the initiation of metabolic syndrome.
UR - http://www.scopus.com/inward/record.url?scp=77950596948&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=77950596948&partnerID=8YFLogxK
U2 - 10.1016/j.amjmed.2009.07.031
DO - 10.1016/j.amjmed.2009.07.031
M3 - Article
C2 - 20399320
AN - SCOPUS:77950596948
SN - 0002-9343
VL - 123
SP - 432
EP - 438
JO - American Journal of Medicine
JF - American Journal of Medicine
IS - 5
ER -