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Clinical Autonomic Research

, Volume 26, Issue 6, pp 407–414 | Cite as

Rosiglitazone influences adipose tissue distribution without deleterious impact on heart rate variability in coronary heart disease patients with type 2 diabetes

  • Audrey Grenier
  • Patrice Brassard
  • Olivier F. Bertrand
  • Jean-Pierre Després
  • Olivier Costerousse
  • Natalie Alméras
  • et Paul Poirier
Research Article

Abstract

Introduction

Obesity is associated with decreased heart rate variability (HRV). Rosiglitazone, a PPARγ agonist, is generally associated with increases in body mass.

Purpose

To assess whether the gain in body mass and adiposity expected from rosiglitazone treatment has an influence on HRV in patients with type 2 diabetes and coronary artery disease.

Methods

One hundred and twenty-five patients with type 2 diabetes and coronary artery disease aged between 40 and 75 years were studied. Anthropometric measurements: (1) body mass index (BMI), (2) waist circumference (WC), (3) abdominal computed tomography (CT) scan, and HRV (using a 24 h Holter) were measured at baseline and after 12 months of treatment. Patients were randomized to rosiglitazone or placebo regimen.

Results

In the rosiglitazone vs. placebo group, there were significant increases in body mass [3.5 (2.6;4.4); mean (95 % CI) vs. 0.2 (−0.4;0.8)] kg), BMI [1.3 (1.0;1.6) vs. 0.1 (−0.1;0.3) kg/m2], WC [2.1 (0.9;3.3) vs. 0.4 (−0.4;1.2) cm, all p ≤ 0.001] and subcutaneous adipose tissue [253 (187;319) vs. 6 (−24;36) cm3, p ≤ 0.001] without statistically significant changes in visceral adipose tissue [−22 (−91;47) vs. 57 (43;71) cm3, p = 0.546], respectively. There was no change in HRV in either group after 12 months. There were no correlations between changes in HRV variables and fat distribution.

Conclusion

Our results suggest that changes in adiposity indices observed after 12 months of rosiglitazone therapy have no deleterious influence on HRV in patients with type 2 diabetes and coronary artery disease.

Keywords

Subcutaneous fat Thiazolidinediones Body fat distribution Autonomic nervous system Heart rate 

Abbreviations

HRV

Heart rate variability

PPARγ

Peroxisome proliferator-activated receptor gamma

BMI

Body mass index

WC

Waist circumference

CT

Computed tomography

CVD

Cardiovascular disease

VAT

Visceral adipose tissue

SAT

Subcutaneous adipose tissue

SNS

Sympathetic nervous system

PNS

Parasympathetic nervous system

T2D

Type 2 diabetes

TZD

Sthiazolidinediones

VICTORY

VeIn Coronary aTherOsclerosis and Rosiglitazone after bypass surgerY

CABG

Coronary artery bypass graft surgery

HbAlc

Glycated hemoglobin

NYHA

New York Heart Association

DEXA

Dual-energy X-ray absorptiometry

LDL-C

Low-density lipoprotein cholesterol

HDL-C

High-density lipoprotein cholesterol

CRP

C-reactive protein

FFA

Free fatty acids

TNF-α

Tumor necrosis factor α

Il-6

Interleukine 6

SDNN

Standard deviation of all normal-to-normal (NN) interval

SDANN

Standard deviation of the averages of NN intervals in all 5 min segments of the entire recording

rMSSD

Square root of the mean of the squared differences between adjacent NN intervals

NN50

Number of pairs of adjacent NN intervals differing by more than 50 ms in the entire recording

pNN50

NN50 divided by the total number or all NN intervals

VLF

Very low frequencies

LF

Low frequencies

HF

High frequencies

CI

Confidence interval of 95 %

TG

Triglycerides

HOMA-IR

Homeostasis model assessment of insulin resistance

ACE

Angiotensin-converting enzyme

Notes

Acknowledgments

VICTORY was designed and executed as an investigator-initiated trial and supported by an unrestricted grant from GlaxoSmithKline. This clinical study have been approved by the ethics committee of Institut universitaire de cardiologie et de pneumologie de Québec. The authors thank the staff and the patients from VICTORY trial for their important contribution. Dr. JP Després is the scientific director of the International Chair on Cardiometabolic Risk. Dr. P Poirier is a clinician-research scholar from the Fonds de la Recherche du Québec-Santé (FRQS). Dr. P Brassard is a Junior 1 research scholar from the FRQS.

Compliance with ethical standards

Conflict of interest

The authors have no relevant conflict of interests.

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Copyright information

© Springer-Verlag Berlin Heidelberg 2016

Authors and Affiliations

  • Audrey Grenier
    • 1
    • 3
  • Patrice Brassard
    • 1
    • 2
  • Olivier F. Bertrand
    • 1
  • Jean-Pierre Després
    • 1
    • 2
  • Olivier Costerousse
    • 1
  • Natalie Alméras
    • 1
  • et Paul Poirier
    • 1
    • 3
  1. 1.Institut universitaire de cardiologie et de pneumologie de QuébecQuebec CityCanada
  2. 2.Department of Kinesiology, Faculty of MedicineLaval UniversityQuebec CityCanada
  3. 3.Faculty of pharmacyLaval UniversityQuebec CityCanada

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