Tıp Fakültesi / Faculty of Medicine

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Author: search.filters.author.Akinci, SinanSubject: search.filters.subject.Glucose

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    Which Is Responsible for Cardiac Autonomic Dysfunction in Non-Diabetic Patients with Metabolic Syndrome: Prediabetes or the Syndrome Itself
    (2016) Balcioglu, Akif Serhat; Akinci, Sinan; Cicek, Davran; Eldem, Halil Olcay; Coner, Ali; Bal, Ugur Abbas; Muderrisoglu, Haldun; https://orcid.org/0000-0001-5250-5404; https://orcid.org/0000-0002-5711-8873; https://orcid.org/0000-0002-9446-2518; 26610403; AAD-5564-2021; ABD-7321-2021; AAK-4322-2021
    Aims: Cardiac autonomic dysfunction (CAD) is associated with both prediabetes and metabolic syndrome (MS). Heart rate variability (HRV) and heart rate turbulence (HRT) are reliable 24-h Holter-ECG findings of cardiac autonomic function. This study aimed to investigate the relation between MS and its components and CAD using HRV and HRT. Materials and methods: The study included 80 non-diabetic patients with MS and 70 control subjects. All study population and the patients with MS were further analyzed for each diagnostic component of MS to investigate which criteria impaired HRV and HRT. Results: HRV and HRT parameters were disturbed in patients in the MS group. While impairment in HRV and HRT was significantly related to the presence of the fasting plasma glucose (FPG) criterion, there were no differences between groups in terms of the other 4 MS criteria. Moreover, FPG level was significantly correlated with SDNN (r = -0.352, p < 0.001), SDNN index (r = -0.423, p < 0.001), SDANN (r = -0.301, p < 0.001), RMSSD (r = -0.237, p < 0.001), pNN50 (r = -0.237, p < 0.001), turbulence onset (TO) (r = 0.365, p < 0.001) and turbulence slope (TS) (r = -0.365, p < 0.001). Among the MS diagnostic criteria, only FPG level was an independent determinant of all HRV and HRT parameters. Conclusions: This study confirms the relation between MS and CAD. Increased FPG alone appears to be responsible for the mentioned findings among the 5 diagnostic criteria. Accordingly, CAD may be the result of prediabetes, not MS in patients with MS. (C) 2015 Diabetes India. Published by Elsevier Ltd. All rights reserved.
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    Cardiac autonomic nervous dysfunction detected by both heart rate variability and heart rate turbulence in prediabetic patients with isolated impaired fasting glucose
    (2016) Balcioglu, Akif Serhat; Akinci, Sinan; Cicek, Davran; Coner, Ali; Bal, Ugur Abbas; Muderrisoglu, Ibrahim Haldun; 0000-0002-9446-2518; 0000-0002-5711-8873; 0000-0001-5250-5404; 27025199; AAK-4322-2021; ABD-7321-2021; AAD-5564-2021; AAC-8036-2020
    Objective: Cardiac autonomic nervous dysfunction (CAND), a severe complication of diabetes, has also been shown to affect prediabetic patients. The role of isolated impaired fasting plasma glucose (IFG), a subtype of prediabetes, is not clear in the pathogenesis of CAND. The aim of this study was to examine the relationship between isolated IFG and cardiac autonomic function using heart rate variability (HRV) and heart rate turbulence (HRT) indices derived from 24-h Holter-electrocardiogram recordings. Methods: This observational, prospective, cross-sectional study examined 400 consecutive subjects divided into three groups according to oral glucose tolerance test results: the control group [Group I, fasting plasma glucose (FPG) <100 mg/dL and normal glucose tolerance, n=193], the isolated IFG group (Group II, FPG >= 100 and <126 mg/dL, n=134), and the isolated impaired glucose tolerance (IGT), both IFG and IGT, or newly diagnosed diabetes' group (Group III, n=73). Patients with non-sinus rhythm, known diabetes mellitus, coronary artery disease, heart failure, severe valvular disease, or receiving medical therapy that may affect HRV and HRT indices were excluded. Time domain HRV parameters, turbulence onset (TO), turbulence slope (TS), and HRT category were examined. Chi-square, one-way analysis of variance, Kruskal-Wallis H, and Mann-Whitney U tests were used to compare variables where appropriate. The correlation between Holter data and FPG levels was analyzed using the Spearman's test. Multiple linear regression analysis was performed to identify independent predictors of the HRV and HRT parameters. Results: Median (interquartile range 25-75) FPG levels in Groups I, II, and III were 89 (83/93) mg/dL, 109 (104/116) mg/dL, and 174 (150.5/197) mg/dL, respectively. There were significant differences in HRV and HRT parameters between and among all groups. While HRV parameters and TS decreased from Group I to Group III, TO and HRT category gradually increased. Additionally, FPG level was significantly correlated with SDNN, r=-0.220; SDNN index, r=-0.192; SDANN, r=-0.207; RMSSD, r=-0.228; pNN50, r=-0.226; TO, r=0.354; and TS, r=-0.331 (all p<0.001). Conclusion: CAND, as detected by both HRV and HRT, appear to be present in the isolated IFG subtype of prediabetes.