title: Effects of gender on sympathovagal imbalance, prehypertension status, and cardiovascular risks in first-degree relatives of type 2 diabetics.
abstract: BACKGROUND
  Although cardiovascular (CV) risks are reported in first-degree relatives (FDRs) of type 2 diabetics, effects of gender on sympathovagal imbalance (SVI) and CV risks in these subjects have not been investigated.
  
  
  METHODS
  Body mass index (BMI), blood pressure variability parameters including baroreflex sensitivity (BRS), spectral indices of heart rate variability, autonomic function tests, insulin resistance, lipid profile, inflammatory markers (interleukin 6, high-sensitivity C-reactive protein, tumor necrosis factor α) and oxidative stress (OS) marker were measured and analyzed in control group (without family history of diabetes; 65 women, 60 men) and study group (FDRs of type 2 diabetics; 52 women, 49 men) subjects.
  
  
  RESULTS
  BMI, heart rate, blood pressure, rate-pressure product, stroke volume, left-ventricular ejection time, cardiac output, total peripheral resistance, homeostatic model of insulin resistance, lipid profile, inflammatory and OS markers, and ratio of low-frequency to high-frequency power of heart rate variability (LF-HF ratio), a sensitive marker of SVI, were significantly increased, and BRS was significantly decreased in study group men compared with women. SVI was more intense in men and was due to concomitant sympathetic activation and vagal inhibition. There was no SVI in control subjects. Multiple regression analysis demonstrated independent contribution of BMI, homeostatic model of insulin resistance, atherogenic index, inflammatory and OS markers, and BRS to LF-HF ratio. Logistic regression analysis demonstrated significant prediction of prehypertension status and rate-pressure product (markers of CV risk) by LF-HF, which was more prominent in men.
  
  
  CONCLUSIONS
  SVI is more intense in male FDRs of type 2 diabetics, and SVI is associated with increased CV risk due to insulin resistance, dyslipidemia, inflammation, and oxidative stress in these subjects.
authors.affiliation: Department of Physiology, Jawaharlal Institute of Post-graduate Medical Education and Research, Puducherry, India.
authors.forename: Gopal K
authors.initials: GK
authors.lastname: Pal
authors.forename: Chandrasekaran
authors.initials: C
authors.lastname: Adithan
authors.forename: Palghat H
authors.initials: PH
authors.lastname: Ananthanarayanan
authors.forename: Pravati
authors.initials: P
authors.lastname: Pal
authors.forename: Nivedita
authors.initials: N
authors.lastname: Nanda
authors.forename: Thiyagarajan
authors.initials: T
authors.lastname: Durgadevi
authors.forename: Venugopal
authors.initials: V
authors.lastname: Lalitha
authors.forename: Avupati N
authors.initials: AN
authors.lastname: Syamsunder
authors.forename: Tarun K
authors.initials: TK
authors.lastname: Dutta
mesh_terms: D000293:Adolescent; D000328:Adult; D015415:Biomarkers / Q000097:blood; D001794:Blood Pressure / Q000235:genetics; D016022:Case-Control Studies; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology* / Q000235:genetics; D050171:Dyslipidemias / Q000453:epidemiology; D005260:Female; D020022:Genetic Predisposition to Disease; D006801:Humans; D007194:India / Q000453:epidemiology; D007249:Inflammation / Q000453:epidemiology; D007333:Insulin Resistance; D016015:Logistic Models; D008297:Male; D015999:Multivariate Analysis; D016017:Odds Ratio; D018384:Oxidative Stress; D010375:Pedigree; D010641:Phenotype; D058246:Prehypertension / Q000097:blood / Q000175:diagnosis / Q000453:epidemiology* / Q000235:genetics / Q000503:physiopathology; D018570:Risk Assessment; D012307:Risk Factors; D012737:Sex Factors; D013564:Sympathetic Nervous System / Q000503:physiopathology*; D014630:Vagus Nerve / Q000503:physiopathology*; D055815:Young Adult
chemical_list: D015415:Biomarkers
keywords: autonomic imbalance; baroflex sensitivity; blood pressure; cardiovascular risk; dyslipidemia; first-degree relatives of type 2 diabetics; gender.; heart rate variability; hypertension; inflammation; insulin resistance; oxidative stress