title: Attenuated baroreflex sensitivity in normotensive prediabetes and diabetes in Indian adults.
abstract: OBJECTIVE
  Though attenuated baroreflex sensitivity (BRS) is known to promote cardiovascular disease (CVD) risk in diabetics, its status in prediabetes has not been reported. Also, the link of BRS to CVD risk in normotensive diabetics has not been reported. This study aimed to evaluate the association of BRS to CVD risk in normotensive prediabetics and diabetics.
  
  
  METHODS
  Participants (n = 154) of 18-45 years were divided into normoglycemics (n = 52), prediabetics (n = 64) and diabetics (n = 38) based on American Diabetes Association criteria. Body mass index, waist-hip ratio, waist-height ratio, body fat mass index, basal heart rate, systolic blood pressure, diastolic blood pressure, rate pressure product, BRS, heart rate variability (HRV), fasting plasma glucose, fasting insulin, lipid profile and atherogenic index of plasma (AIP) were measured. Indian Diabetes Risk Score (IDRS) and homeostatic model assessment of insulin resistance were calculated.
  
  
  RESULTS
  There was significant increase in all the parameters except BRS, HRV and high-density lipoprotein in prediabetics and diabetics compared to normoglycemics. All these parameters were significantly altered in prediabetics compared to diabetics. Significant negative correlation was found between BRS and other parameters in prediabetics and diabetics.
  
  
  CONCLUSIONS
  BRS was attenuated in normotensive prediabetics and diabetics with high IDRS, insulin resistance, AIP, dyslipidemia and reduced HRV that predisposes them to CVD risk. The study demonstrates CVD risk quite early in the prediabetics with reduced HRV, high body fat, hyperinsulinemia, insulin resistance, AIP and rate pressure product.
authors.affiliation: a Department of Physiology.
authors.forename: Gorantla Shravya
authors.initials: GS
authors.lastname: Keerthi
authors.affiliation: a Department of Physiology.
authors.forename: Pravati
authors.initials: P
authors.lastname: Pal
authors.affiliation: a Department of Physiology.
authors.forename: Gopal Krushna
authors.initials: GK
authors.lastname: Pal
authors.affiliation: b Department of Endocrinology.
authors.forename: Jaya Prakash
authors.initials: JP
authors.lastname: Sahoo
authors.affiliation: c Department of Biochemistry.
authors.forename: Magadi Gopalakrishna
authors.initials: MG
authors.lastname: Sridhar
authors.affiliation: d Department of Cardiology , Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER) , Puducherry , India.
authors.forename: Jayaraman
authors.initials: J
authors.lastname: Balachander
mesh_terms: D000293:Adolescent; D000328:Adult; D017704:Baroreflex; D002318:Cardiovascular Diseases / Q000097:blood / Q000209:etiology / Q000503:physiopathology*; D003920:Diabetes Mellitus / Q000097:blood / Q000503:physiopathology*; D005260:Female; D006801:Humans; D007194:India; D008297:Male; D008875:Middle Aged; D011236:Prediabetic State / Q000097:blood / Q000150:complications / Q000503:physiopathology*; D055815:Young Adult
keywords: Baroreflex sensitivity; cardiovascular disease risk; heart rate variability; prediabetes; sympathovagal imbalance