Rosiglitazone influences adipose tissue distribution without deleterious impact on heart rate variability in coronary heart disease patients with type 2 diabetes
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Obesity is associated with decreased heart rate variability (HRV). Rosiglitazone, a PPARγ agonist, is generally associated with increases in body mass.
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.
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.
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.
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.
KeywordsSubcutaneous fat Thiazolidinediones Body fat distribution Autonomic nervous system Heart rate
Heart rate variability
Peroxisome proliferator-activated receptor gamma
Body mass index
Visceral adipose tissue
Subcutaneous adipose tissue
Sympathetic nervous system
Parasympathetic nervous system
Type 2 diabetes
VeIn Coronary aTherOsclerosis and Rosiglitazone after bypass surgerY
Coronary artery bypass graft surgery
New York Heart Association
Dual-energy X-ray absorptiometry
Low-density lipoprotein cholesterol
High-density lipoprotein cholesterol
Free fatty acids
Tumor necrosis factor α
Standard deviation of all normal-to-normal (NN) interval
Standard deviation of the averages of NN intervals in all 5 min segments of the entire recording
Square root of the mean of the squared differences between adjacent NN intervals
Number of pairs of adjacent NN intervals differing by more than 50 ms in the entire recording
NN50 divided by the total number or all NN intervals
Very low frequencies
Confidence interval of 95 %
Homeostasis model assessment of insulin resistance
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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