ArticleAnnals of noninvasive electrocardiology : the official journal of the International Society for Holter and Noninvasive Electrocardiology, Inc2020
Assessing heart rate variability in type 1 diabetes mellitus-Psychosocial stress a possible confounder.
Article in Annals of noninvasive electrocardiology : the official journal of the International Society for Holter and Noninvasive Electrocardiology, Inc, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 1 of them a synthesis that pooled it.
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Who cites it
11 citing papers in PubMed, 1 synthesis or guideline pooled it, 17 citations in OpenAlex.
- Salivary Biomarkers Associated with Psychological Alterations in Patients with Diabetes: A Systematic Review.Medicina (Kaunas, Lithuania) · 2022Pooled it
- Physical Exercise Before Long-Term Electrocardiogram May Enhance the Assessment of Nocturnal Heart Rate Variability in Young Individuals With Type 1 Diabetes Melltius.Annals of noninvasive electrocardiology : the official journal of the International Society for Holter and Noninvasive Electrocardiology, Inc · 2025Article
- Measuring salivary cortisol in biobehavioral research: A systematic review and methodological considerations.Brain, behavior, & immunity - health · 2025Review
- The Role of Insulin Within the Socio-Psycho-Biological Framework in Type 2 Diabetes-A Perspective from Psychoneuroimmunology.Biomedicines · 2024Review
- Article
- Lower left atrial function in young individuals with type 1 diabetes mellitus compared to healthy controls: an echocardiographic study.Scientific reports · 2024Article
- Psychological Alterations in Youths with Type I Diabetes: Associations with Salivary Cortisol Concentration.Medicina (Kaunas, Lithuania) · 2023Article
- Adynamic response to cold pain reflects dysautonomia in type 1 diabetes and polyneuropathy.Scientific reports · 2023Article
- The Potential of Current Noninvasive Wearable Technology for the Monitoring of Physiological Signals in the Management of Type 1 Diabetes: Literature Survey.Journal of medical Internet research · 2022Review
- Rapid glucose rise reduces heart rate variability in adults with type 1 diabetes: A prospective secondary outcome analysis.Diabetes, obesity & metabolism · 2021Article
- Assessing heart rate variability in type 1 diabetes mellitus-Psychosocial stress a possible confounder.Annals of noninvasive electrocardiology : the official journal of the International Society for Holter and Noninvasive Electrocardiology, Inc · 2020Article
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Authors and funding
6 authors at 3 institutions in 1 country.
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No grant is acknowledged in the PubMed record.
Abstract
backgroundAutonomic neuropathy (AN) commonly arises as a long-term complication in diabetes mellitus and can be diagnosed from heart rate variability (HRV), calculated from electrocardiogram recordings. Psychosocial stress also affects HRV and could be one of several confounders for cardiac AN. The present work investigated the impact of psychosocial stress on HRV in individuals with type 1 diabetes mellitus (T1DM) and assessed the use of salivary cortisol as a biomarker for psychosocial stress in this context.
methodsA total of 167 individuals 6-60 years old (113 with T1DM and 54 healthy controls) underwent 24-hr ECG recordings with HRV analysis. Salivary cortisol was sampled thrice during the registration day. Perceived psychosocial stress along with other factors of possible importance for the interpretation of HRV was documented in a diary.
resultsHeart rate variability (high-frequency power during sleep) was reduced (p < .05) with older age, longer diabetes duration, higher mean glucose levels, physical inactivity, and perceived psychosocial stress. Salivary cortisol levels in the evening were increased (p < .05) in women in ovulation phase, in individuals with preceding hypoglycemia or with hyperglycemia. The amplitude of salivary cortisol was reduced (p < .05) with the presence of perceived psychosocial stress, but only in adult healthy controls, not in individuals with diabetes.
conclusionPsychosocial stress might be a confounder for reduced HRV when diagnosing cardiac AN in T1DM. Salivary cortisol is, however, not a useful biomarker for psychosocial stress in diabetes since the physiological stress of both hypoglycemia and hyperglycemia seems to overrule the effect of psychosocial stress on cortisol.
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