Insulin resistance and reduced cardiac autonomic function in older adults: the Atherosclerosis Risk in Communities study
Abstract Background Prior studies have shown insulin resistance is associated with reduced cardiac autonomic function measured at rest, but few studies have determined whether insulin resistance is associated with reduced cardiac autonomic function measured during daily activities. Methods We examin...
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| Format: | Article |
| Language: | English |
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BMC
2020-05-01
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| Series: | BMC Cardiovascular Disorders |
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| Online Access: | http://link.springer.com/article/10.1186/s12872-020-01496-z |
| _version_ | 1818305658559135744 |
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| author | Anna K. Poon Eric A. Whitsel Gerardo Heiss Elsayed Z. Soliman Lynne E. Wagenknecht Takeki Suzuki Laura Loehr |
| author_facet | Anna K. Poon Eric A. Whitsel Gerardo Heiss Elsayed Z. Soliman Lynne E. Wagenknecht Takeki Suzuki Laura Loehr |
| author_sort | Anna K. Poon |
| collection | DOAJ |
| description | Abstract Background Prior studies have shown insulin resistance is associated with reduced cardiac autonomic function measured at rest, but few studies have determined whether insulin resistance is associated with reduced cardiac autonomic function measured during daily activities. Methods We examined older adults without diabetes with 48-h ambulatory electrocardiography (n = 759) in an ancillary study of the Atherosclerosis Risk in Communities Study. Insulin resistance, the exposure, was defined by quartiles for three indexes: 1) the homeostatic model assessment of insulin resistance (HOMA-IR), 2) the triglyceride and glucose index (TyG), and 3) the triglyceride to high-density lipoprotein cholesterol ratio (TG/HDL-C). Low heart rate variability, the outcome, was defined by <25th percentile for four measures: 1) standard deviation of normal-to-normal R-R intervals (SDNN), a measure of total variability; 2) root mean square of successive differences in normal-to-normal R-R intervals (RMSSD), a measure of vagal activity; 3) low frequency spectral component (LF), a measure of sympathetic and vagal activity; and 4) high frequency spectral component (HF), a measure of vagal activity. Logistic regression was used to estimate odds ratios (OR) and 95% confidence intervals weighted for sampling/non-response, adjusted for age at ancillary visit, sex, and race/study-site. Insulin resistance quartiles 4, 3, and 2 were compared to quartile 1; high indexes refer to quartile 4 versus quartile 1. Results The average age was 78 years, 66% (n = 497) were women, and 58% (n = 438) were African American. Estimates of association were not robust at all levels of HOMA-IR, TyG, and TG/HDL-C, but suggest that high indexes were associated consistently with indicators of vagal activity. High HOMA-IR, high TyG, and high TG/HDL-C were consistently associated with low RMSSD (OR: 1.68 (1.00, 2.81), OR: 2.03 (1.21, 3.39), and OR: 1.73 (1.01, 2.91), respectively). High HOMA-IR, high TyG, and high TG/HDL-C were consistently associated with low HF (OR: 1.90 (1.14, 3.18), OR: 1.98 (1.21, 3.25), and OR: 1.76 (1.07, 2.90), respectively). Conclusions In older adults without diabetes, insulin resistance was associated with reduced cardiac autonomic function – specifically and consistently for indicators of vagal activity – measured during daily activities. Primary prevention of insulin resistance may reduce the related risk of cardiac autonomic dysfunction. |
| first_indexed | 2024-12-13T06:30:05Z |
| format | Article |
| id | doaj.art-eaf3b890f25e4c389909324494489ba5 |
| institution | Directory Open Access Journal |
| issn | 1471-2261 |
| language | English |
| last_indexed | 2024-12-13T06:30:05Z |
| publishDate | 2020-05-01 |
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| series | BMC Cardiovascular Disorders |
| spelling | doaj.art-eaf3b890f25e4c389909324494489ba52022-12-21T23:56:39ZengBMCBMC Cardiovascular Disorders1471-22612020-05-012011810.1186/s12872-020-01496-zInsulin resistance and reduced cardiac autonomic function in older adults: the Atherosclerosis Risk in Communities studyAnna K. Poon0Eric A. Whitsel1Gerardo Heiss2Elsayed Z. Soliman3Lynne E. Wagenknecht4Takeki Suzuki5Laura Loehr6Department of Epidemiology, University of North Carolina at Chapel HillDepartment of Epidemiology, University of North Carolina at Chapel HillDepartment of Epidemiology, University of North Carolina at Chapel HillDivision of Epidemiology and Prevention, Wake Forest School of MedicineDivision of Public Health Sciences, Wake Forest School of MedicineDepartment of Medicine, Indiana University School of MedicineDepartment of Medicine, University of North Carolina at Chapel HillAbstract Background Prior studies have shown insulin resistance is associated with reduced cardiac autonomic function measured at rest, but few studies have determined whether insulin resistance is associated with reduced cardiac autonomic function measured during daily activities. Methods We examined older adults without diabetes with 48-h ambulatory electrocardiography (n = 759) in an ancillary study of the Atherosclerosis Risk in Communities Study. Insulin resistance, the exposure, was defined by quartiles for three indexes: 1) the homeostatic model assessment of insulin resistance (HOMA-IR), 2) the triglyceride and glucose index (TyG), and 3) the triglyceride to high-density lipoprotein cholesterol ratio (TG/HDL-C). Low heart rate variability, the outcome, was defined by <25th percentile for four measures: 1) standard deviation of normal-to-normal R-R intervals (SDNN), a measure of total variability; 2) root mean square of successive differences in normal-to-normal R-R intervals (RMSSD), a measure of vagal activity; 3) low frequency spectral component (LF), a measure of sympathetic and vagal activity; and 4) high frequency spectral component (HF), a measure of vagal activity. Logistic regression was used to estimate odds ratios (OR) and 95% confidence intervals weighted for sampling/non-response, adjusted for age at ancillary visit, sex, and race/study-site. Insulin resistance quartiles 4, 3, and 2 were compared to quartile 1; high indexes refer to quartile 4 versus quartile 1. Results The average age was 78 years, 66% (n = 497) were women, and 58% (n = 438) were African American. Estimates of association were not robust at all levels of HOMA-IR, TyG, and TG/HDL-C, but suggest that high indexes were associated consistently with indicators of vagal activity. High HOMA-IR, high TyG, and high TG/HDL-C were consistently associated with low RMSSD (OR: 1.68 (1.00, 2.81), OR: 2.03 (1.21, 3.39), and OR: 1.73 (1.01, 2.91), respectively). High HOMA-IR, high TyG, and high TG/HDL-C were consistently associated with low HF (OR: 1.90 (1.14, 3.18), OR: 1.98 (1.21, 3.25), and OR: 1.76 (1.07, 2.90), respectively). Conclusions In older adults without diabetes, insulin resistance was associated with reduced cardiac autonomic function – specifically and consistently for indicators of vagal activity – measured during daily activities. Primary prevention of insulin resistance may reduce the related risk of cardiac autonomic dysfunction.http://link.springer.com/article/10.1186/s12872-020-01496-zInsulin resistanceHomeostatic model assessment of insulin resistanceCardiac autonomic functionAmbulatory electrocardiogramsHeart rate variability |
| spellingShingle | Anna K. Poon Eric A. Whitsel Gerardo Heiss Elsayed Z. Soliman Lynne E. Wagenknecht Takeki Suzuki Laura Loehr Insulin resistance and reduced cardiac autonomic function in older adults: the Atherosclerosis Risk in Communities study BMC Cardiovascular Disorders Insulin resistance Homeostatic model assessment of insulin resistance Cardiac autonomic function Ambulatory electrocardiograms Heart rate variability |
| title | Insulin resistance and reduced cardiac autonomic function in older adults: the Atherosclerosis Risk in Communities study |
| title_full | Insulin resistance and reduced cardiac autonomic function in older adults: the Atherosclerosis Risk in Communities study |
| title_fullStr | Insulin resistance and reduced cardiac autonomic function in older adults: the Atherosclerosis Risk in Communities study |
| title_full_unstemmed | Insulin resistance and reduced cardiac autonomic function in older adults: the Atherosclerosis Risk in Communities study |
| title_short | Insulin resistance and reduced cardiac autonomic function in older adults: the Atherosclerosis Risk in Communities study |
| title_sort | insulin resistance and reduced cardiac autonomic function in older adults the atherosclerosis risk in communities study |
| topic | Insulin resistance Homeostatic model assessment of insulin resistance Cardiac autonomic function Ambulatory electrocardiograms Heart rate variability |
| url | http://link.springer.com/article/10.1186/s12872-020-01496-z |
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