Heart rate variability based on risk stratification for type 2 <i>diabetes mellitus</i>

Silva-e-Oliveira, Julia; Amélio, Pâmela Marina; Abranches, Isabela Lopes Laguardia; Damasceno, Dênis Derly; Furtado, Fabianne

doi:10.1590/S1679-45082017AO3888

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ORIGINAL ARTICLE • Einstein (São Paulo) 15 (2) • Apr-Jun 2017 • https://doi.org/10.1590/S1679-45082017AO3888 copy

Heart rate variability based on risk stratification for type 2 diabetes mellitus

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

Objective

To evaluate heart rate variability among adults with different risk levels for type 2 diabetes mellitus.

Methods

The risk for type 2 diabetes mellitus was assessed in 130 participants (89 females) based on the questionnaire Finnish Diabetes Risk Score and was classified as low risk (n=26), slightly elevated risk (n=41), moderate risk (n=27) and high risk (n=32). To measure heart rate variability, a heart-rate monitor Polar S810i^® was employed to obtain RR series for each individual, at rest, for 5 minutes, followed by analysis of linear and nonlinear indexes.

Results

The groups at higher risk of type 2 diabetes mellitus had significantly lower linear and nonlinear heart rate variability indexes.

Conclusion

The individuals at high risk for type 2 diabetes mellitus have lower heart rate variability.

Autonomic nervous system; Diabetes mellitus; Heart rate; Risk; Cardiovascular diseases

Variables	Group 1	Group 2	Group 3	Group 4	p value	Multiple comparisons between groups*
Variables	(n=26)	(n=41)	(n=27)	(n=32)	p value	Multiple comparisons between groups*
Age, years^†	46.5 (7.5)	51.4 (8.6)	52.1 (7.2)	54.5 (8.3)	0.02^‡	1 and 4
Sex, male^§	8 (30.7)	17 (41.5)	5 (18.5)	11 (34.4)	0.24^•
Body mass, kg^†	64.4 (9.0)	66.1 (10.8)	69.2 (10.0)	78.5 (11.8)	0.0003^‡	1 and 4; 2 and 4; 3 and 4
Height, m^†	1.60 (0.1)	1.60 (10.8)	1.60 (0.1)	1.60 (0.1)	0.19^‡
BMI, kg/m^2†	23.5 (4.7)	25.5 (3.1)	27.8 (3.0)	30.6 (4.0)	<0.0001^‡	1 and 3; 1 and 4; 2 and 4
Waist circumference, cm^†	79.6 (5.1)	82.8 (8.1)	87.5 (7.5)	93.9 (9.5)	<0.0001^‡	1 and 3; 1 and 4; 2 and 4
Hip circumference, cm^†	97.7 (4.7)	100.6 (8.0)	101.9 (5.5)	105.7 (8.0)	0.01^‡	1 and 4
WHR^†	0.8 (0.0)	0.8 (0.1)	0.9 (0.1)	0.9 (0.1)	0.001^‡	1 and 4; 2 and 4
Percentagen of fat^†	32.5 (11.5)	33.3 (5.1)	35.5 (3.8)	36.4 (5.7)	0.0004^‡	1 and 3; 1 and 4
Fasting glucose	89 (4.9)	99.2 (13.2)	100.2 (11.6)	102.3 (13.8)	0.05^‡
SBP, mmHg	119.2 (8.6)	119.6 (8.3)	119.1 (11.9)	121.1 (10.1)	0.92^‡
DBP, mmHg	77.3 (6.6)	76.6 (8.2)	79.3 (7.7)	78.9 (8.2)	0.66^‡
MAP, mmHg	90.4 (10.5)	92.6 (7.4)	92.3 (10.5)	93.7 (7.9)	0.76^‡
Minimum HR, bpm	60.8 (5.6)	61.5 (7.7)	64.2 (9.0)	61.5 (7.0)	0.46^‡
Mean HR, bpm	67.6 (5.5)	68.0 (7.5)	68.7 (11.3)	67.7 (6.8)	0.97^‡
Maximum HR, bpm	78.8 (6.9)	78.7 (9.7)	80.4 (9.9)	75.9 (7.4)	0.54^‡

Variables	Group 1	Group 2	Group 3	Group 4	p value*	Multiple comparisons between groups^†
Variables	(n=26)	(n=41)	(n=27)	(n=32)	p value*	Multiple comparisons between groups^†
Mean RR, ms	904.7 (81.3)	911.8 (96.9)	869.7 (122.1)	915.7 (104.4)	0.53
SDNN, ms	64.7 (19.4)	56.3 (17.8)	53.2 (22.5)	47.2 (16.0)	0.04	1 and 4
RMSSD, ms	43.0 (16.6)	39.0 (14.9)	35.7 (20.7)	25.2 (9.9)	0.007	1 and 4; 2 and 4
pNN50, %	19.4 (12.6)	17.0 (12.4)	12.3 (12.7)	6.8 (6.5)	0.004	1 and 4; 2 and 4
Triangular index	14.0 (3.3)	12.2 (3.5)	11.4 (3.7)	10.4 (2.7)	0.01	1 and 4

Variables	Group 1	Group 2	Group 3	Group 4	p value*	Multiple comparisons between groups^†
Variables	(n=26)	(n=41)	(n=27)	(n=32)	p value*	Multiple comparisons between groups^†
VLF
ms²	2,193.3 (1700.7)	1,658.5 (1198.2)	1,554.9 (1321.5)	1,537.0 (1084.5)	0.55
%	47.5 (14.6)	48.5 (14.6)	51.4 (12.1)	64.4 (10.3)	0.0002	1 and 4; 2 and 4; 3 and 4
LF
ms²	1,519.4 (993.7)	1,044.5 (652.1)	1,003.9 (887.2)	526.9 (360.1)	0.003	1 and 4
%	36.9 (11.3)	33.2 (12.0)	33.9 (12.3)	24.1 (7.9)	0.002	1 and 3; 2 and 4; 3 and 4
HF
ms²	608.7 (490.5)	581.4 (452.2)	576.0 (618.1)	252.2 (189.6)	0.17
%	15.6 (7.0)	18.2 (8.6)	14.6 (6.5)	11.5 (5.7)	0.03	2 and 4
LF/HF	2,718.7 (1769.3)	2,097.2 (1409.4)	3,187.3 (1824.2)	3,147.2 (2078.2)	0.58

Variables	Group 1	Group 2	Group 3	Group 4	p value*	Multiple comparisons between groups^†
Variables	(n=26)	(n=41)	(n=27)	(n=32)	p value*	Multiple comparisons between groups^†
SD1, ms	30.5 (11.7)	27.6 (10.6)	25.3 (14.7)	17.9 (7.0)	0.007	1 and 4; 2 and 4
SD2, ms	85.9 (25.7)	74.2 (23.4)	70.3 (28.1)	63.9 (21.7)	0.05
ApEn	1.0 (0.1)	1.0 (0.1)	1.0 (0.1)	1.0 (0.1)	0.16
SampEn	1.5 (0.2)	1.5 (0.2)	1.4 (0.3)	1.3 (0.2)	0.008	2 and 4

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[1] Corresponding author: Fabianne Furtado – Instituto Federal do Sudeste de Minas Gerais, Campus Barbacena – Rua Monsenhor José Augusto, 204 – São José – Zip code: 36205-018 – Barbacena, MG, Brazil. Phone: (55 32) 3693-8600 – E-mail: fabianne.furtado@ifsudestemg.edu.br