Relationship between autonomic cardiac activity, β-cell function, anthropometrics and metabolic indices in type II diabetics

Daniela Manzella, Marco Carbonella, Emilia Ragno, Nicola Passariello, Rodolfo Grella, Giuseppe Paolisso

Research output: Contribution to journalArticle

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Abstract

OBJECTIVE: Recent studies have demonstrated that C-peptide exerts beneficial effects on the diabetic state, including improvements in kidney and nerve function. Thus, we investigated the effect of residual pancreatic C-peptide secretion on the cardiac autonomic nervous system in well- and poorly controlled type II diabetic patients. DESIGN: Randomised cross-sectional study. PATIENTS: Forty type II diabetic patients free from diabetic neuropathy, with similar anthropometric parameters, volunteered for our study. MEASUREMENTS: Insulin action, residual pancreatic C-peptide secretion and the cardiac autonomic nervous system were investigated by euglycaemic hyperinsuli-naemic clamp, glucagon bolus test and heart rate variability, respectively. M-values were used as an index of insulin sensitivity. High frequency (HF) and low frequency (LF) oscillations in heart rate were analysed. RESULTS: The patients were categorized into those with good (HbA1c ≤ 7.0) and poor (HbA1c ≥ 8.0) metabolic control. The patients with good metabolic control had fasting plasma glucose and C-peptide levels, plasma area under the curve (AUC) insulin and C-peptide levels, M-values, LF values and LF/HF ratio significantly lower than patients with poor metabolic control. In contrast, RR interval, total power and HF values had an opposite trend. Basal plasma C-peptide correlated with LF/HF in patients with good (r = -0.42; P <0.05) and poor metabolic control (r = -0.45; P <0.05). An even stronger correlation between AUC C-peptide and LF/HF in patients with good (r = -0.53, P <0.002) and poor metabolic control (r = -0.49; P <0.03), as well as in the whole group (r = -0.83; P <0.001) was found. By multiple regression analyses performed in all patients, LF/HF were independently associated with AUC C-peptide (t = -8.618; P <0.001) but not basal C-peptide levels (t = -0.137; P <0.88). CONCLUSION: Our study demonstrated that preserved C-peptide secretion is associated with a well balanced cardiac autonomic activity in type II diabetic patients.

Original languageEnglish
Pages (from-to)259-264
Number of pages6
JournalClinical Endocrinology
Volume57
Issue number2
DOIs
Publication statusPublished - 2002

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C-Peptide
Area Under Curve
Autonomic Nervous System
Heart Rate
Insulin
Diabetic Neuropathies
Glucagon
Insulin Resistance
Fasting
Cross-Sectional Studies
Regression Analysis
Kidney
Glucose

ASJC Scopus subject areas

  • Endocrinology

Cite this

Relationship between autonomic cardiac activity, β-cell function, anthropometrics and metabolic indices in type II diabetics. / Manzella, Daniela; Carbonella, Marco; Ragno, Emilia; Passariello, Nicola; Grella, Rodolfo; Paolisso, Giuseppe.

In: Clinical Endocrinology, Vol. 57, No. 2, 2002, p. 259-264.

Research output: Contribution to journalArticle

Manzella, Daniela ; Carbonella, Marco ; Ragno, Emilia ; Passariello, Nicola ; Grella, Rodolfo ; Paolisso, Giuseppe. / Relationship between autonomic cardiac activity, β-cell function, anthropometrics and metabolic indices in type II diabetics. In: Clinical Endocrinology. 2002 ; Vol. 57, No. 2. pp. 259-264.
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T1 - Relationship between autonomic cardiac activity, β-cell function, anthropometrics and metabolic indices in type II diabetics

AU - Manzella, Daniela

AU - Carbonella, Marco

AU - Ragno, Emilia

AU - Passariello, Nicola

AU - Grella, Rodolfo

AU - Paolisso, Giuseppe

PY - 2002

Y1 - 2002

N2 - OBJECTIVE: Recent studies have demonstrated that C-peptide exerts beneficial effects on the diabetic state, including improvements in kidney and nerve function. Thus, we investigated the effect of residual pancreatic C-peptide secretion on the cardiac autonomic nervous system in well- and poorly controlled type II diabetic patients. DESIGN: Randomised cross-sectional study. PATIENTS: Forty type II diabetic patients free from diabetic neuropathy, with similar anthropometric parameters, volunteered for our study. MEASUREMENTS: Insulin action, residual pancreatic C-peptide secretion and the cardiac autonomic nervous system were investigated by euglycaemic hyperinsuli-naemic clamp, glucagon bolus test and heart rate variability, respectively. M-values were used as an index of insulin sensitivity. High frequency (HF) and low frequency (LF) oscillations in heart rate were analysed. RESULTS: The patients were categorized into those with good (HbA1c ≤ 7.0) and poor (HbA1c ≥ 8.0) metabolic control. The patients with good metabolic control had fasting plasma glucose and C-peptide levels, plasma area under the curve (AUC) insulin and C-peptide levels, M-values, LF values and LF/HF ratio significantly lower than patients with poor metabolic control. In contrast, RR interval, total power and HF values had an opposite trend. Basal plasma C-peptide correlated with LF/HF in patients with good (r = -0.42; P <0.05) and poor metabolic control (r = -0.45; P <0.05). An even stronger correlation between AUC C-peptide and LF/HF in patients with good (r = -0.53, P <0.002) and poor metabolic control (r = -0.49; P <0.03), as well as in the whole group (r = -0.83; P <0.001) was found. By multiple regression analyses performed in all patients, LF/HF were independently associated with AUC C-peptide (t = -8.618; P <0.001) but not basal C-peptide levels (t = -0.137; P <0.88). CONCLUSION: Our study demonstrated that preserved C-peptide secretion is associated with a well balanced cardiac autonomic activity in type II diabetic patients.

AB - OBJECTIVE: Recent studies have demonstrated that C-peptide exerts beneficial effects on the diabetic state, including improvements in kidney and nerve function. Thus, we investigated the effect of residual pancreatic C-peptide secretion on the cardiac autonomic nervous system in well- and poorly controlled type II diabetic patients. DESIGN: Randomised cross-sectional study. PATIENTS: Forty type II diabetic patients free from diabetic neuropathy, with similar anthropometric parameters, volunteered for our study. MEASUREMENTS: Insulin action, residual pancreatic C-peptide secretion and the cardiac autonomic nervous system were investigated by euglycaemic hyperinsuli-naemic clamp, glucagon bolus test and heart rate variability, respectively. M-values were used as an index of insulin sensitivity. High frequency (HF) and low frequency (LF) oscillations in heart rate were analysed. RESULTS: The patients were categorized into those with good (HbA1c ≤ 7.0) and poor (HbA1c ≥ 8.0) metabolic control. The patients with good metabolic control had fasting plasma glucose and C-peptide levels, plasma area under the curve (AUC) insulin and C-peptide levels, M-values, LF values and LF/HF ratio significantly lower than patients with poor metabolic control. In contrast, RR interval, total power and HF values had an opposite trend. Basal plasma C-peptide correlated with LF/HF in patients with good (r = -0.42; P <0.05) and poor metabolic control (r = -0.45; P <0.05). An even stronger correlation between AUC C-peptide and LF/HF in patients with good (r = -0.53, P <0.002) and poor metabolic control (r = -0.49; P <0.03), as well as in the whole group (r = -0.83; P <0.001) was found. By multiple regression analyses performed in all patients, LF/HF were independently associated with AUC C-peptide (t = -8.618; P <0.001) but not basal C-peptide levels (t = -0.137; P <0.88). CONCLUSION: Our study demonstrated that preserved C-peptide secretion is associated with a well balanced cardiac autonomic activity in type II diabetic patients.

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