{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T21:55:36Z","timestamp":1790114136898,"version":"4.0.1"},"reference-count":30,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2017,8,17]],"date-time":"2017-08-17T00:00:00Z","timestamp":1502928000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100004191","name":"Novo Nordisk","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100004191","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100002702","name":"Aalborg Universitet","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100002702","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Diabet. Med."],"published-print":{"date-parts":[[2017,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aims<\/jats:title><jats:p>To compare a novel index of parasympathetic tone, cardiac vagal tone, with established autonomic variables and to test the hypotheses that (1) cardiac vagal tone would be associated with established time and frequency domain measures of heart rate and (2) cardiac vagal tone would be lower in people with Type 1 diabetes than in a matched healthy cohort and lower still in people with established neuropathy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Cardiac vagal tone is a validated cardiometrically derived index of parasympathetic tone. It is measured using a standard three\u2010lead electrocardiogram which connects, via Bluetooth, to a smartphone application. A 5\u2010min resting recording of cardiac vagal tone was undertaken and observational comparisons were made between 42 people with Type 1 diabetes and peripheral neuropathy and 23 without peripheral neuropathy and 65 healthy people. In those with neuropathy, 24\u2010h heart rate variability values were compared with cardiac vagal tone. Correlations between cardiac vagal tone and clinical variables were also made.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p><jats:bold>C<\/jats:bold>ardiac vagal tone was lower in people with established neuropathy and Type 1 diabetes in comparison with healthy participants [median (interquartile range) linear vagal scale 3.4 (1.6\u20135.5 vs 7.0 (5.5\u20139.6); <jats:italic>P\u00a0<\/jats:italic>&lt;<jats:italic>\u00a0<\/jats:italic>0.0001]. Cardiac vagal tone was positively associated with time (<jats:italic>r\u00a0<\/jats:italic>=<jats:italic>\u00a0<\/jats:italic>0.8, <jats:italic>P\u00a0<\/jats:italic>&lt;<jats:italic>\u00a0<\/jats:italic>0.0001) and frequency domain markers of heart rate variability (<jats:italic>r\u00a0<\/jats:italic>=<jats:italic>\u00a0<\/jats:italic>0.75, <jats:italic>P\u00a0<\/jats:italic>&lt;<jats:italic>\u00a0<\/jats:italic>0.0001), representing established measures of parasympathetic function. Cardiac vagal tone was negatively associated with age (<jats:italic>r<\/jats:italic>=\u20130.32, <jats:italic>P\u00a0<\/jats:italic>=<jats:italic>\u00a0<\/jats:italic>0.003), disease duration (<jats:italic>r<\/jats:italic>=\u20130.43, <jats:italic>P\u00a0<\/jats:italic>&lt;<jats:italic>\u00a0<\/jats:italic>0.0001) and cardiovascular risk score (<jats:italic>r<\/jats:italic>=\u20130.32, <jats:italic>P\u00a0<\/jats:italic>=<jats:italic>\u00a0<\/jats:italic>0.006).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Cardiac vagal tone represents a convenient, clinically relevant method of assessing parasympathetic nervous system tone, potentially facilitating the earlier identification of people with Type 1 diabetes who should undergo formal autonomic function testing.<\/jats:p><\/jats:sec>","DOI":"10.1111\/dme.13421","type":"journal-article","created":{"date-parts":[[2017,7,13]],"date-time":"2017-07-13T15:20:15Z","timestamp":1499959215000},"page":"1428-1434","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":35,"title":["Cardiac vagal tone, a non\u2010invasive measure of parasympathetic tone, is a clinically relevant tool in Type 1 diabetes mellitus"],"prefix":"10.1111","volume":"34","author":[{"given":"C.","family":"Brock","sequence":"first","affiliation":[{"name":"Department of Mech\u2010Sense Department of Gastroenterology and Hepatology and Clinical Institute Aalborg University Hospital Aalborg Denmark"},{"name":"Department of Pharmacotherapy and Development University of Copenhagen Copenhagen"},{"name":"Department of Rheumatology Aarhus University Hospital Aarhus"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"N.","family":"Jessen","sequence":"additional","affiliation":[{"name":"Department of Clinical Medicine Aarhus University Hospital Aarhus"},{"name":"Department of Clinical Pharmacology Aarhus University Hospital Aarhus"},{"name":"Department of Biomedicine Aarhus University Hospital Aarhus"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"B.","family":"Brock","sequence":"additional","affiliation":[{"name":"Department of Clinical Medicine Aarhus University Hospital Aarhus"},{"name":"Department of Biochemistry Aarhus University Hospital Aarhus"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P. E.","family":"Jakobsen","sequence":"additional","affiliation":[{"name":"Department of Endocrinology Aalborg University Hospital Aalborg Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"T. K.","family":"Hansen","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Internal Medicine Aarhus University Hospital Aarhus"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J. M.","family":"Rantanen","sequence":"additional","affiliation":[{"name":"Department of Nephrology Aalborg University Hospital Aalborg Denmark"},{"name":"Department of Clinical Medicine Aalborg University Hospital Aalborg Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S.","family":"Riahi","sequence":"additional","affiliation":[{"name":"Department of Cardiology Aalborg University Hospital Aalborg Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Y. K.","family":"Dimitrova","sequence":"additional","affiliation":[{"name":"Department of Mech\u2010Sense Department of Gastroenterology and Hepatology and Clinical Institute Aalborg University Hospital Aalborg Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A.","family":"Dons\u2010Jensen","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Internal Medicine Aarhus University Hospital Aarhus"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Q.","family":"Aziz","sequence":"additional","affiliation":[{"name":"Centre for Neuroscience and Trauma Wingate Institute of Neurogastroenterology, Blizard Institute London School of Medicine and Dentistry Queen Mary University of London London"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A. M.","family":"Drewes","sequence":"additional","affiliation":[{"name":"Department of Mech\u2010Sense Department of Gastroenterology and Hepatology and Clinical Institute Aalborg University Hospital Aalborg Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1902-2640","authenticated-orcid":false,"given":"A. D.","family":"Farmer","sequence":"additional","affiliation":[{"name":"Department of Mech\u2010Sense Department of Gastroenterology and Hepatology and Clinical Institute Aalborg University Hospital Aalborg Denmark"},{"name":"Centre for Neuroscience and Trauma Wingate Institute of Neurogastroenterology, Blizard Institute London School of Medicine and Dentistry Queen Mary University of London London"},{"name":"Department of Gastroenterology University Hospitals of North Midlands Stoke on Trent Staffordshire UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2017,8,17]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc16-1397"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.2337\/diacare.29.02.06.dc05-1242"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.diabres.2008.08.012"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1136\/openhrt-2015-000336"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.4239\/wjd.v5.i1.17"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1469-8986.1997.tb02140.x"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/dmrr.1239"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.4239\/wjd.v6.i1.80"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.0954-6820.1979.tb06069.x"},{"key":"e_1_2_8_11_1","first-page":"928","article-title":"Heart rate independent QT variability component can detect subclinical cardiac autonomic neuropathy in diabetes","volume":"2016","author":"Imam MH","year":"2016","journal-title":"Conf Proc IEEE Eng Med Biol Soc"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc09-1294"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.106.634949"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2013.11.005"},{"key":"e_1_2_8_15_1","first-page":"362","article-title":"Normal values and reproducibility of the real\u2010time index of vagal tone in healthy humans: a multi\u2010center study","volume":"27","author":"Farmer AD","year":"2014","journal-title":"Ann Gastroenterol"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1474-8673.1992.tb00368.x"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.93.5.1043"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00125-014-3461-z"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.1002\/dmrr.1224"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.1900\/RDS.2015.12.213"},{"key":"e_1_2_8_21_1","doi-asserted-by":"publisher","DOI":"10.1038\/jhh.2015.126"},{"key":"e_1_2_8_22_1","doi-asserted-by":"publisher","DOI":"10.1007\/s001250050924"},{"key":"e_1_2_8_23_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.45.4.773"},{"key":"e_1_2_8_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9149(00)00920-6"},{"key":"e_1_2_8_25_1","doi-asserted-by":"publisher","DOI":"10.2337\/diacare.26.6.1895"},{"key":"e_1_2_8_26_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc10-0125"},{"key":"e_1_2_8_27_1","doi-asserted-by":"publisher","DOI":"10.1111\/jdi.12042"},{"key":"e_1_2_8_28_1","first-page":"245","article-title":"Power spectral analysis of heart rate variability: a noninvasive signature of cardiac autonomic function","volume":"21","author":"Kamath MV","year":"1993","journal-title":"Crit Rev Biomed Eng"},{"key":"e_1_2_8_29_1","doi-asserted-by":"publisher","DOI":"10.1136\/hrt.65.5.239"},{"key":"e_1_2_8_30_1","doi-asserted-by":"publisher","DOI":"10.1038\/ejcn.2009.35"},{"key":"e_1_2_8_31_1","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.88.2.562"}],"container-title":["Diabetic Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fdme.13421","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/dme.13421","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,24]],"date-time":"2023-09-24T15:40:48Z","timestamp":1695570048000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/dme.13421"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,8,17]]},"references-count":30,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2017,10]]}},"alternative-id":["10.1111\/dme.13421"],"URL":"https:\/\/doi.org\/10.1111\/dme.13421","archive":["Portico"],"relation":{},"ISSN":["0742-3071","1464-5491"],"issn-type":[{"value":"0742-3071","type":"print"},{"value":"1464-5491","type":"electronic"}],"subject":[],"published":{"date-parts":[[2017,8,17]]},"assertion":[{"value":"2017-07-10","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2017-08-17","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}