ArticleDiabetologia2015
Increased prevalence of cardiac autonomic dysfunction at different degrees of glucose intolerance in the general population: the KORA S4 survey.
Article in Diabetologia, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 56 papers, 4 of them syntheses that pooled it.
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Who cites it
56 citing papers in PubMed, 4 syntheses or guidelines pooled it, 131 citations in OpenAlex.
- The Relationship Between Prediabetes and Peripheral Neuropathy-A Systematic Review and Meta-Analysis.European journal of neurology · 2025Pooled it
- Exploring heart rate variability in polycystic ovary syndrome: implications for cardiovascular health: a systematic review and meta-analysis.Systematic reviews · 2024Pooled it
- American Association of Clinical Endocrinology Clinical Practice Guideline: Developing a Diabetes Mellitus Comprehensive Care Plan-2022 Update.Endocrine practice : official journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists · 2022Guideline
- The prevalence of cardiac autonomic neuropathy in prediabetes: a systematic review.Diabetologia · 2021Pooled it
- Dysglycaemia and Autonomic Dysfunction: The Diabetes Prevention Program Outcomes Study.Diabetes, obesity & metabolism · 2026Article
- Differential associations of resting heart rate and heart rate variability indices with cardiovascular and coronary heart disease mortality risk: the prospective KORA study.Scientific reports · 2026Article
- Clinical Characteristics of Diabetic Cardiovascular Autonomic Neuropathy in Korean Individuals With Type 2 Diabetes.Journal of diabetes · 2026Article
- Associations of the atherogenic index of plasma and its modified indices with the incidence and progression of cardiovascular-liver-metabolic multimorbidity: a prospective cohort study from UK Biobank.Cardiovascular diabetology · 2026Article
- Article
- Dynamic Sleep-Derived Heart Rate and Heart Rate Variability Features Associated with Glucose Metabolism Status: An Exploratory Feature-Selection Study Using Consumer Wearables.Sensors (Basel, Switzerland) · 2026Article
- Circulating Neutrophil and Monocyte Counts Are Inversely Associated With Heart Rate Variability Indices: The Maastricht Study.Journal of the American Heart Association · 2026Article
- Cardiac autonomic neuropathy in patients with SGA-treated schizophrenia: a randomized controlled trial of 30 weeks' treatment with semaglutide.Cardiovascular diabetology. Endocrinology reports · 2026Article
- Association of triglyceride glucose index with cardiovascular autonomic neuropathy in type 2 diabetes mellitus.Frontiers in cardiovascular medicine · 2026Article
- Autonomic neuropathy in diabetes.Archives of endocrinology and metabolism · 2025Review
- Association of Inflammatory and Cardiovascular Proteomics Biomarkers With Indices of Heart Rate Variability in the General Population: KORA S4/FF4 Study.Journal of the American Heart Association · 2025Article
- Cohort profile of the Heidelberg study on diabetes and complications HEIST-DiC.Scientific reports · 2025Article
- Glycaemic control, low levels of high-density lipoprotein, and high cardiovascular risk are associated with cardiovascular autonomic neuropathy.Diabetology & metabolic syndrome · 2025Article
- Heart rate variability indices for predicting cardiorenal outcomes: A lesson from the PERL and ACCORD cohorts.Journal of diabetes investigation · 2025Article
- Diabetes: A Subspecialty of Medicine and a Matter of Public Health.Diabetes, metabolic syndrome and obesity : targets and therapy · 2025Article
- Neuropad Assessment of Sudomotor Function Across Glycemic Levels in Adults.Diabetes, metabolic syndrome and obesity : targets and therapy · 2025Article
Corrections and comments
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Authors and funding
9 authors at 4 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
aims/hypothesisCardiac autonomic nervous dysfunction (CAND) raises the risk of mortality, but the glycaemic threshold at which it develops is unclear. We aimed to determine the prevalence of, risk factors for and impact of CAND in glucose intolerance and diabetes.
methodsAmong 1,332 eligible participants aged 55-74 years in the population-based cross-sectional KORA S4 study, 130 had known diabetes mellitus (k-DM), and the remaining 1,202 underwent an OGTT. Heart rate variability (HRV) and QT variability were computed from supine 5 min ECGs.
resultsIn all, 565 individuals had normal glucose tolerance (NGT), 336 had isolated impaired fasting glucose (i-IFG), 72 had isolated impaired glucose tolerance (i-IGT), 151 had combined IFG-IGT (IFG-IGT) and 78 had newly detected diabetes mellitus (n-DM). Adjusted normal HRV limits were defined in the NGT population (5th and 95th percentiles). Three HRV measures were more frequently abnormal in those with k-DM, n-DM, IFG-IGT and i-IFG than in those with NGT (p < 0.05). The rates of CAND (≥2 of 4 HRV indices abnormal) were: NGT, 4.5%; i-IFG, 8.1%; i-IGT, 5.9%; IFG-IGT, 11.4%; n-DM, 11.7%; and k-DM, 17.5% (p < 0.05 vs NGT, except for i-IGT). Reduced HRV was associated with cardiovascular risk factors used to construct a simple screening score for CAND. Mortality was higher in participants with reduced HRV (p < 0.05 vs normal HRV). CONCLUSIONS/
interpretationIn the general population aged 55-74 years, the prevalence of CAND is increased not only in individuals with diabetes, but also in those with IFG-IGT and, to a lesser degree, in those with i-IFG. It is associated with mortality and modifiable cardiovascular risk factors which may be used to screen for diminished HRV in clinical practice.
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