Abstract
Introduction: Limited data exist on links between glycemic markers and cardiac autonomic neuropathy (CAN) across the dysglycemia spectrum (including prediabetes and diabetes). We assessed associations of multiple glycemic markers with heart rate (HR) and CAN, measured via heart rate variability (HRV). Methods: This cross-sectional analysis included 2,266 participants who attended a 14-year follow up DPPOS visit. We evaluated associations of glycemic markers (fasting glucose, HbA1c and HOMA-IR) with HR and HRV (standard deviation of all normal-to-normal intervals [SDNN], root mean square of successive differences between normal-to-normal intervals [rMSSD] and QT index [QTI]) measures, using linear regression. Similarly, the relations between glycemic markers and CAN (SDNN ≤17.13 ms, rMSSD ≤24.94 ms or QTI ≥112) were assessed using logistic regression. Results: Participants had 65 years old on average, 68.2% were women, 53.4% were White, and 57.3% had diabetes. Glycemic measures were positively associated with HR and negatively associated with SDNN and rMSSD (Figure 1). Greater HbA1C, FPG and HOMA IR were associated with greater odds of CAN (OR [95% CI] per SD change: 1.34 [1.14, 1.62], 1.27 [1.08, 1.53] and 1.19 [1.02, 1.39], P<0.05). Conclusions: Glucose metabolism is associated with heart rate and risk of cardiac autonomic dysfunction across the spectrum of dysglycemia. Disclosure J. Echouffo Tcheugui: None. X. Liu: None. R.B. Goldberg: None. M. Budoff: Speaker's Bureau; Boehringer-Ingelheim, Lilly Diabetes, AstraZeneca. S. Dagogo-Jack: Consultant; Merck Sharp & Dohme Corp., Medtronic, Bayer Inc. Stock/Shareholder; Aerami. S. Golden: None. U.N. Ibebuogu: None. W.C. Knowler: None. N. White: None. M. Temprosa: None. D. Research Group: None. Funding National Institute of Diabetes and Digestive and Kidney Diseases (UDK048489, UDK048339, UDK048377, UDK048349, UDK048381, UDK048468, UDK048434, UDK048485, UDK048375, UDK048514, UDK048437, UDK048413, UDK048411, UDK048406, UDK048380, UDK048397, UDK048412, UDK048404, UDK048387, UDK048407, UDK048443, UDK048400)