ArticleCardiovascular diabetology2024
Effects of adipose tissues on the relationship between type 2 diabetes mellitus and reduced heart rate variability: mediation analysis.
Article in Cardiovascular diabetology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.
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Who cites it
10 citing papers in PubMed.
- Body mass index, sedentary lifestyle, and HbA1c predict cardiac autonomic neuropathy in type 2 diabetes.Cardiovascular diabetology. Endocrinology reports · 2026Article
- LDL-C combined with Chinese visceral adiposity index as a risk stratification tool for cardiometabolic multimorbidity in middle-aged and older Chinese adults: a national prospective cohort study.Cardiovascular diabetology · 2026Article
- Epicardial adipose tissue volume outperforms density in association with cardiorenal complications in hypertensive patients.Lipids in health and disease · 2026Article
- Heart rate variability in epilepsy and its association with disease duration: a retrospective case-control study.Frontiers in neurology · 2026Article
- Effects of oral glucose tolerance test on microvascular and autonomic nervous system regulation in young healthy individuals.Scientific reports · 2025Article
- Epicardial Adipose Tissue and Liver Fibrosis in Patients With Type 2 Diabetes Mellitus and Metabolic Dysfunction-Associated Liver Disease.Reviews in cardiovascular medicine · 2025Article
- Association between visceral fat area and heart rate variability in high altitude migrants with OSA: the mediating effect of insulin resistance.Lipids in health and disease · 2025Article
- Obesity indicators mediate the association between the aggregate index of systemic inflammation (AISI) and type 2 diabetes mellitus (T2DM).Lipids in health and disease · 2025Article
- Association between the triglyceride glucose-Chinese visceral adiposity index and new-onset stroke risk: a national cohort study.Cardiovascular diabetology · 2025Article
- Adipose tissue quantity, distribution and pathology and its relationship with type-2 diabetes, insulin resistance and other clustering disease risk in South Asians: a cross-sectional study.Frontiers in endocrinology · 2025Article
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13 authors.
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Abstract
backgroundType 2 diabetes mellitus (T2DM) is associated with decreased heart rate variability (HRV) with an unclear intermediate mechanism. This study aimed to conduct mediation analysis to explore the impact of various adipose tissues on the relationship between T2DM and HRV.
methodsA total of 380 participants were enrolled for analysis, including 249 patients with T2DM and 131 non-diabetic controls. The thicknesses of four adipose tissues (subcutaneous, extraperitoneal, intraperitoneal, and epicardial) were measured by abdominal ultrasound or echocardiography respectively. HRV was assessed by 24-hour Holter for monitoring both frequency domain indices (LF, HF, and LF/HF) and time domain indices (SDNN, SDANN, SDNN index, rMSSD and pNN50). Mediation analysis was used toexamine whether adipose tissues mediated the relationship between T2DM and each index of HRV. Then, a latent variable - HRV burden - was constructed by structural equation model with selected HRV indices to comprehensively assess the whole HRV.
resultsCompared to non-diabetic controls, patients with T2DM exhibited a significant reduction in indices of HRV, and a remarkable increase in the thicknesses of extraperitoneal, intraperitoneal, and epicardial adipose tissues. Mediation analysis found significant indirect effects of T2DM on six indices of HRV, including HF, SDNN, SDANN, SDNN index, rMSSD, and pNN50, which was mediated by epicardial adipose tissue rather than other adipose tissues, with the mediation proportions of 64.21%, 16.38%, 68.33%, 24.34%, 24.10% and 30.51%, respectively. Additionally, epicardial adipose tissue partially mediated the relationship between T2DM and reduced HRV burden (24.26%), which composed by SDNN, SDNN index, rMSSD, and pNN50.
conclusionEpicardial adipose tissue partially mediated the relationship between T2DM and reduced HRV, which reinforces the value of targeting heart-specific visceral fat to prevent cardiac autonomic neuropathy in diabetes.
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