{
  "abstract": "Objective To ascertain the cross-sectional association between cardiovascular autonomic dysfunction and arterial stiffness across glucose metabolism status.Research design and methods We performed a cross-sectional analysis of participants of the Maastricht study. Cardiovascular autonomic function was based on heart rate variability (HRV) indices from 24-hour ECG recordings and summarized in z-scores for time and frequency domains. Aortic and carotid stiffness were assessed by carotid-femoral pulse wave velocity (PWV) and carotid artery distensibility (CD), respectively. We used multiple linear regression to study the associations and adjusted for demographic and lifestyle factors and a range of cardiovascular risk factors. We tested for effect modification of the associations by glucose metabolism status.Results PWV and CD measures were available in 3673 and 1802 participants, respectively (median (25th; 75th percentile) age: 60 years (53; 66), 51% women, 20% type 2 diabetes by design. Participants with lower HRV had higher aortic stiffness. Per SD lower time-domain and frequency-domain HRV z-scores were associated with 2.8% (95% CI 2.1% to 3.4%) and 2.8% (95% CI 2.1% to 3.5%) higher PWV, respectively. Similar trends were observed for carotid stiffness, with 3.2% (95% CI 1.4% to 5.0%) and 3.1% (95% CI 1.2% to 5.0%) lower CD per SD lower time-domain and frequency-domain HRV, respectively. The magnitude of these associations was higher in groups with prediabetes and type 2 diabetes compared with those with normal glucose metabolism, with evidence of effect modification by glucose metabolism status (p value for interaction: <0.01 for prediabetes and <0.05 to <0.10 for type 2 diabetes, both compared with normal glucose metabolism).Conclusion Cardiovascular autonomic dysfunction is associated with higher aortic and carotid stiffness, especially in people with dysglycemia.",
  "authors": [
    {
      "affiliations": [
        "Department of Public Health, Aarhus University, Aarhus, Denmark",
        "Steno Diabetes Center Aarhus, Aarhus, Denmark"
      ],
      "name": "Jonas R. Schaarup"
    },
    {
      "affiliations": [
        "Steno Diabetes Center Aarhus, Aarhus, Denmark"
      ],
      "name": "Lasse Bjerg"
    },
    {
      "affiliations": [
        "Steno Diabetes Center Copenhagen, Herlev, Denmark"
      ],
      "name": "Christian Stevns Hansen"
    },
    {
      "affiliations": [
        "Steno Diabetes Center Aarhus, Aarhus, Denmark",
        "Department of Medicine, Gødstrup Hospital, Herning, Denmark"
      ],
      "name": "Signe Toft Andersen"
    },
    {
      "affiliations": [
        "Internal Medicine, Maastricht University, Maastricht, The Netherlands"
      ],
      "name": "Marleen MJ van Greevenbroek"
    },
    {
      "affiliations": [
        "Department of Medicine, Maastricht University Medical Center (MUMC+), Maastricht, The Netherlands"
      ],
      "name": "Miranda T Schram"
    },
    {
      "affiliations": [
        "Department of Internal Medicine 463, Section Diabetes, Radboud University Nijmegen Medical Center, Nijmegen, The Netherlands",
        "Internal Medicine/Endocrinology, Maastricht University Medical Centre+, Maastricht, The Netherlands"
      ],
      "name": "Bastiaan E De Galan"
    },
    {
      "affiliations": [
        "Clinical and Experimental Endocrinology, KU Leuven, Leuven, Belgium"
      ],
      "name": "Coen Stehouwer"
    },
    {
      "affiliations": [
        "Department of Public Health, Aarhus University, Aarhus, Denmark",
        "Steno Diabetes Center Aarhus, Aarhus, Denmark"
      ],
      "name": "Daniel R Witte"
    }
  ],
  "title": "Cardiovascular autonomic dysfunction is linked with arterial stiffness across glucose metabolism: the Maastricht study",
  "uid": "14bbf3d9-43c5-5dd0-8a8f-4853743d069d"
}