{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T22:51:49Z","timestamp":1789771909168,"version":"4.0.1"},"reference-count":38,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2024,6,13]],"date-time":"2024-06-13T00:00:00Z","timestamp":1718236800000},"content-version":"am","delay-in-days":366,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#am"},{"start":{"date-parts":[[2023,6,13]],"date-time":"2023-06-13T00:00:00Z","timestamp":1686614400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000199","name":"U.S. Department of Agriculture","doi-asserted-by":"publisher","award":["USDA\u2010ARS CRIS Award"],"award-info":[{"award-number":["USDA\u2010ARS CRIS Award"]}],"id":[{"id":"10.13039\/100000199","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Obesity"],"published-print":{"date-parts":[[2023,10]]},"abstract":"<jats:title>Summary<\/jats:title><jats:sec><jats:title>Objectives<\/jats:title><jats:p>To characterize the determinants of heart rate variability (HRV) in youth with obesity across the glycemia spectrum.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A total of 94 adolescents, 15\u2009\u00b1\u20092.1\u2009years (21 with normal weight, 23 with overweight\u2010normal glucose tolerance, 26 with prediabetes and 24 with type 2 diabetes [T2D]) underwent an assessment of body composition (dual\u2010energy x\u2010ray absorptiometry), 2\u2010h oral glucose tolerance test with the calculation of indices of glycemia and insulin sensitivity (IS), inflammatory markers (high\u2010sensitivity C\u2010reactive protein [hs\u2010CRP] and tumour necrosis factor\u2010\u03b1 [TNF\u2010\u03b1]), and HRV by peripheral arterial tonometry.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The HRV frequency\u2010domain index (low\u2010frequency to high\u2010frequency ratio [LF\/HF]), an estimate of the ratio between sympathetic and parasympathetic activity, increased across the glycemic spectrum, and was highest in T2D compared with the other three groups (<jats:italic>p<\/jats:italic>\u2009=\u20090.004). LF\/HF correlated with %body fat (<jats:italic>r<\/jats:italic>\u2009=\u20090.22, <jats:italic>p<\/jats:italic>\u2009=\u20090.04); fasting (<jats:italic>r<\/jats:italic>\u2009=\u20090.39, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001), 2\u2010h (<jats:italic>r<\/jats:italic>\u2009=\u20090.31, <jats:italic>p<\/jats:italic>\u2009=\u20090.004), and area under the curve glucose (<jats:italic>r<\/jats:italic>\u2009=\u20090.32, <jats:italic>p<\/jats:italic>\u2009=\u20090.003); hs\u2010CRP (<jats:italic>r<\/jats:italic>\u2009=\u20090.33, <jats:italic>p<\/jats:italic>\u2009=\u20090.002) and TNF\u2010\u03b1 (<jats:italic>r<\/jats:italic>\u2009=\u20090.38, <jats:italic>p<\/jats:italic>\u2009=\u20090.006). In a linear regression model, fasting glucose (<jats:italic>\u03b2<\/jats:italic>\u2009=\u20090.39, <jats:italic>p<\/jats:italic>\u2009=\u20090.003) and hs\u2010CRP (<jats:italic>\u03b2<\/jats:italic>\u2009=\u20090.21, <jats:italic>p<\/jats:italic>\u2009=\u20090.09) contributed to the variance in Ln LF\/HF independent of IS, %body fat, age, sex, race\u2010ethnicity and Tanner stage (<jats:italic>R<\/jats:italic><jats:sup>2<\/jats:sup>\u2009=\u20090.23, <jats:italic>p<\/jats:italic>\u2009=\u20090.013).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Youth with impaired glucose regulation have evidence of cardiac autonomic dysfunction with decreased HRV, and sympathetic overdrive (increased LF\/HF). This dysfunction is mainly related to glycemia and systemic inflammation.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ijpo.13063","type":"journal-article","created":{"date-parts":[[2023,6,14]],"date-time":"2023-06-14T04:35:30Z","timestamp":1686717330000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Hyperglycemia: A determinant of cardiac autonomic dysfunction in youth with obesity across the spectrum of glycemic regulation"],"prefix":"10.1111","volume":"18","author":[{"given":"Heba","family":"El\u2010Ayash","sequence":"first","affiliation":[{"name":"USDA\/ARS Children's Nutrition Research Center Baylor College of Medicine  Houston Texas USA"},{"name":"Division of Pediatric Endocrinology and Diabetes, Texas Children's Hospital Baylor College of Medicine  Houston Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maurice","family":"Puyau","sequence":"additional","affiliation":[{"name":"USDA\/ARS 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