Abstract
Background Cardiac autonomic neuropathy in type 2 diabetes mellitus (T2DM) patients is associated with high cardiovascular mortality. Heart rate variability (HRV) is the gold standard to measure cardiac autonomic neuropathy. We aimed to conduct a systematic review and meta-analysis to evaluate the impact of T2DM on HRV parameters. Methods Main databases were searched on 1st October 2017 using the keywords “diabetes” AND (“heart rate variability” OR “HRV”). Included articles reported HRV parameters in T2DM patients and healthy controls measured during 24 hours. Measurements of HRV retrieved were: RR intervals, standard deviation of RR intervals (SDNN), percentage of adjacent NN intervals differing by more than 50 milliseconds (pNN50), square root of the mean squared difference of successive RR intervals (RMSSD), total power, low frequency (LF), high frequency (HF) and LF/HF ratio. Results We included 1356 T2DM patients and 1576 healthy controls. T2DM patients had significantly (P Conclusions T2DM was associated with an overall decrease in the HRV of T2DM patients. Both sympathetic and parasympathetic activity were decreased, which can be explained by the deleterious effects of altered glucose metabolism on HRV, leading to cardiac autonomic neuropathy.
Highlights
Type 2 diabetes mellitus (T2DM) is a public health concern [1]
Levels of blood glucose and HbA1c were associated with several Heart rate variability (HRV) parameters, as well as Time from diagnosis of type 2 dibetes mellitus (T2DM)
T2DM was associated with an overall decrease in the HRV of T2DM patients
Summary
Type 2 diabetes mellitus (T2DM) is a public health concern [1]. T2DM is increasingly frequent in the world in association with the increase of sedentary behaviours, unhealthy diet, obesity and metabolic syndrome [2,3,4,5,6]. Cardiovascular mortality has been related to the cardiac autonomic neuropathy frequently associated with T2DM [1,5,14]. Screening for cardiac autonomic neuropathy has been recommended at the diagnosis of T2DM, in patients with a history of poor glycaemic control, macro/micro vascular complications, and increased cardiovascular risk [15]. The evaluation of HRV in T2DM has been assessed in several studies, conflicting results have been reported [20,21,22]. Cardiac autonomic neuropathy in type 2 dibetes mellitus (T2DM) patients is frequent and associated with high cardiovascular mortality. Heart rate variability (HRV) is the gold standard to measure cardiac autonomic neuropathy. We aimed to conduct a systematic review and meta–analysis to evaluate the impact of T2DM on HRV parameters
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