SEDA ELÇİM YILDIRIM, TARIK YILDIRIM, FATİH ÖZÇELİK
Acta Medica Anatolia - 2016;4(4):141-147
Introduction: Autonomic neuropathy is a common complication of diabetes mellitus. The aim of the present study was to compare heart rate recovery time and heart rate variation among the indicators of cardiac autonomic function between patients with glucometabolic abnormalities in various levels and normal glucose homeostasis. Methods: A total of 90 patients were enrolled in the study. The patients were divided into four groups: impaired fasting glucose (IFG) (n=18), impaired glucose tolerance (IGT) (n=25), type 2 diabetes mellitus (DM) (n=21), and the control group (n=26). Cardiac autonomic neuropathy (CAN) was evaluated by the maximum exercise stress test and Holter electrocardiography. Results: The baseline heart rate in the DM group was higher than the IFG, IGT, and control groups, but the difference was not statistically significant (93.5±15.5, 87.8±9.4, 84.3±10.8, and 84.3±14.2, respectively; p=0.06). In multiple regression analysis FPG level was an independent variable, increased baseline heart rate was correlated with an elevated FPG level (constant: 71.35, p: 0.004). The metabolic equivalent of task (MET) value was lower in the DM group compared to the IFG, IGT, and control groups (9.9±1.2, 9.0±1.6, 9.78±1.46, 8.77±1.74 p=0.06). Conclusion: When compared to patients with normal glucose homeostasis heart rate at rest was higher in the IGT, IFG, and DM groups. Elevated fasting glucose levels were correlated with an increased baseline heart rate. A negative correlation was found between HbA1c levels and HRRT, and HR index. These finding indicate autonomic functions are impaired in patients with DM, IGT and IFG groups.
