Effects of adipose tissues on the relationship between type 2 diabetes mellitus and reduced heart rate variability: mediation analysis
Authors' conclusion
Epicardial 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.
Study context
- Population
- Patients with T2D and non-diabetic controls; thicknesses of subcutaneous, extraperitoneal, intraperitoneal and epicardial adipose tissue by abdominal US or echocardiography; Heart rate variability (HRV) by 24-hour Holter
- Participants
- 380 patients
- Exposure
- T2D vs non-diabetic controls; mediation by adipose tissues
- T2DMn = 249
- Non-diabetic controlsn = 131reference
- Outcome
- Mediation by adipose tissues of the relationship between T2D and each HRV index
Methodological detailsmediation analysis, structural equation model
- Mediation analysis
- Structural equation model
Main finding
As reported in the abstract
Mediation of T2D–HRV relationship by epicardial adipose tissue
- Mediation proportion by epicardial adipose tissue, HF
- 64.21%
- Mediation proportion, SDNN
- 16.38%
- Mediation proportion, SDANN
- 68.33%
- Mediation proportion, SDNN index
- 24.34%
- Mediation proportion, rMSSD
- 24.10%
- Mediation proportion, pNN50
- 30.51%
Observational data: associations, not effects.
Further findings
HRV burden (latent variable: SDNN, SDNN index, rMSSD, pNN50)
- Epicardial adipose tissue partially mediated relationship between T2D and reduced HRV burden
- 24.26%
HRV indices and adipose tissue thickness, T2D vs controls
- Significant reduction in HRV indices with T2D vs controls
- Remarkable increase in extraperitoneal, intraperitoneal and epicardial adipose tissue thickness with T2D
Original publication
Effects of adipose tissues on the relationship between type 2 diabetes mellitus and reduced heart rate variability: mediation analysis. Cardiovasc Diabetol. Published 28 September 2024. doi:10.
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