{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,31]],"date-time":"2025-12-31T16:55:26Z","timestamp":1767200126230,"version":"build-2238731810"},"reference-count":34,"publisher":"American Diabetes Association","issue":"10","license":[{"start":{"date-parts":[[2022,8,2]],"date-time":"2022-08-02T00:00:00Z","timestamp":1659398400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/www.diabetesjournals.org\/journals\/pages\/license"}],"funder":[{"DOI":"10.13039\/100000050","name":"National Heart, Lung, and Blood Institute","doi-asserted-by":"publisher","award":["This research was supported by contracts HHSN26820"],"award-info":[{"award-number":["This research was supported by contracts HHSN26820"]}],"id":[{"id":"10.13039\/100000050","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["diabetesjournals.org"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2022,10,1]]},"abstract":"<jats:sec>\n                    <jats:title>OBJECTIVE<\/jats:title>\n                    <jats:p>The autonomic nervous system (ANS) innervates pancreatic endocrine cells, muscle, and liver, all of which participate in glucose metabolism. We tested whether measures of cardiovascular ANS function are independently associated with incident diabetes and annual change in fasting glucose (FG) levels as well as with insulin secretion and insulin sensitivity in older adults without diabetes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESEARCH DESIGN AND METHODS<\/jats:title>\n                    <jats:p>Heart rate (HR) and measures of HR variability (HRV) were derived from 24-h electrocardiographic monitoring. Blood pressure, seated and standing, was measured. Cox proportional hazards models and linear mixed models were used to analyze the associations between HRV, HR, and orthostatic hypotension (SBP &amp;gt;20 mmHg decline) and incident diabetes or longitudinal FG change.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>The mean annual unadjusted FG change was 1 mg\/dL. Higher detrended fluctuation analyses (DFA) values, averaged over 4\u201311 (DFA1) or 12\u201320 beats (DFA2)\u2014reflecting greater versus less organization of beat-to-beat intervals\u2014were associated with less FG increase over time (per 1-SD increment: DFA1: \u22120.49 mg\/dL\/year [\u22120.96, \u22120.03]; DFA2: \u22120.55 mg\/dL\/year [\u22121.02, \u22120.09]). In mutually adjusted analyses, higher SD of the N-N interval (SDNN) was associated with less FG increase over time (per 1-SD increment: SDNN: \u22120.62 mg\/dL\/year [\u22121.22, \u22120.03]). Higher values of DFA1, DFA2, and SDNN were not significantly associated with insulin secretion, insulin sensitivity, or incident diabetes. We observed no association of HR or orthostatic hypotension with diabetes or FG change.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS<\/jats:title>\n                    <jats:p>Specific measures of cardiac autonomic function are prospectively related to FG level changes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.2337\/dc22-0553","type":"journal-article","created":{"date-parts":[[2022,8,2]],"date-time":"2022-08-02T10:42:10Z","timestamp":1659436930000},"page":"2376-2382","update-policy":"https:\/\/doi.org\/10.2337\/ada-journal-policies","source":"Crossref","is-referenced-by-count":4,"title":["The Association of Measures of Cardiovascular Autonomic Function, Heart Rate, and Orthostatic Hypotension With Incident Glucose Disorders: The Cardiovascular Health Study"],"prefix":"10.2337","volume":"45","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7044-4166","authenticated-orcid":false,"given":"Joshua I.","family":"Barzilay","sequence":"first","affiliation":[{"name":"1Division of Endocrinology, Kaiser Permanente of Georgia, Atlanta, GA"},{"name":"2Division of Endocrinology, Emory School of Medicine, Atlanta, GA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"William","family":"Tressel","sequence":"additional","affiliation":[{"name":"3Department of Biostatistics, School of Public Health, University of Washington, Seattle, WA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mary L.","family":"Biggs","sequence":"additional","affiliation":[{"name":"3Department of Biostatistics, School of Public Health, University of Washington, Seattle, WA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Phyllis K.","family":"Stein","sequence":"additional","affiliation":[{"name":"4Cardiovascular Division, Department of Medicine, Washington University in St. Louis School of Medicine, Saint Louis, MO"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9936-7803","authenticated-orcid":false,"given":"Jorge R.","family":"Kizer","sequence":"additional","affiliation":[{"name":"5Cardiology Section, San Francisco VA Health Care System, San Francisco, CA"},{"name":"6Department of Medicine, University of California, San Francisco, San Francisco, CA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3831-5118","authenticated-orcid":false,"given":"Sanyog G.","family":"Shitole","sequence":"additional","affiliation":[{"name":"5Cardiology Section, San Francisco VA Health Care System, San Francisco, CA"},{"name":"6Department of Medicine, University of California, San Francisco, San Francisco, CA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yakubu","family":"Bene-Alhasan","sequence":"additional","affiliation":[{"name":"7Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Brookline, MA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kenneth J.","family":"Mukamal","sequence":"additional","affiliation":[{"name":"7Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Brookline, MA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1167","published-online":{"date-parts":[[2022,8,2]]},"reference":[{"key":"2023041316073284700_","doi-asserted-by":"crossref","first-page":"87","DOI":"10.1111\/dom.12346","article-title":"Neural regulation of pancreatic islet cell mass and function","volume":"16","author":"Thorens","year":"2014","journal-title":"Diabetes Obes Metab"},{"key":"2023041316073284700_","doi-asserted-by":"crossref","first-page":"39","DOI":"10.1055\/a-0972-1302","article-title":"Endothelial and autonomic dysfunction at early stages of glucose intolerance and in metabolic syndrome","volume":"52","author":"Dimova","year":"2020","journal-title":"Horm Metab 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