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  • Title: [Exercise testing to estimate dysfunction of the autonomic nervous system in subjects with carbohydrate disorders].
    Author: Kowalski J, Brylik A, Barylski M, Kowalczyk E, Pawlicki L, Mejer A, Irzmański R.
    Journal: Pol Merkur Lekarski; 2012 Jan; 32(187):18-21. PubMed ID: 22400174.
    Abstract:
    UNLABELLED: Slow heart rate recovery (HRR) 2 minutes after exercise testing is a predictor of cardiovascular mortality and index of decreased parasympathetic activity. The aim of the study was to evaluate the heart rate recovery in subjects with carbohydrate disorders. MATERIAL AND METHODS: The study comprised 112 subjects with carbohydrate disorders (54 females and 58 males), aged 30-78 (57.4 +/- 9.6) years. Carbohydrate disorders were diagnosed according to the Polish Diabetes Association criteria from 2007 (group I). 56 subjects had impaired fasting glucose (IFG), 36 - impaired glucose tolerance (IGT) and 20 - type 2 diabetes. Comparative group comprised 30 subjects without cardiovascular diseases and carbohydrate disorders (15 females and 15 males), aged 29-64 (52.70 +/- 8.8) years (group II). The fasting serum glucose level was evaluated using an enzymatic method, Kone-Pro biochemical analyzer and bioMérieux Glucose RTU kit. In subjects with fasting glucose level > or = 100 mg/dl, an oral glucose tolerance test (OGTT) was performed. In all subjects submaximal exercise treadmill testing was performed. Heart rate recovery was defined as a difference between the peak heart rate and that after 2 minutes of recovery in sitting position. RESULTS: In subjects with carbohydrate disorders the mean value of HRR was 38.93 +/- 12.08/min and it was significantly lower (p < 0.05) than in comparative group (57.0 +/- 11.44/min). In subjects with carbohydrate disorders negative correlation between HRR and patients' age as well as between HRR and fasting glucose level in males. On the basis of ROC curve analysis and OR (odds ratio) it was shown that HRR < or = 43.5/min results in almost threefold increased risk of carbohydrate disorders. CONCLUSIONS: In subjects with carbohydrate disorders the value of HRR is lowered, what stands for decreased parasympathetic activity and increased cardiovascular risk. HRR < or = 43.5/min results in almost threefold increased risk of carbohydrate disorders.
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