Abstract
BackgroundThe worldwide burden of diabetes in 2030 is projected around 552 million. Diabetes leads to higher risk for cardiovascular diseases (CVD). Altered cardiac autonomic function (CAF) measured by heart rate variability (HRV) is observed in early stages of diabetes but the relationship between impaired fasting glucose (IFG) and HRV is still debatable. The aim of the study was to evaluate the association between CAF, oxidative stress, insulin resistance (IR), and inflammatory response in IFG subjects.Subjects and MethodsCross-sectional blinded study. Volunteers recruited from health awareness camps underwent CAF and biochemical tests. Based on fasting plasma glucose (FPG) participants (n = 123) were divided into two groups, normal fasting glucose (n = 76) and IFG (n = 47). The comparison of parameters between the groups was carried out using student t test and Mann-Whitney U test for parametric and non-parametric data respectively. The correlation between the parameters was analyzed by Spearman’s rank correlation using SPSS 13.0.ResultsThe resting cardiovagal modulation parameters, heart rate response to forced timed breathing, and orthostatic stress were reduced in IFG subjects. Fasting plasma lipid profile, coronary atherogenic lipid risk factors, IR, thiobarbituric acid reactive substance (TBARS), high sensitive C-reactive protein, and tumor necrosis factor alpha were increased and total antioxidant capacity (TAC) was decreased significantly in IFG group but no significant alteration was observed in high-density lipoprotein (HDL-c). Cardiovagal modulation parameters were negatively correlated with triglycerides, FPG, insulin, IR, TBARS, and inflammatory markers and positively with TAC.ConclusionThere is a continuous interplay between the altered CAF, hyperinsulinemia, IR, oxidative stress parameters, inflammatory response, and IFG in which one factor perpetuates another leading to the progression of disease.
Highlights
Diabetes, the most common endocrine disorder, is projected to show a worldwide increase from 366 million in the year 2011 to 552 million in the year 2030, out of which, around 101 million is expected to be contributed by India [1]
Coronary atherogenic lipid risk factors, insulin resistance (IR), thiobarbituric acid reactive substance (TBARS), high sensitive C-reactive protein, and tumor necrosis factor alpha were increased and total antioxidant capacity (TAC) was decreased significantly in impaired fasting glucose (IFG) group but no significant alteration was observed in highdensity lipoprotein (HDL-c)
There is a continuous interplay between the altered cardiac autonomic function (CAF), hyperinsulinemia, IR, oxidative stress parameters, inflammatory response, and IFG in which one factor perpetuates another leading to the progression of disease
Summary
The most common endocrine disorder, is projected to show a worldwide increase from 366 million in the year 2011 to 552 million in the year 2030, out of which, around 101 million is expected to be contributed by India [1]. Diabetic patients have higher risk for cardiovascular diseases (CVDs) which further increases the rate of mortality [2,3]. Prediabetes is associated with increased risk of progression to type-2 diabetes and with increased CVD risk [4,6]. The degree of progression to type-2 diabetes, intensity of risk factors and cardiovascular complications vary between individuals with IGT and IFG [8,9,10]. Recent studies based on new and modified criteria of ADA, lower cut off for IFG was adopted as 5.5 mmol/L showed IFG is associated with CVD risk [6,14]. The aim of the study was to evaluate the association between CAF, oxidative stress, insulin resistance (IR), and inflammatory response in IFG subjects
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