Cardiac Autonomic Neuropathy in Prediabetes: A Case-Control Study

Area of Science:

• Cardiology
• Endocrinology
• Neurology

Background:

• Diabetic autonomic neuropathy, particularly cardiac autonomic neuropathy (CAN), is linked to increased cardiovascular mortality.
• Emerging evidence suggests that autonomic dysfunction may precede the clinical diagnosis of type 2 diabetes mellitus, appearing in the prediabetes stage.

Purpose of the Study:

• To compare the prevalence of cardiac autonomic neuropathy (CAN) in individuals with prediabetes versus normoglycemic controls.
• To investigate subclinical autonomic dysfunction in prediabetes.

Main Methods:

• A comparative study involving 50 individuals with prediabetes and 50 age- and gender-matched healthy controls.
• Assessment of CAN using standard cardiovascular reflex tests and heart rate variability (HRV) analysis, including time-domain (SDNN, rMSSD, pNN50) and frequency-domain (VLF, LF, HF, LF/HF ratio) indices.

Main Results:

• Individuals with prediabetes exhibited significantly lower mean heart rate compared to controls.
• All three time-domain HRV indices were significantly reduced in the prediabetes group.
• Specific frequency-domain indices (LF peak frequency, LF peak power, normalized LF, and LF/HF ratio) were significantly lower in individuals with prediabetes.

Conclusions:

• The study confirms the presence of subclinical autonomic dysfunction in individuals with prediabetes.
• Early identification of CAN in prediabetes holds potential for future cardiovascular risk stratification and management strategies.