Sympathovagal balance and 1-h postload plasma glucose in normoglucose tolerant hypertensive patients.

Abstract

Normoglucose tolerant (NGT) subjects with a 1-h postload plasma glucose (PLPG) value ≥155mg/dL have an increased risk of type-2 diabetes and subclinical organ damage. Heart rate variability (HRV) reflects cardiac autonomic balance, frequently impaired in course of diabetes. At this time, no data support the association between 1-h PLPG and HRV; thus, we investigated the possible association between 1-h PLPG and HRV. We enrolled 92 never-treated hypertensive subjects (56 women, 36 men), aged 55±9.8years. During OGTT, the patients underwent electrocardiographic recordings to evaluate HRV in the time domain (SDNN). Insulin sensitivity was assessed by Matsuda index. Among participants, 56 were NGT, 20 had impaired glucose tolerance (IGT), and 16 had type-2 diabetes. According to the 1-h PLPG cutoff point of 155mg/dL, we divided NGT subjects into: NGT<155 (n=38) and NGT≥155 (n=18). Glucose tolerance status was associated with a significant (P<0.0001) increase in PLPG and insulin and the reduction in Matsuda index. In all groups, the SDNN values significantly (P<0.0001) decreased during the first hour of OGTT. A complete recovery in NGT groups was observed at the end of the second hour; in IGT and type-2 diabetes, SDNN remained significantly lower with respect to baseline values. At multiple regression analysis, Matsuda index resulted in the only determinant of SDNN modification, explaining the 12.3% of its variability. Our data demonstrate that during OGTT, sympathovagal balance is acutely affected by both glucose and insulin modifications. Particularly, NGT≥155 subjects behave in the same way of IGT and type-2 diabetes patients.