Irina Kurnikova
RUDN-University, Russia
Title: Heart rate variability at the stages of carbohydrate metabolism disturbance and the phenomenon of early aging of regulatory system in diabetes type-2
Biography
Biography: Irina Kurnikova
Abstract
Statement of the Problem: Study of heart rate variability indices allows not only to identify already existing disorders with the system of regulation and adaptation, but also to predict the risk of developing diseases by measuring the overall stress of regulatory mechanisms, neurohumoral regulation of the heart and the relationship between sympathetic and parasympathetic parts of the autonomic nervous system.
Purpose: Is to assess the impact of diabetes mellitus on mechanisms of autonomic regulatory at the different stages of carbohydrate metabolism disturbance.
Methodology & Theoretical Orientation: At the first stage of this study, patients were divided into several groups. The group of patients without metabolic disorders as the primary cause of the disease - group 1 (n=27); patients with abdominal obesity, hypertension, dyslipidemia - metabolic syndrome - group 2 (n=33); group with symptomatic of DT 2 - group 3b (n=62) at the stage of clinically expressed disorders. Group 3a (n=39) - patients with DT 2 and HTN with normal body weight (endogenous insulin at the lower limit of the norm or below). At the second stage patients with DT 2 (101 people) were divided in four age group: 20-30 years, 31-40 years, 41-50 years,51-60 years of age. All patients were evaluated autonomic regulation by the method of spectral analysis of daily variability of the heart rhythm power spectrum of oscillation in three frequency bands: 0,004-0,08 Hz (very low frequency – VLF), 0,09-0,16 Hz (low frequency – LF), 0,17-0,5 Hz (high frequency – HF). The selection of three frequency ranges is due to differences in their formation. The low frequency range reflects the activity of the sympathetic system on the segmental level, the high-frequency range, the activity of parasympathetic nervous system at the segmental level.
Findings: Simultaneous progressive increase in the power spectra of low-frequency and high-frequency waves at the stages of the progression of metabolic disturbances indicates the transition of the mechanisms of vegetative regulation to a higher energy-consuming level, and the decrease in VLF is about the centralization of regulation and depletion of body resources. Evaluation of spectral analysis revealed a significant increase in the power of ULF% waves in patients with type 2 diabetes, which indicates disruption in adaptation and violation of autonomic regulation of heart rhythm. The revealed significant difference in the analysis of the centralization index in groups with metabolic syndrome and type 2 diabetes with obesity and hypertension emphasizes the importance of the stages of carbohydrate metabolism disorders. Changing the IC towards the increase at the stages of the progression of the violations of the carbohydrate metabolism testifies to the activation of the central contour of regulation and the gradual transition of systemic vegetative regulation from the control level to the management level. Patients with diabetes at the age of 30-40 years we have seen a decrease in parasympathetic activity, which is more typical for patients the next decade of life. Since the age of 41, there was considerable centralization on mechanism of regulation (increase VLF), which usually starts 10-15 years later. The decrease in the total power spectrum on the background of inadequate compensator of diabetes showed decrease of reserve opportunities of the organism.