Heart Rate Variability, Insulin Resistance, and Insulin Sensitivity in Japanese Adults: The Toon Health Study

Background: Although impaired cardiac autonomic function is associated with an increased risk of type 2 diabetes in Caucasians, evidence in Asian populations with a lower body mass index is limited. Methods: Between 2009-2012, the Toon Health Study recruited 1899 individuals aged 30-79 years who wer...

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Published in:Journal of epidemiology 2015, Vol.25 (9), p.583-591
Main Authors: Saito, Isao, Hitsumoto, Shinichi, Maruyama, Koutatsu, Nishida, Wataru, Eguchi, Eri, Kato, Tadahiro, Kawamura, Ryoichi, Takata, Yasunori, Onuma, Hiroshi, Osawa, Haruhiko, Tanigawa, Takeshi
Format: Article
Language:English
Subjects:
Body mass index
Cardiovascular Disease
Diabetes
Epidemiology
Glucose
glucose intolerance
Heart rate
heart rate variability
Insulin resistance
insulin sensitivity
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Summary:Background: Although impaired cardiac autonomic function is associated with an increased risk of type 2 diabetes in Caucasians, evidence in Asian populations with a lower body mass index is limited. Methods: Between 2009-2012, the Toon Health Study recruited 1899 individuals aged 30-79 years who were not taking medication for diabetes. A 75-g oral glucose tolerance test was used to diagnose type 2 diabetes, and fasting and 2-h-postload glucose and insulin concentrations were measured. We assessed the homeostasis model assessment index for insulin resistance (HOMA-IR) and Gutt's insulin sensitivity index (ISI). Pulse was recorded for 5 min, and time-domain heart rate variability (HRV) indices were calculated: the standard deviation of normal-to-normal intervals (SDNN) and the root mean square of successive difference (RMSSD). Power spectral analysis provided frequency domain measures of HRV: high frequency (HF) power, low frequency (LF) power, and the LF:HF ratio. Results: Multivariate-adjusted logistic regression models showed decreased SDNN, RMSSD, and HF, and increased LF:HF ratio were associated significantly with increased HOMA-IR and decreased ISI. When stratified by overweight status, the association of RMSSD, HF, and LF:HF ratio with decreased ISI was also apparent in non-overweight individuals. The interaction between LF:HF ratio and decreased ISI in overweight individuals was significant, with the odds ratio for decreased ISI in the highest quartile of LF:HF ratio in non-overweight individuals being 2.09 (95% confidence interval, 1.41-3.10). Conclusions: Reduced HRV was associated with insulin resistance and lower insulin sensitivity. Decreased ISI was linked with parasympathetic dysfunction, primarily in non-overweight individuals.
ISSN:0917-5040
1349-9092
DOI:10.2188/jea.JE20140254