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Navarro-Lomas G, Plaza-Florido A, De-la-O A, Castillo MJ, Amaro-Gahete FJ. Exercise-induced changes in plasma S-Klotho levels are associated with the obtained enhancements of heart rate variability in sedentary middle-aged adults: the FIT-AGEING study. J Physiol Biochem 2024; 80:317-328. [PMID: 38175501 DOI: 10.1007/s13105-023-01005-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Accepted: 12/21/2023] [Indexed: 01/05/2024]
Abstract
The shed form of the Klotho protein (S-Klotho) is considered a biomarker of longevity, but it is still unknown whether the levels are related to heart rate (HR) and heart rate variability (HRV); both of them greatly influenced by the ageing process, physical fitness, exercise, and health status. This study aimed (i) to investigate the association between S-Klotho plasma levels with HR and HRV parameters and (ii) to examine the association of exercise-induced changes in S-Klotho and those obtained in HR and HRV parameters after a 12-week exercise intervention in sedentary middle-aged adults. Sixty-six sedentary middle-aged adults participated in this study (50% women; 45-65 years old). Participants were randomized into 4 groups: (a) a control group (no exercise), (b) a physical activity recommendation from the World Health Organization group, (c) a high-intensity interval training group, and (d) a high-intensity interval training group adding whole-body electromyostimulation. S-Klotho plasma levels, HR, and HRV parameters (SDNN, RMSSD, high frequency, stress score, and sympathetic/parasympathetic ratio) were measured. At baseline, S-Klotho plasma levels were not related to HR and HRV parameters. After the intervention, exercise-induced changes in S-Klotho plasma levels were positively associated with changes in SDNN (β=0.261; R2=0.102; p=0.014) and negatively related to changes in stress score and sympathetic/parasympathetic ratio (all β=-0.257; R2 ranges between 0.092 and 0.131; all p<0.020). Our study suggests that higher S-Klotho plasma levels are related to increased vagal influence and reduced sympathetic tone in the autonomic nervous system in sedentary middle-aged adults after different training programs. ClinicalTrials.gov identifier: CT03334357.
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Affiliation(s)
- Ginés Navarro-Lomas
- Department of Physiology, Faculty of Medicine, University of Granada, Avda. de la Investigación 11, 18016, Granada, Spain
| | - Abel Plaza-Florido
- PROFITH "PROmoting FITness and Health Through Physical Activity" Research Group, Sport and Health University Research Institute (iMUDS), Department of Physical and Sports Education, Faculty of Sport Sciences, University of Granada, Granada, Spain
- Pediatric Exercise and Genomics Research Center, Department of Pediatrics, School of Medicine, University of California at Irvine, Irvine, CA, USA
| | - Alejandro De-la-O
- Department of Physiology, Faculty of Medicine, University of Granada, Avda. de la Investigación 11, 18016, Granada, Spain
| | - Manuel J Castillo
- Department of Physiology, Faculty of Medicine, University of Granada, Avda. de la Investigación 11, 18016, Granada, Spain
| | - Francisco J Amaro-Gahete
- Department of Physiology, Faculty of Medicine, University of Granada, Avda. de la Investigación 11, 18016, Granada, Spain.
- CIBER de Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Granada, Spain.
- Instituto de Investigación Biosanitaria, ibs.Granada, Granada, Spain.
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Muñoz-Islas E, Santiago-SanMartin ED, Mendoza-Sánchez E, Torres-Rodríguez HF, Ramírez-Quintanilla LY, Peters CM, Jiménez-Andrade JM. Long-term effects of gestational diabetes mellitus on the pancreas of female mouse offspring. World J Diabetes 2024; 15:758-768. [PMID: 38680692 PMCID: PMC11045410 DOI: 10.4239/wjd.v15.i4.758] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2023] [Revised: 01/29/2024] [Accepted: 03/11/2024] [Indexed: 04/11/2024] Open
Abstract
BACKGROUND Prolonged fetal exposure to hyperglycemia may increase the risk of developing abnormal glucose metabolism and type-2 diabetes during childhood, adolescence, and adulthood; however, the mechanisms by which gestational diabetes mellitus (GDM) predisposes offspring to metabolic disorders remain unknown. AIM To quantify the nerve axons, macrophages, and vasculature in the pancreas from adult offspring born from mouse dams with GDM. METHODS GDM was induced by i.p. administration of streptozotocin (STZ) in ICR mouse dams. At 12 wk old, fasting blood glucose levels were determined in offspring. At 15 wk old, female offspring born from dams with and without GDM were sacrificed and pancreata were processed for immunohistochemistry. We quantified the density of sensory [calcitonin gene-related peptide (CGRP)] and tyrosine hydroxylase (TH) axons, blood vessels (endomucin), and macro-phages (CD68) in the splenic pancreas using confocal microscopy. RESULTS Offspring mice born from STZ-treated dams had similar body weight and blood glucose values compared to offspring born from vehicle-treated dams. However, the density of CGRP+ and TH+ axons, endomucin+ blood vessels, and CD68+ macrophages in the exocrine pancreas was significantly greater in offspring from mothers with GDM vs control offspring. Likewise, the microvasculature in the islets was significantly greater, but not the number of macrophages within the islets of offspring born from dams with GDM compared to control mice. CONCLUSION GDM induces neuronal, vascular, and inflammatory changes in the pancreas of adult progeny, which may partially explain the higher propensity for offspring of mothers with GDM to develop metabolic diseases.
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Affiliation(s)
- Enriqueta Muñoz-Islas
- Unidad Académica Multidisciplinaria Reynosa-Aztlán, Universidad Autónoma de Tamaulipas, Reynosa 88740, Tamaulipas, Mexico
| | - Edgar David Santiago-SanMartin
- Unidad Académica Multidisciplinaria Reynosa-Aztlán, Universidad Autónoma de Tamaulipas, Reynosa 88740, Tamaulipas, Mexico
| | - Eduardo Mendoza-Sánchez
- Unidad Académica Multidisciplinaria Reynosa-Aztlán, Universidad Autónoma de Tamaulipas, Reynosa 88740, Tamaulipas, Mexico
| | - Héctor Fabián Torres-Rodríguez
- Unidad Académica Multidisciplinaria Reynosa-Aztlán, Universidad Autónoma de Tamaulipas, Reynosa 88740, Tamaulipas, Mexico
| | | | - Christopher Michael Peters
- Department of Anesthesiology, Wake Forest University School of Medicine, Winston Salem, NC 27101, United States
| | - Juan Miguel Jiménez-Andrade
- Unidad Académica Multidisciplinaria Reynosa-Aztlán, Universidad Autónoma de Tamaulipas, Reynosa 88740, Tamaulipas, Mexico
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Hamaoka T, Leuenberger UA, Drew RC, Murray M, Blaha C, Luck JC, Sinoway LI, Cui J. Glucose metabolism and autonomic function in healthy individuals and patients with type 2 diabetes mellitus at rest and during exercise. Exp Physiol 2024; 109:214-226. [PMID: 38050866 PMCID: PMC10841625 DOI: 10.1113/ep091444] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Accepted: 10/31/2023] [Indexed: 12/07/2023]
Abstract
Autonomic dysfunction is a common complication of type 2 diabetes mellitus (T2DM). However, the character of dysfunction varies in different reports. Differences in measurement methodology and complications might have influenced the inconsistent results. We sought to evaluate comprehensively the relationship between abnormal glucose metabolism and autonomic function at rest and the response to exercise in healthy individuals and T2DM patients. We hypothesized that both sympathetic and parasympathetic indices would decrease with the progression of abnormal glucose metabolism in individuals with few complications related to high sympathetic tone. Twenty healthy individuals and 11 T2DM patients without clinically evident cardiovascular disease other than controlled hypertension were examined. Resting muscle sympathetic nerve activity (MSNA), heart rate variability, spontaneous cardiovagal baroreflex sensitivity (CBRS), sympathetic baroreflex sensitivity and the MSNA response to handgrip exercise were measured. Resting MSNA was lower in patients with T2DM than in healthy control subjects (P = 0.011). Resting MSNA was negatively correlated with haemoglobin A1c in all subjects (R = -0.45, P = 0.024). The parasympathetic components of heart rate variability and CBRS were negatively correlated with glycaemic/insulin indices in all subjects and even in the control group only (all, P < 0.05). In all subjects, the MSNA response to exercise was positively correlated with fasting blood glucose (R = 0.69, P < 0.001). Resting sympathetic activity and parasympathetic modulation of heart rate were decreased in relationship to abnormal glucose metabolism. Meanwhile, the sympathetic responses to handgrip were preserved in diabetics. The responses were correlated with glucose/insulin parameters throughout diabetic and control subjects. These results suggest the importance of a comprehensive assessment of autonomic function in T2DM.
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Affiliation(s)
- Takuto Hamaoka
- Penn State Heart and Vascular InstitutePennsylvania State University College of MedicineHersheyPennsylvaniaUSA
| | - Urs A. Leuenberger
- Penn State Heart and Vascular InstitutePennsylvania State University College of MedicineHersheyPennsylvaniaUSA
| | - Rachel C. Drew
- Penn State Heart and Vascular InstitutePennsylvania State University College of MedicineHersheyPennsylvaniaUSA
- Department of Exercise and Health SciencesUniversity of Massachusetts BostonBostonMassachusettsUSA
| | - Matthew Murray
- Penn State Heart and Vascular InstitutePennsylvania State University College of MedicineHersheyPennsylvaniaUSA
| | - Cheryl Blaha
- Penn State Heart and Vascular InstitutePennsylvania State University College of MedicineHersheyPennsylvaniaUSA
| | - Jonathan Carter Luck
- Penn State Heart and Vascular InstitutePennsylvania State University College of MedicineHersheyPennsylvaniaUSA
| | - Lawrence I. Sinoway
- Penn State Heart and Vascular InstitutePennsylvania State University College of MedicineHersheyPennsylvaniaUSA
| | - Jian Cui
- Penn State Heart and Vascular InstitutePennsylvania State University College of MedicineHersheyPennsylvaniaUSA
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Wang K, Ahmadizar F, Geurts S, Arshi B, Kors JA, Rizopoulos D, Sijbrands EJG, Ikram MA, Kavousi M. Heart Rate Variability and Incident Type 2 Diabetes in General Population. J Clin Endocrinol Metab 2023; 108:2510-2516. [PMID: 37022971 PMCID: PMC10505535 DOI: 10.1210/clinem/dgad200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2022] [Revised: 03/31/2023] [Accepted: 04/04/2023] [Indexed: 04/07/2023]
Abstract
CONTEXT Hyperglycemia and autonomic dysfunction are bidirectionally related. OBJECTIVE We investigated the association of longitudinal evolution of heart rate variability (HRV) with incident type 2 diabetes (T2D) among the general population. METHODS We included 7630 participants (mean age 63.7 years, 58% women) from the population-based Rotterdam Study who had no history of T2D and atrial fibrillation at baseline and had repeated HRV assessments at baseline and during follow-up. We used joint models to assess the association between longitudinal evolution of heart rate and different HRV metrics (including the heart rate-corrected SD of the normal-to-normal RR intervals [SDNNc], and root mean square of successive RR-interval differences [RMSSDc]) with incident T2D. Models were adjusted for cardiovascular risk factors. Bidirectional Mendelian randomization (MR) using summary-level data was also performed. RESULTS During a median follow-up of 8.6 years, 871 individuals developed incident T2D. One SD increase in heart rate (hazard ratio [HR] 1.20; 95% CI, 1.09-1.33), and log(RMSSDc) (HR 1.16; 95% CI, 1.01-1.33) were independently associated with incident T2D. The HRs were 1.54 (95% CI, 1.08-2.06) for participants younger than 62 years and 1.15 (95% CI, 1.01-1.31) for those older than 62 years for heart rate (P for interaction <.001). Results from bidirectional MR analyses suggested that HRV and T2D were not significantly related to each other. CONCLUSION Autonomic dysfunction precedes development of T2D, especially among younger individuals, while MR analysis suggests no causal relationship. More studies are needed to further validate our findings.
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Affiliation(s)
- Kan Wang
- Department of Epidemiology, Erasmus MC, University Medical Center Rotterdam, 3000 CA Rotterdam, The Netherlands
| | - Fariba Ahmadizar
- Department of Epidemiology, Erasmus MC, University Medical Center Rotterdam, 3000 CA Rotterdam, The Netherlands
- Julius Global Health, University Medical Center Utrecht, 3508 GA Utrecht, The Netherlands
| | - Sven Geurts
- Department of Epidemiology, Erasmus MC, University Medical Center Rotterdam, 3000 CA Rotterdam, The Netherlands
| | - Banafsheh Arshi
- Department of Epidemiology, Erasmus MC, University Medical Center Rotterdam, 3000 CA Rotterdam, The Netherlands
| | - Jan A Kors
- Department of Medical Informatics, Erasmus MC, University Medical Center Rotterdam, 3000 CA Rotterdam, The Netherlands
| | - Dimitris Rizopoulos
- Department of Epidemiology, Erasmus MC, University Medical Center Rotterdam, 3000 CA Rotterdam, The Netherlands
- Department of Biostatistics, Erasmus MC, University Medical Center Rotterdam, 3000 CA Rotterdam, The Netherlands
| | - Eric J G Sijbrands
- Department of Internal Medicine, Erasmus MC, University Medical Center Rotterdam, 3000 CA Rotterdam, The Netherlands
| | - M Arfan Ikram
- Department of Epidemiology, Erasmus MC, University Medical Center Rotterdam, 3000 CA Rotterdam, The Netherlands
| | - Maryam Kavousi
- Department of Epidemiology, Erasmus MC, University Medical Center Rotterdam, 3000 CA Rotterdam, The Netherlands
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Waataja JJ, Asp AJ, Billington CJ. Combining Celiac and Hepatic Vagus Nerve Neuromodulation Reverses Glucose Intolerance and Improves Glycemic Control in Pre- and Overt-Type 2 Diabetes Mellitus. Biomedicines 2023; 11:2452. [PMID: 37760895 PMCID: PMC10525327 DOI: 10.3390/biomedicines11092452] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Revised: 08/16/2023] [Accepted: 08/18/2023] [Indexed: 09/29/2023] Open
Abstract
Neurological disorders and type 2 diabetes mellitus (T2DM) are deeply intertwined. For example, autonomic neuropathy contributes to the development of T2DM and continued unmanaged T2DM causes further progression of nerve damage. Increasing glycemic control has been shown to prevent the onset and progression of diabetic autonomic neuropathies. Neuromodulation consisting of combined stimulation of celiac vagal fibers innervating the pancreas with concurrent electrical blockade of neuronal hepatic vagal fibers innervating the liver has been shown to increase glycemic control in animal models of T2DM. The present study demonstrated that the neuromodulation reversed glucose intolerance in alloxan-treated swine in both pre- and overt stages of T2DM. This was demonstrated by improved performance on oral glucose tolerance tests (OGTTs), as assessed by area under the curve (AUC). In prediabetic swine (fasting plasma glucose (FPG) range: 101-119 mg/dL) the median AUC decreased from 31.9 AUs (IQR = 28.6, 35.5) to 15.9 AUs (IQR = 15.1, 18.3) p = 0.004. In diabetic swine (FPG range: 133-207 mg/dL) the median AUC decreased from 54.2 AUs (IQR = 41.5, 56.6) to 16.0 AUs (IQR = 15.4, 21.5) p = 0.003. This neuromodulation technique may offer a new treatment for T2DM and reverse glycemic dysregulation at multiple states of T2DM involved in diabetic neuropathy including at its development and during progression.
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Affiliation(s)
| | - Anders J. Asp
- Department of Physical Medicine and Rehabilitation, Mayo Clinic, Rochester, MN 55605, USA
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Yu L, Yang M, Nie X, Zhou M, Tan Q, Ye Z, Liu W, Liang R, Feng X, Wang B, Chen W. Associations of glucose metabolism and diabetes with heart rate variability: a population-based cohort study. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2023; 30:85569-85577. [PMID: 37391563 DOI: 10.1007/s11356-023-28415-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Accepted: 06/19/2023] [Indexed: 07/02/2023]
Abstract
The present study aimed to investigate the potential causal pathways and temporal relationships of glucose metabolism and diabetes with heart rate variability (HRV). This cohort study was conducted among a sample of 3858 Chinese adults. At baseline and 6 years follow-up, participants underwent HRV measurement (low frequency [LF], high frequency [HF], total power [TP], standard deviation of all normal-to-normal intervals [SDNN], and square root of the mean squared difference between adjacent normal-to-normal intervals [r-MSSD]) and determination of glucose homeostasis (fasting plasma glucose [FPG] and insulin [FPI], homeostatic model assessment for insulin resistance [HOMA-IR]). The temporal relationships of glucose metabolism and diabetes with HRV were evaluated using cross-lagged panel analysis. FPG, FPI, HOMA-IR, and diabetes were cross-sectionally negatively associated with HRV indices at baseline and follow-up (P < 0.05). Cross-lagged panel analyses demonstrated significant unidirectional paths from baseline FPG to follow-up SDNN (β = -0.06), and baseline diabetes to follow-up low TP group (β = 0.08), low SDNN group (β = 0.05), and low r-MSSD group (β = 0.10) (P < 0.05). No significant path coefficients were observed from baseline HRV to follow-up impaired glucose homeostasis or diabetes. These significant findings persisted even after excluding participants who were taking antidiabetic medication. The results support that elevated FPG and the presence of diabetes may be the causes rather than the consequences of HRV reduction over time.
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Affiliation(s)
- Linling Yu
- Department of Occupational and Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, Hubei, China
- Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, Hubei, China
| | - Meng Yang
- Wuhan Children's Hospital (Wuhan Maternal and Child Health Care Hospital), Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430019, Hubei, China
| | - Xiuquan Nie
- Department of Occupational and Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, Hubei, China
- Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, Hubei, China
| | - Min Zhou
- Department of Occupational and Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, Hubei, China
- Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, Hubei, China
| | - Qiyou Tan
- Department of Occupational and Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, Hubei, China
- Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, Hubei, China
| | - Zi Ye
- Department of Occupational and Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, Hubei, China
- Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, Hubei, China
| | - Wei Liu
- Department of Occupational and Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, Hubei, China
- Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, Hubei, China
| | - Ruyi Liang
- Department of Occupational and Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, Hubei, China
- Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, Hubei, China
| | - Xiaobin Feng
- Department of Occupational and Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, Hubei, China
- Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, Hubei, China
| | - Bin Wang
- Department of Occupational and Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, Hubei, China
- Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, Hubei, China
| | - Weihong Chen
- Department of Occupational and Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, Hubei, China.
- Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, Hubei, China.
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Alonge KM, Porte D, Schwartz MW. Distinct Roles for Brain and Pancreas in Basal and Postprandial Glucose Homeostasis. Diabetes 2023; 72:547-556. [PMID: 37146276 PMCID: PMC10130484 DOI: 10.2337/db22-0969] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Accepted: 02/04/2023] [Indexed: 05/07/2023]
Abstract
The glucose homeostasis system ensures that the circulating glucose level is maintained within narrow physiological limits both in the fasting (or basal) state and following a nutrient challenge. Although glucose homeostasis is traditionally conceptualized as a single overarching system, evidence reviewed here suggests that basal glycemia and glucose tolerance are governed by distinct control systems. Specifically, whereas glucose tolerance appears to be determined largely by interactions between insulin secretion and insulin sensitivity, basal-state glucose homeostasis is predominated by insulin-independent mechanisms governed largely by the brain. In addition to a new perspective on how glucose homeostasis is achieved, this "dual control system" hypothesis offers a feasible and testable explanation for observations that are otherwise difficult to reconcile and sheds new light on the integration of central and peripheral metabolic control mechanisms. The implications of this model for the pathogenesis and treatment of impaired fasting glucose, impaired glucose tolerance, and type 2 diabetes are also discussed.
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Affiliation(s)
- Kimberly M. Alonge
- Department of Medicine, University of Washington Medicine Diabetes Institute, Seattle, WA
| | - Daniel Porte
- Division of Endocrinology, School of Medicine, University of California San Diego, San Diego, CA
| | - Michael W. Schwartz
- Department of Medicine, University of Washington Medicine Diabetes Institute, Seattle, WA
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Saengmolee W, Cheaha D, Sa-ih N, Kumarnsit E. Exploring of cardiac autonomic activity with heart rate variability in long-term kratom ( Mitragyna speciosa Korth.) users: a preliminary study. PeerJ 2022; 10:e14280. [PMID: 36312758 PMCID: PMC9615942 DOI: 10.7717/peerj.14280] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Accepted: 09/30/2022] [Indexed: 01/24/2023] Open
Abstract
Background Kratom is a psychoactive plant used to enhance productivity among laborers in Southeast Asian countries. Previous findings from in vitro research of mitragynine, a major component of kratom, suggested a possible risk of heart function abnormality. However, the cardiac autonomic function in long-term kratom users with chewing forms has never been studied. This study aimed to investigate heart rate variability (HRV) indices of cardiac autonomic function in long-term kratom chewers (LKC), compared to the control levels, and also to examine the correlation between HRV indices and relevant kratom use factors. Method A total number of 50 participants consisted of LKC (n = 31) who regularly chewed fresh kratom leaves for at least 2 years and demographically matched control subjects (n = 19). Resting electrocardiogram (ECG) signals were recorded from subjects for 3 min to analyze the ultrashort HRV in the frequency domain. The normalized low frequency (LFn) and high frequency (HFn) were chosen to be the HRV indices to evaluate cardiac autonomic function. The comparison of HRV indices between groups and the correlation between HRV indices and duration and quantity of kratom use was further conducted in statistical analysis. Results The LKC significantly increased LFn together with enhanced HFn compared to the control group tested, indicating that LKC changed cardiac autonomic function with parasympathetic dominance. Furthermore, no significant correlation between the HRV indices and the duration and quantity of kratom use was found, suggesting that the HRV indices were not relevant to these factors. The present study provided scientific-based evidence of cardiac autonomic modulation in long-term kratom chewers. LFn and HFn may be promising cardiac autonomic indicators for monitoring health outcomes in LKC.
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Affiliation(s)
- Wanumaidah Saengmolee
- Biosignal Research Center for Health, Faculty of Science, Prince of Songkla University, Hatyai, Songkhla, Thailand,Physiological Program, Division of Health and Applied Sciences, Faculty of Science, Prince of Songkla University, Hatyai, Songkhla, Thailand,Bio-Inspired Robotics and Neural Engineering (BRAIN) Laboratory, School of Information Science and Technology (IST), Vidyasirimedhi Institute of Science and Technology (VISTEC), Rayong, Thailand
| | - Dania Cheaha
- Biosignal Research Center for Health, Faculty of Science, Prince of Songkla University, Hatyai, Songkhla, Thailand,Biology Program, Division of Biological Science, Faculty of Science, Prince of Songkla University, Hatyai, Songkhla, Thailand
| | - Nusaib Sa-ih
- Biosignal Research Center for Health, Faculty of Science, Prince of Songkla University, Hatyai, Songkhla, Thailand,Physiological Program, Division of Health and Applied Sciences, Faculty of Science, Prince of Songkla University, Hatyai, Songkhla, Thailand
| | - Ekkasit Kumarnsit
- Biosignal Research Center for Health, Faculty of Science, Prince of Songkla University, Hatyai, Songkhla, Thailand,Physiological Program, Division of Health and Applied Sciences, Faculty of Science, Prince of Songkla University, Hatyai, Songkhla, Thailand
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9
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Kang J, Chang Y, Kim Y, Shin H, Ryu S. Ten-Second Heart Rate Variability, Its Changes Over Time, and the Development of Hypertension. Hypertension 2022; 79:1308-1318. [PMID: 35317608 DOI: 10.1161/hypertensionaha.121.18589] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND The role of ultrashort-term heart rate variability (HRV) and its temporal changes in incident hypertension are unknown. We aimed to investigate the association between 10-second HRV, its changes, and incident hypertension in adults aged <40 years and older. METHODS This cohort study included 232 587 Koreans (mean age 37.6 years) without hypertension. Hypertension was defined according to the 2017 American College of Cardiology and American Heart Association hypertension guidelines. HRV, including the root mean square of successive RR interval differences and the SD of normal-to-normal RR intervals, was estimated using standard 12-lead, 10-second electrocardiography. RESULTS During a median follow-up of 3.8 years, 40 268 hypertension cases were identified (incidence rates: 36.1 and 67.9 per 1000 person-years for young and older participants, respectively). An inverse association was observed between HRV and hypertension risk, in a dose-dependent manner. The multivariable-adjusted hazard ratios (95% CIs) for hypertension comparing the first to the fifth quintiles of root mean square of successive RR interval difference and SD of normal-to-normal RR interval were 1.58 (1.52-1.63) and 1.35 (1.30-1.39), respectively. These associations were stronger in young adults than in older adults. In a subsample of 150 301 participants, compared with stable HRV, an increase in HRV over time was also inversely associated with incident hypertension. CONCLUSIONS A higher HRV and its increase over time on a 10-second electrocardiography were associated with a lower risk of hypertension. Our findings indicate that autonomic function, estimated using 10-second standard electrocardiography, plays a role in predicting hypertension, with a stronger effect in young adults.
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Affiliation(s)
- Jeonggyu Kang
- Total Healthcare Center, Sungkyunkwan University, Seoul, South Korea. (J.K., H.S.).,Center for Cohort Studies, Total Healthcare Center, Sungkyunkwan University, Seoul, South Korea. (J.K., Y.C., Y.K., S.R.)
| | - Yoosoo Chang
- Center for Cohort Studies, Total Healthcare Center, Sungkyunkwan University, Seoul, South Korea. (J.K., Y.C., Y.K., S.R.).,Department of Occupational and Environmental Medicine, Sungkyunkwan University, Seoul, South Korea. (Y.C., S.R.).,Kangbuk Samsung Hospital, School of Medicine and Department of Clinical Research Design and Evaluation, SAIHST, Sungkyunkwan University, Seoul, South Korea. (Y.C., S.R.)
| | - Yejin Kim
- Center for Cohort Studies, Total Healthcare Center, Sungkyunkwan University, Seoul, South Korea. (J.K., Y.C., Y.K., S.R.)
| | - Hocheol Shin
- Total Healthcare Center, Sungkyunkwan University, Seoul, South Korea. (J.K., H.S.).,Department of Family Medicine, Sungkyunkwan University, Seoul, South Korea. (H.S.)
| | - Seungho Ryu
- Center for Cohort Studies, Total Healthcare Center, Sungkyunkwan University, Seoul, South Korea. (J.K., Y.C., Y.K., S.R.).,Department of Occupational and Environmental Medicine, Sungkyunkwan University, Seoul, South Korea. (Y.C., S.R.).,Kangbuk Samsung Hospital, School of Medicine and Department of Clinical Research Design and Evaluation, SAIHST, Sungkyunkwan University, Seoul, South Korea. (Y.C., S.R.)
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10
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The cardiac autonomic response to acute psychological stress in type 2 diabetes. PLoS One 2022; 17:e0265234. [PMID: 35303015 PMCID: PMC8933038 DOI: 10.1371/journal.pone.0265234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Accepted: 02/24/2022] [Indexed: 12/03/2022] Open
Abstract
Background Impaired cardiac autonomic control is common among people with type 2 diabetes. The autonomic nervous system and its regulatory influence on the cardiovascular system also play a key role in the physiological response to psychosocial stressors. It is unclear whether the disease-related impairment of cardiac autonomic control in people with type 2 diabetes affects the stress response. The aim of this study was therefore to examine the cardiac autonomic and the psychological stress response of people with type 2 diabetes compared to healthy control participants. Methods We used the trier social stress test to induce stress in n = 51 participants with type 2 diabetes and n = 47 healthy controls. We assessed heart rate (HR) and heart rate variability (HRV) using six ECG samples before, during and after the stress test. We measured participants’ psychological stress response using visual analogue scales. Results Longitudinal multilevel models showed an attenuated HR increase in response to the stress test combined with a slower HR recovery after the stress test, in people with type 2 diabetes. This pattern was accompanied by significantly lower low frequency HRV but no differences in high frequency HRV between the groups. Additionally, people with type 2 diabetes showed an increased level of self-reported psychological tension 45 minutes after the stress test. Conclusions The impairment of the autonomic nervous system found in people with type 2 diabetes is reflected in the HR response to stress—but not in the HRV response—and partially mirrored in the psychological stress response. Our results underline the importance of considering the interplay of psychosocial stress and disease-related changes in the physiological stress response system in research and treatment of type 2 diabetes.
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11
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Mirzadeh Z, Faber CL, Schwartz MW. Central Nervous System Control of Glucose Homeostasis: A Therapeutic Target for Type 2 Diabetes? Annu Rev Pharmacol Toxicol 2022; 62:55-84. [PMID: 34990204 PMCID: PMC8900291 DOI: 10.1146/annurev-pharmtox-052220-010446] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
Historically, pancreatic islet beta cells have been viewed as principal regulators of glycemia, with type 2 diabetes (T2D) resulting when insulin secretion fails to compensate for peripheral tissue insulin resistance. However, glycemia is also regulated by insulin-independent mechanisms that are dysregulated in T2D. Based on evidence supporting its role both in adaptive coupling of insulin secretion to changes in insulin sensitivity and in the regulation of insulin-independent glucose disposal, the central nervous system (CNS) has emerged as a fundamental player in glucose homeostasis. Here, we review and expand upon an integrative model wherein the CNS, together with the islet, establishes and maintains the defended level of glycemia. We discuss the implications of this model for understanding both normal glucose homeostasis and T2D pathogenesis and highlight centrally targeted therapeutic approaches with the potential to restore normoglycemia to patients with T2D.
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Affiliation(s)
- Zaman Mirzadeh
- Ivy Brain Tumor Center, Department of Neurosurgery, Barrow Neurological Institute, Phoenix, Arizona 85013, USA;
| | - Chelsea L Faber
- Ivy Brain Tumor Center, Department of Neurosurgery, Barrow Neurological Institute, Phoenix, Arizona 85013, USA;
- UW Medicine Diabetes Institute, Department of Medicine, University of Washington, Seattle, Washington 98109, USA;
| | - Michael W Schwartz
- UW Medicine Diabetes Institute, Department of Medicine, University of Washington, Seattle, Washington 98109, USA;
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12
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Li Y, Cui J, Liu Y, Chen K, Huang L, Liu Y. Development and Validation of Risk Prediction Model for New-Onset Diabetes After Percutaneous Coronary Intervention (NODAP): A Study Protocol for a Retrospective, Multicenter Analysis. Front Cardiovasc Med 2021; 8:748256. [PMID: 34708095 PMCID: PMC8542850 DOI: 10.3389/fcvm.2021.748256] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Accepted: 08/25/2021] [Indexed: 11/30/2022] Open
Abstract
Background: Type 2 Diabetes mellitus (T2DM) is a major risk factor for cardiovascular diseases and increase mortality. Clinical outcomes of patients after percutaneous coronary intervention (PCI) were worse in T2DM patients than those without T2DM. New-onset diabetes after PCI (NODAP) is often observed during long-term follow-up and this further aggravates cardiovascular diseases. Several studies had focused on patients after PCI with known T2DM. Previous studies showed that impaired glucose tolerance and aging are risk factors that promote NODAP. Considering the unique characteristics of patients after PCI, we will further study relevant risk factors. We sought to investigate the potential predictors of acute coronary syndrome patients with NODAP by a multicenter retrospective cohort study. Methods: This is a multicenter retrospective cohort study including patients after PCI. Clinical medical records of these patients were collected from four hospitals in different areas in China, from 2010 to 2021. Patients' demographic information, medical history, diagnostic testing, PCI-related information, medication situation will be summarized using descriptive statistics, and correlation analysis was performed on the development of new-onset diabetes. Variation will be described and evaluated using χ2 test or Kreskas-Wallis test. The prediction model will be verified by a validation set. Discussion: A novel diabetes prediction model for patients after PCI is established, and this study can achieve advanced intervention for the occurrence of NODAP. Owing to its retrospective nature, this study has some limitations, but it will be further studied through supplement data collection or prospective study. The study has been registered for clinical trials by the Chinese Clinical Trial Registry (ChiCTR2100047241).
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Affiliation(s)
- Yiwen Li
- National Clinical Research Center for TCM Cardiology, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Jing Cui
- National Clinical Research Center for TCM Cardiology, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Yanfei Liu
- The Second Department of Geriatrics, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Keji Chen
- National Clinical Research Center for TCM Cardiology, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Luqi Huang
- China Center for Evidence-based Medicine of TCM, China Academy of Chinese Medical Sciences, Beijing, China
| | - Yue Liu
- National Clinical Research Center for TCM Cardiology, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
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13
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Martins DF, Viseux FJF, Salm DC, Ribeiro ACA, da Silva HKL, Seim LA, Bittencourt EB, Bianco G, Moré AOO, Reed WR, Mazzardo-Martins L. The role of the vagus nerve in fibromyalgia syndrome. Neurosci Biobehav Rev 2021; 131:1136-1149. [PMID: 34710514 DOI: 10.1016/j.neubiorev.2021.10.021] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Revised: 08/08/2021] [Accepted: 10/18/2021] [Indexed: 12/15/2022]
Abstract
Fibromyalgia (FM) syndrome is a common illness characterized by chronic widespread pain, sleep problems, fatigue, and cognitive difficulties. Dysfunctional neurotransmitter systems that influence the body's endogenous stress response systems are thought to underlie many of the major FM-related symptoms. A model of FM pathogenesis suggests biological and psychosocial variables interact to influence the genetic predisposition, but the precise mechanisms remain unclear. The Polyvagal Theory provides a theoretical framework from which to investigate potential biological mechanisms. The vagus nerve (VN) has anti-inflammatory properties via its afferent and efferent fibers. A low vagal tone (as assessed by low heart rate variability), has been observed in painful and inflammatory diseases, including FM, while the ventral branch of the VN is linked to emotional expression and social engagement. These anti-inflammatory and psychological (limbic system) properties of the VN may possess therapeutic potential in treating FM. This review paper summarizes the scientific literature regarding the potential role of the VN in transducing and/or therapeutically managing FM signs and symptoms.
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Affiliation(s)
- Daniel F Martins
- Experimental Neuroscience Laboratory (LaNEx), Physiotherapy Graduate Course, University of Southern Santa Catarina, Palhoça, SC, Brazil; Postgraduate Program in Health Sciences, University of Southern Santa Catarina, Palhoça, SC, Brazil.
| | - Frederic J F Viseux
- Laboratoire d'Automatique, de Mécanique et d'Informatique industrielle et Humaine (LAMIH), UMR CNRS 8201, Université Polytechnique des Hauts-de-France, Valenciennes, France; Centre d'Evaluation et de Traitement de la Douleur (CETD), Hôpital Jean Bernard, Centre Hospitalier de Valenciennes, F-59322 Valenciennes, France
| | - Daiana C Salm
- Experimental Neuroscience Laboratory (LaNEx), Physiotherapy Graduate Course, University of Southern Santa Catarina, Palhoça, SC, Brazil; Postgraduate Program in Health Sciences, University of Southern Santa Catarina, Palhoça, SC, Brazil
| | - Anny Caroline Avelino Ribeiro
- Experimental Neuroscience Laboratory (LaNEx), Physiotherapy Graduate Course, University of Southern Santa Catarina, Palhoça, SC, Brazil
| | - Helen Kassiana Lopes da Silva
- Experimental Neuroscience Laboratory (LaNEx), Physiotherapy Graduate Course, University of Southern Santa Catarina, Palhoça, SC, Brazil
| | - Lynsey A Seim
- Hospital Internal Medicine, 4500 San Pablo Road, Mayo Clinic, Jacksonville, FL, USA
| | | | - Gianluca Bianco
- Research Laboratory of Posturology and Neuromodulation RELPON, Department of Human Neuroscience, Sapienza University, Rome, Italy; Istituto di Formazione in Agopuntura e Neuromodulazione IFAN, Rome, Italy
| | - Ari Ojeda Ocampo Moré
- Integrative Medicine and Acupuncture Service, University Hospital, Federal University of Santa Catarina, Florianópolis, Santa Catarina, Brazil
| | - William R Reed
- Department of Physical Therapy, University of Alabama at Birmingham, Birmingham, AL, USA; Rehabilitation Science Program, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Leidiane Mazzardo-Martins
- Postgraduate Program in Neuroscience, Center of Biological Sciences, Federal University of Santa Catarina, Florianópolis, Santa Catarina, Brazil
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14
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Yu TY, Lee MK. Autonomic dysfunction, diabetes and metabolic syndrome. J Diabetes Investig 2021; 12:2108-2111. [PMID: 34622579 PMCID: PMC8668070 DOI: 10.1111/jdi.13691] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Revised: 09/14/2021] [Accepted: 09/16/2021] [Indexed: 11/29/2022] Open
Affiliation(s)
- Tae Yang Yu
- Division of Endocrinology and Metabolism, Department of Medicine, Wonkwang Medical Center, Wonkwang University School of Medicine, Iksan, Korea
| | - Moon-Kyu Lee
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Uijeongbu Eulji Medical Center, Eulji University School of Medicine, Uijeongbu, Korea
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15
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Morgalla MH, Fritschle H, Vosseler A, Benkendorff C, Lamprinou A, Heni M, Fritsche A. Influence of Spinal Cord Stimulation on Insulin Sensitivity in Chronic Pain Patients. Exp Clin Endocrinol Diabetes 2021; 130:17-21. [PMID: 34255321 DOI: 10.1055/a-1525-3339] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
BACKGROUND AND OBJECTIVE This prospective, sham-controlled, randomized, cross-over study (NCT03637075), was designed to test the hypothesis that spinal cord stimulation (SCS) for the treatment of pain can also improve glucose metabolism and insulin sensitivity when compared to sham stimulation. METHODS Ten non-diabetic participants (5 females, mean age 48.8 years) who had an SCS system implanted for the treatment of chronic neuropathic pain were studied. Whilst applying a hyperinsulinemic-euglycemic clamp, sham-stimulation and tonic stimulation were performed for 45 min (n=4) or 60 min (n=6) in each case randomly. The insulin sensitivity index and pain levels were determined. A second investigation, BurstDR stimulation was also conducted and the result was compared to that of sham stimulation (cross-over design). RESULTS The insulin sensitivity improved significantly under the tonic stimulation when compared to the sham stimulation (p=0.037). BurstDR stimulation independently did not lead to a significantly improved insulin sensitivity compared to that after sham stimulation (p=0.16). We also examined the pain during the test and found no significant difference between sham and tonic stimulation (p=0.687). CONCLUSION The results of this study show that tonic stimulation used for the treatment of pain could also improve glucose metabolism and insulin sensitivity. Further investigations are required to investigate the clinical relevance of the role of glucose metabolism in diabetic chronic pain participants and its underlying mechanisms.
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Affiliation(s)
| | | | - Andreas Vosseler
- Medical Clinic IV, University of Tübingen, Tübingen, Germany.,Institute for Diabetes Research and Metabolic Diseases of the Helmholtz Center Munich at the University of Tübingen, Tübingen, Germany.,German Center for Diabetes Research (DZD), Neuherberg, Germany
| | | | - Apostolia Lamprinou
- Medical Clinic IV, University of Tübingen, Tübingen, Germany.,Institute for Diabetes Research and Metabolic Diseases of the Helmholtz Center Munich at the University of Tübingen, Tübingen, Germany.,German Center for Diabetes Research (DZD), Neuherberg, Germany
| | - Martin Heni
- Medical Clinic IV, University of Tübingen, Tübingen, Germany.,Institute for Diabetes Research and Metabolic Diseases of the Helmholtz Center Munich at the University of Tübingen, Tübingen, Germany.,German Center for Diabetes Research (DZD), Neuherberg, Germany
| | - Andreas Fritsche
- Medical Clinic IV, University of Tübingen, Tübingen, Germany.,Institute for Diabetes Research and Metabolic Diseases of the Helmholtz Center Munich at the University of Tübingen, Tübingen, Germany.,German Center for Diabetes Research (DZD), Neuherberg, Germany
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16
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Jung I, Lee DY, Lee MY, Kwon H, Rhee EJ, Park CY, Oh KW, Lee WY, Park SW, Park SE. Autonomic Imbalance Increases the Risk for Non-alcoholic Fatty Liver Disease. Front Endocrinol (Lausanne) 2021; 12:752944. [PMID: 34819920 PMCID: PMC8606663 DOI: 10.3389/fendo.2021.752944] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Accepted: 10/21/2021] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Although autonomic imbalance is associated with an increased risk for metabolic disease, its effects on nonalcoholic fatty liver disease (NAFLD) remains unclear. We aimed to evaluate whether autonomic dysfunction predicts the risk for nonalcoholic fatty liver disease (NAFLD). METHODS A total of 33,899 participants without NAFLD who underwent health screening programs between 2011 and 2018 were enrolled. NAFLD was identified by ultrasonography. Autonomic activity was estimated using heart rate variability (HRV). Time domain [standard deviation of the normal-to-normal interval (SDNN) and root mean square difference (RMSSD)]; frequency domain [total power (TP), low frequency (LF), and high frequency (HF), and LF/HF ratio were analyzed. FINDINGS A total 6,466 participants developed NAFLD within a median of 5.7 years. Subjects with incident NAFLD showed decreased overall autonomic modulation and vagal activity with lowered SDNN, RMSSD, HF, normalized HF, compared to those without NAFLD. As the SDNN, RMSSD, TP, LF, and HF tertiles increased, the risk of NAFLD decreased with tertile 1 being the reference group [the hazard ratios (95% confidence intervals) of tertile 3 were 0.90 (0.85-0.96), 0.83 (0.78-0.88), 0.91 (0.86-0.97), 0.93 (0.87-0.99) and 0.89 (0.83-0.94), respectively] after adjusting for potential confounders. The risk for NAFLD was significantly higher in subjects in whom sustained elevated heart rate, normalized LF, and LF/HF ratio values than in those with sustained decrease in these parameters during follow-up. CONCLUSIONS Overall autonomic imbalance, decreased parasympathetic activity, and recently increased sympathetic activity might increase the risk of NAFLD.
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Affiliation(s)
- Inha Jung
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Da Young Lee
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Korea University College of Medicine, Seoul, South Korea
| | - Mi Yeon Lee
- Division of Biostatistics, Department of R&D Management, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Hyemi Kwon
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Eun-Jung Rhee
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Cheol-Young Park
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Ki-Won Oh
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Won-Young Lee
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Sung-Woo Park
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Se Eun Park
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, South Korea
- *Correspondence: Se Eun Park,
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17
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Herzfrequenzvariabilität und Diabetesrisiko. DIABETOL STOFFWECHS 2020. [DOI: 10.1055/a-1213-3812] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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