Heart rate variability in different sleep stages is associated with metabolic function and glycemic control in type 2 diabetes mellitus

Introduction: Autonomic nervous system (ANS) plays an important role in the exchange of metabolic information between organs and regulation on peripheral metabolism with obvious circadian rhythm in a healthy state. Sleep, a vital brain phenomenon, significantly affects both ANS and metabolic functio...

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Main Authors: Wenquan Cheng, Hongsen Chen, Leirong Tian, Zhimin Ma, Xingran Cui
Format: Article
Language:English
Published: Frontiers Media S.A. 2023-04-01
Series:Frontiers in Physiology
Subjects:
Online Access:https://www.frontiersin.org/articles/10.3389/fphys.2023.1157270/full
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author Wenquan Cheng
Hongsen Chen
Leirong Tian
Zhimin Ma
Xingran Cui
Xingran Cui
author_facet Wenquan Cheng
Hongsen Chen
Leirong Tian
Zhimin Ma
Xingran Cui
Xingran Cui
author_sort Wenquan Cheng
collection DOAJ
description Introduction: Autonomic nervous system (ANS) plays an important role in the exchange of metabolic information between organs and regulation on peripheral metabolism with obvious circadian rhythm in a healthy state. Sleep, a vital brain phenomenon, significantly affects both ANS and metabolic function.Objectives: This study investigated the relationships among sleep, ANS and metabolic function in type 2 diabetes mellitus (T2DM), to support the evaluation of ANS function through heart rate variability (HRV) metrics, and the determination of the correlated underlying autonomic pathways, and help optimize the early prevention, post-diagnosis and management of T2DM and its complications.Materials and methods: A total of 64 volunteered inpatients with T2DM took part in this study. 24-h electrocardiogram (ECG), clinical indicators of metabolic function, sleep quality and sleep staging results of T2DM patients were monitored.Results: The associations between sleep quality, 24-h/awake/sleep/sleep staging HRV and clinical indicators of metabolic function were analyzed. Significant correlations were found between sleep quality and metabolic function (|r| = 0.386 ± 0.062, p < 0.05); HRV derived ANS function showed strengthened correlations with metabolic function during sleep period (|r| = 0.474 ± 0.100, p < 0.05); HRV metrics during sleep stages coupled more tightly with clinical indicators of metabolic function [in unstable sleep: |r| = 0.453 ± 0.095, p < 0.05; in stable sleep: |r| = 0.463 ± 0.100, p < 0.05; in rapid eye movement (REM) sleep: |r| = 0.453 ± 0.082, p < 0.05], and showed significant associations with glycemic control in non-linear analysis [fasting blood glucose within 24 h of admission (admission FBG), |r| = 0.420 ± 0.064, p < 0.05; glycated hemoglobin (HbA1c), |r| = 0.417 ± 0.016, p < 0.05].Conclusions: HRV metrics during sleep period play more distinct role than during awake period in investigating ANS dysfunction and metabolism in T2DM patients, and sleep rhythm based HRV analysis should perform better in ANS and metabolic function assessment, especially for glycemic control in non-linear analysis among T2DM patients.
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spelling doaj.art-bfcfbdc73fb24116949c33d5d503aba32023-04-14T05:40:16ZengFrontiers Media S.A.Frontiers in Physiology1664-042X2023-04-011410.3389/fphys.2023.11572701157270Heart rate variability in different sleep stages is associated with metabolic function and glycemic control in type 2 diabetes mellitusWenquan Cheng0Hongsen Chen1Leirong Tian2Zhimin Ma3Xingran Cui4Xingran Cui5State Key Laboratory of Bioelectronics, School of Biological Science and Medical Engineering, Southeast University, Nanjing, ChinaState Key Laboratory of Bioelectronics, School of Biological Science and Medical Engineering, Southeast University, Nanjing, ChinaState Key Laboratory of Bioelectronics, School of Biological Science and Medical Engineering, Southeast University, Nanjing, ChinaEndocrinology Department, Suzhou Science and Technology Town Hospital, Suzhou, ChinaState Key Laboratory of Bioelectronics, School of Biological Science and Medical Engineering, Southeast University, Nanjing, ChinaInstitute of Medical Devices (Suzhou), Southeast University, Suzhou, ChinaIntroduction: Autonomic nervous system (ANS) plays an important role in the exchange of metabolic information between organs and regulation on peripheral metabolism with obvious circadian rhythm in a healthy state. Sleep, a vital brain phenomenon, significantly affects both ANS and metabolic function.Objectives: This study investigated the relationships among sleep, ANS and metabolic function in type 2 diabetes mellitus (T2DM), to support the evaluation of ANS function through heart rate variability (HRV) metrics, and the determination of the correlated underlying autonomic pathways, and help optimize the early prevention, post-diagnosis and management of T2DM and its complications.Materials and methods: A total of 64 volunteered inpatients with T2DM took part in this study. 24-h electrocardiogram (ECG), clinical indicators of metabolic function, sleep quality and sleep staging results of T2DM patients were monitored.Results: The associations between sleep quality, 24-h/awake/sleep/sleep staging HRV and clinical indicators of metabolic function were analyzed. Significant correlations were found between sleep quality and metabolic function (|r| = 0.386 ± 0.062, p < 0.05); HRV derived ANS function showed strengthened correlations with metabolic function during sleep period (|r| = 0.474 ± 0.100, p < 0.05); HRV metrics during sleep stages coupled more tightly with clinical indicators of metabolic function [in unstable sleep: |r| = 0.453 ± 0.095, p < 0.05; in stable sleep: |r| = 0.463 ± 0.100, p < 0.05; in rapid eye movement (REM) sleep: |r| = 0.453 ± 0.082, p < 0.05], and showed significant associations with glycemic control in non-linear analysis [fasting blood glucose within 24 h of admission (admission FBG), |r| = 0.420 ± 0.064, p < 0.05; glycated hemoglobin (HbA1c), |r| = 0.417 ± 0.016, p < 0.05].Conclusions: HRV metrics during sleep period play more distinct role than during awake period in investigating ANS dysfunction and metabolism in T2DM patients, and sleep rhythm based HRV analysis should perform better in ANS and metabolic function assessment, especially for glycemic control in non-linear analysis among T2DM patients.https://www.frontiersin.org/articles/10.3389/fphys.2023.1157270/fullT2DMheart rate variability (HRV)sleepautonomic nervous system (ANS)metabolic functionnonlinear analysis
spellingShingle Wenquan Cheng
Hongsen Chen
Leirong Tian
Zhimin Ma
Xingran Cui
Xingran Cui
Heart rate variability in different sleep stages is associated with metabolic function and glycemic control in type 2 diabetes mellitus
Frontiers in Physiology
T2DM
heart rate variability (HRV)
sleep
autonomic nervous system (ANS)
metabolic function
nonlinear analysis
title Heart rate variability in different sleep stages is associated with metabolic function and glycemic control in type 2 diabetes mellitus
title_full Heart rate variability in different sleep stages is associated with metabolic function and glycemic control in type 2 diabetes mellitus
title_fullStr Heart rate variability in different sleep stages is associated with metabolic function and glycemic control in type 2 diabetes mellitus
title_full_unstemmed Heart rate variability in different sleep stages is associated with metabolic function and glycemic control in type 2 diabetes mellitus
title_short Heart rate variability in different sleep stages is associated with metabolic function and glycemic control in type 2 diabetes mellitus
title_sort heart rate variability in different sleep stages is associated with metabolic function and glycemic control in type 2 diabetes mellitus
topic T2DM
heart rate variability (HRV)
sleep
autonomic nervous system (ANS)
metabolic function
nonlinear analysis
url https://www.frontiersin.org/articles/10.3389/fphys.2023.1157270/full
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AT leirongtian heartratevariabilityindifferentsleepstagesisassociatedwithmetabolicfunctionandglycemiccontrolintype2diabetesmellitus
AT zhiminma heartratevariabilityindifferentsleepstagesisassociatedwithmetabolicfunctionandglycemiccontrolintype2diabetesmellitus
AT xingrancui heartratevariabilityindifferentsleepstagesisassociatedwithmetabolicfunctionandglycemiccontrolintype2diabetesmellitus
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