Sympathetic and baroreflex abnormalities in the uncomplicated prediabetic state

Raffaella Dell'Oro, Fosca Quarti Trevano, Pierluigi Gamba, Claudia Ciuffarella, Gino Seravalle, Giuseppe Mancia, Guido Grassi

Research output: Contribution to journalArticle

Abstract

BACKGROUND: Neurogenic abnormalities characterize overt diabetic state. However, how early is their appearance in the clinical course of the disease is unclear.

METHODS: In 26 normotensive and normoweight prediabetic patients, aged 45.2 ± 3.2 years (mean ± SEM), we assessed efferent postganglionic muscle sympathetic nerve traffic (MSNA, microneurography), spontaneous baroreflex sensitivity, and a number of hemodynamic and metabolic variables, including homeostatic model assessment (HOMA) index. Measurements were compared with those obtained in a group of 30 healthy controls of similar age.

RESULTS: For similar clinic and ambulatory blood pressure and BMI values, prediabetic patients displayed significantly greater MSNA values than controls, both when expressed as bursts incidence over time (33.3 ± 2.0 vs. 25.6 ± 1.2 bursts/min, P < 0.01) and when corrected for heart rate values (49.6 ± 1.9 vs. 36.7 ± 1.4 bursts/100 heart beats, P < 0.01). This neurogenic abnormality was associated with a reduced spontaneous baroreflex MSNA sensitivity (-3.20 ± 0.2 vs. -4.72 ± 0.2 a.u., P < 0.01) and significantly greater HOMA index values (3.73 ± 0.1 vs. 1.65 ± 0.1 a.u., P < 0.01). In the multivariate analysis, performed in prediabetic patients, MSNA values were directly and significantly related to HOMA index and inversely and significantly to baroreflex-MSNA sensitivity.

CONCLUSION: These data provide evidence that sympathetic and reflex abnormalities are of early appearance in the clinical course of the diabetic disease. The adrenergic overdrive and the baroreflex impairment may thus participate at the disease progression, favoring the development of the hypertensive state and adversely affecting the disease prognosis.

Original languageEnglish
Pages (from-to)1195-1200
Number of pages6
JournalJournal of Hypertension
Volume36
Issue number5
DOIs
Publication statusPublished - May 2018

Fingerprint

Prediabetic State
Baroreflex
Adrenergic Agents
Reflex
Disease Progression
Multivariate Analysis
Heart Rate
Hemodynamics
Blood Pressure
Muscles
Incidence

Cite this

Dell'Oro, R., Trevano, F. Q., Gamba, P., Ciuffarella, C., Seravalle, G., Mancia, G., & Grassi, G. (2018). Sympathetic and baroreflex abnormalities in the uncomplicated prediabetic state. Journal of Hypertension, 36(5), 1195-1200. https://doi.org/10.1097/HJH.0000000000001659

Sympathetic and baroreflex abnormalities in the uncomplicated prediabetic state. / Dell'Oro, Raffaella; Trevano, Fosca Quarti; Gamba, Pierluigi; Ciuffarella, Claudia; Seravalle, Gino; Mancia, Giuseppe; Grassi, Guido.

In: Journal of Hypertension, Vol. 36, No. 5, 05.2018, p. 1195-1200.

Research output: Contribution to journalArticle

Dell'Oro, R, Trevano, FQ, Gamba, P, Ciuffarella, C, Seravalle, G, Mancia, G & Grassi, G 2018, 'Sympathetic and baroreflex abnormalities in the uncomplicated prediabetic state', Journal of Hypertension, vol. 36, no. 5, pp. 1195-1200. https://doi.org/10.1097/HJH.0000000000001659
Dell'Oro R, Trevano FQ, Gamba P, Ciuffarella C, Seravalle G, Mancia G et al. Sympathetic and baroreflex abnormalities in the uncomplicated prediabetic state. Journal of Hypertension. 2018 May;36(5):1195-1200. https://doi.org/10.1097/HJH.0000000000001659
Dell'Oro, Raffaella ; Trevano, Fosca Quarti ; Gamba, Pierluigi ; Ciuffarella, Claudia ; Seravalle, Gino ; Mancia, Giuseppe ; Grassi, Guido. / Sympathetic and baroreflex abnormalities in the uncomplicated prediabetic state. In: Journal of Hypertension. 2018 ; Vol. 36, No. 5. pp. 1195-1200.
@article{f284503c2fa64aacb7f31f0949539bf2,
title = "Sympathetic and baroreflex abnormalities in the uncomplicated prediabetic state",
abstract = "BACKGROUND: Neurogenic abnormalities characterize overt diabetic state. However, how early is their appearance in the clinical course of the disease is unclear.METHODS: In 26 normotensive and normoweight prediabetic patients, aged 45.2 ± 3.2 years (mean ± SEM), we assessed efferent postganglionic muscle sympathetic nerve traffic (MSNA, microneurography), spontaneous baroreflex sensitivity, and a number of hemodynamic and metabolic variables, including homeostatic model assessment (HOMA) index. Measurements were compared with those obtained in a group of 30 healthy controls of similar age.RESULTS: For similar clinic and ambulatory blood pressure and BMI values, prediabetic patients displayed significantly greater MSNA values than controls, both when expressed as bursts incidence over time (33.3 ± 2.0 vs. 25.6 ± 1.2 bursts/min, P < 0.01) and when corrected for heart rate values (49.6 ± 1.9 vs. 36.7 ± 1.4 bursts/100 heart beats, P < 0.01). This neurogenic abnormality was associated with a reduced spontaneous baroreflex MSNA sensitivity (-3.20 ± 0.2 vs. -4.72 ± 0.2 a.u., P < 0.01) and significantly greater HOMA index values (3.73 ± 0.1 vs. 1.65 ± 0.1 a.u., P < 0.01). In the multivariate analysis, performed in prediabetic patients, MSNA values were directly and significantly related to HOMA index and inversely and significantly to baroreflex-MSNA sensitivity.CONCLUSION: These data provide evidence that sympathetic and reflex abnormalities are of early appearance in the clinical course of the diabetic disease. The adrenergic overdrive and the baroreflex impairment may thus participate at the disease progression, favoring the development of the hypertensive state and adversely affecting the disease prognosis.",
author = "Raffaella Dell'Oro and Trevano, {Fosca Quarti} and Pierluigi Gamba and Claudia Ciuffarella and Gino Seravalle and Giuseppe Mancia and Guido Grassi",
year = "2018",
month = "5",
doi = "10.1097/HJH.0000000000001659",
language = "English",
volume = "36",
pages = "1195--1200",
journal = "Journal of Hypertension",
issn = "0263-6352",
publisher = "Lippincott Williams and Wilkins",
number = "5",

}

TY - JOUR

T1 - Sympathetic and baroreflex abnormalities in the uncomplicated prediabetic state

AU - Dell'Oro, Raffaella

AU - Trevano, Fosca Quarti

AU - Gamba, Pierluigi

AU - Ciuffarella, Claudia

AU - Seravalle, Gino

AU - Mancia, Giuseppe

AU - Grassi, Guido

PY - 2018/5

Y1 - 2018/5

N2 - BACKGROUND: Neurogenic abnormalities characterize overt diabetic state. However, how early is their appearance in the clinical course of the disease is unclear.METHODS: In 26 normotensive and normoweight prediabetic patients, aged 45.2 ± 3.2 years (mean ± SEM), we assessed efferent postganglionic muscle sympathetic nerve traffic (MSNA, microneurography), spontaneous baroreflex sensitivity, and a number of hemodynamic and metabolic variables, including homeostatic model assessment (HOMA) index. Measurements were compared with those obtained in a group of 30 healthy controls of similar age.RESULTS: For similar clinic and ambulatory blood pressure and BMI values, prediabetic patients displayed significantly greater MSNA values than controls, both when expressed as bursts incidence over time (33.3 ± 2.0 vs. 25.6 ± 1.2 bursts/min, P < 0.01) and when corrected for heart rate values (49.6 ± 1.9 vs. 36.7 ± 1.4 bursts/100 heart beats, P < 0.01). This neurogenic abnormality was associated with a reduced spontaneous baroreflex MSNA sensitivity (-3.20 ± 0.2 vs. -4.72 ± 0.2 a.u., P < 0.01) and significantly greater HOMA index values (3.73 ± 0.1 vs. 1.65 ± 0.1 a.u., P < 0.01). In the multivariate analysis, performed in prediabetic patients, MSNA values were directly and significantly related to HOMA index and inversely and significantly to baroreflex-MSNA sensitivity.CONCLUSION: These data provide evidence that sympathetic and reflex abnormalities are of early appearance in the clinical course of the diabetic disease. The adrenergic overdrive and the baroreflex impairment may thus participate at the disease progression, favoring the development of the hypertensive state and adversely affecting the disease prognosis.

AB - BACKGROUND: Neurogenic abnormalities characterize overt diabetic state. However, how early is their appearance in the clinical course of the disease is unclear.METHODS: In 26 normotensive and normoweight prediabetic patients, aged 45.2 ± 3.2 years (mean ± SEM), we assessed efferent postganglionic muscle sympathetic nerve traffic (MSNA, microneurography), spontaneous baroreflex sensitivity, and a number of hemodynamic and metabolic variables, including homeostatic model assessment (HOMA) index. Measurements were compared with those obtained in a group of 30 healthy controls of similar age.RESULTS: For similar clinic and ambulatory blood pressure and BMI values, prediabetic patients displayed significantly greater MSNA values than controls, both when expressed as bursts incidence over time (33.3 ± 2.0 vs. 25.6 ± 1.2 bursts/min, P < 0.01) and when corrected for heart rate values (49.6 ± 1.9 vs. 36.7 ± 1.4 bursts/100 heart beats, P < 0.01). This neurogenic abnormality was associated with a reduced spontaneous baroreflex MSNA sensitivity (-3.20 ± 0.2 vs. -4.72 ± 0.2 a.u., P < 0.01) and significantly greater HOMA index values (3.73 ± 0.1 vs. 1.65 ± 0.1 a.u., P < 0.01). In the multivariate analysis, performed in prediabetic patients, MSNA values were directly and significantly related to HOMA index and inversely and significantly to baroreflex-MSNA sensitivity.CONCLUSION: These data provide evidence that sympathetic and reflex abnormalities are of early appearance in the clinical course of the diabetic disease. The adrenergic overdrive and the baroreflex impairment may thus participate at the disease progression, favoring the development of the hypertensive state and adversely affecting the disease prognosis.

U2 - 10.1097/HJH.0000000000001659

DO - 10.1097/HJH.0000000000001659

M3 - Article

VL - 36

SP - 1195

EP - 1200

JO - Journal of Hypertension

JF - Journal of Hypertension

SN - 0263-6352

IS - 5

ER -