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Research for correlation between heart rate variability parameters and bone mineral density in patients of type 2 diabetes mellitus

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Abstract

Purpose

The relationship of CAN and BMD, fracture risk is still unclear in T2DM. The aim of the present study is to investigate the correlation between heart rate variability (HRV) and BMD in T2DM.

Methods

The study included 276 patients with T2DM aged ≥ 50 years, and Cardiovascular Autonomic Reflex Tests (CARTs) were applied to divide patients into two groups: CAN ( ±). 24 h Ambulatory ECG was assessed for HRV, BMD was measured by dual-energy X-ray bone densitometry, and FRAX scores were calculated for 10-year hip fracture risk (HF1) and major osteoporotic fracture risk (MOF). Adjusted regression analysis was performed to investigate influence factors for BMD and fracture risk. ROC curve was used to analyze the optimal cut-off point of LF/HF for screening osteoporosis.

Results

Baseline data showed significant differences in the duration of T2DM, insulin resistance index (HOMA-IR), 25-hydroxyvitamin D[25(OH)D], femoral neck BMD, hip BMD, lumbar BMD, HF1, and MOF between the CAN ( +) and CAN (−) groups. The proportion of patients with osteoporosis increased as the degree of CAN lesion increased. Correlation analysis showed that LF/HF was significantly correlated with BMD, especially with hip (r = − 0.534, p < 0.001). Regression analysis showed that LF/HF was a risk factor for reduced BMD and increased fracture risk. The optimal cut-point value for LF/HF to predict osteoporosis by ROC curve analysis was 3.17.

Conclusions

CAN is associated with reduced BMD and increased fracture risk in patients with T2DM, and LF/HF may have the potential to be a predictor of diabetic osteoporosis and have some clinical value in early diagnosis of diabetic osteoporosis and non-traumatic fractures in T2DM.

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Abbreviations

BMD:

Bone mineral density

HRV:

Heart rate variability

HF1 :

Hip fracture risk

MOF:

Major osteoporotic fracture risk

HOMA-IR:

Insulin resistance index

25(OH)D:

25-Hydroxyvitamin D

SBP:

Systolic blood pressure

DBP:

Diastolic blood pressure

FPG:

Fasting plasma glucose

HbA1c:

Glycosylated hemoglobin

TC:

Cholesterol

TG:

Triglyceride

LDL-C:

Low-density lipoprotein cholesterol

HDL-C:

High-density lipoprotein cholesterol

OC:

Osteocalcin

PTH:

Parathyroid hormone

BALP:

Bone alkaline phosphatase

RANKL:

Receptor activator of nuclear factor-κB ligand

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Funding

This study was supported by The Natural Science Foundation of Gansu Province in 2021(No. 21JR1RA080) and The First Hospital of Lanzhou University Foundation in 2019 (No. ldyyn2019-39).

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Authors and Affiliations

  1. Department of Endocrinology, The First Hospital of Lanzhou University, No.1 Donggang West Road, Lanzhou, 730000, Gansu, People’s Republic of China

    Y. Zhang, J. Bai, L. Li, H. Yang, Y. Yang & H. Lv

  2. The First Clinical Medical College of Lanzhou University, Lanzhou, 730000, Gansu, People’s Republic of China

    Y. Zhang, J. Bai, L. Li, H. Yang, Y. Yang & H. Lv

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  1. Y. Zhang
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  2. J. Bai
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Contributions

All authors participated in the conception and design of the study. Also, they participated in data collection, statistical analysis, and interpretation of data, drafted the submitted article, and accomplished the final approval of the version to be submitted.

Corresponding author

Correspondence to H. Lv.

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Conflict of interest

Yangyang Zhang, Jia Bai, Lingling Li, Hong Yang, Ying Yang, and Haihong Lv declare that they have no conflict of interest.

Research involving human participants and/or animals

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (the Ethics Committee of the First Hospital of Lanzhou University, China) and with the Helsinki Declaration of 1964 and later versions.

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Informed consent was obtained from all patients for being included in the study.

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Zhang, Y., Bai, J., Li, L. et al. Research for correlation between heart rate variability parameters and bone mineral density in patients of type 2 diabetes mellitus. J Endocrinol Invest 46, 79–88 (2023). https://doi.org/10.1007/s40618-022-01886-4

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  • DOI: https://doi.org/10.1007/s40618-022-01886-4

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