@article {952, title = {The relationship of heart rate and heart rate variability to non-diabetic fasting glucose levels and the metabolic syndrome: the Cardiovascular Health Study.}, journal = {Diabet Med}, volume = {24}, year = {2007}, month = {2007 Aug}, pages = {855-63}, abstract = {

BACKGROUND: Increased heart rate (HR) and diminished heart rate variability (HRV) are signs of early cardiovascular autonomic neuropathy. We tested the hypotheses that increased HR and diminished HRV are present in people: (i) with increased fasting glucose (FG) levels not in the range of diabetes mellitus (DM), and (ii) in people with the metabolic syndrome (MetS) independent of elevated FG levels.

METHODS: HR and HRV were determined in 1267 adults (mean age 72 years) who had Holter monitoring and FG measures: 536 had normal FG levels (NORM, FG 4.5-5.5 mmol/l), 363 had mildly impaired FG (IFG-1, FG 5.6-6.0 mmol/l), 182 had significantly impaired FG (IFG-2, FG 6.1-6.9 mmol/l) and 178 had DM (FG > 6.9 mmol/l or use of glucose-lowering agents/insulin). HR and HRV in NORM/IFG-1 was further compared by the number of components of the MetS and compared by the presence or absence of MetS in IFG-2/DM.

RESULTS: HRV indices were more impaired in IFG-2 and DM than in NORM or IFG-1. There were few differences in HRV indices between NORM and IFG-1 or between IFG-2 and DM. In NORM/IFG-1 participants, having > or = 2 components of the MetS was associated with a greater decrease in HRV compared with having no or one components. In IFG-2/DM participants, MetS was associated with decreased HRV compared with no MetS.

CONCLUSIONS: Increased HR and diminished HRV occur in the non-diabetic FG range. Diminished HRV is associated with the MetS, independent of FG levels. Both these results suggest that factors associated with increasing non-diabetic FG levels and the MetS play a role in the onset of cardiac autonomic impairment.

}, keywords = {Aged, Aged, 80 and over, Arrhythmias, Cardiac, Blood Glucose, Fasting, Female, Glucose Intolerance, Heart Rate, Humans, Male, Metabolic Syndrome, Risk Factors}, issn = {0742-3071}, doi = {10.1111/j.1464-5491.2007.02163.x}, author = {Stein, P K and Barzilay, J I and Domitrovich, P P and Chaves, P M and Gottdiener, J S and Heckbert, S R and Kronmal, R A} } @article {1073, title = {Metabolic syndrome and risk of venous thromboembolism: Longitudinal Investigation of Thromboembolism Etiology.}, journal = {J Thromb Haemost}, volume = {7}, year = {2009}, month = {2009 May}, pages = {746-51}, abstract = {

SUMMARY BACKGROUND: In a recent case-control study, the odds of metabolic syndrome (MetSyn) among deep vein thrombosis cases were almost twice those among controls. We tested the hypothesis that the incidence of non-cancer-related venous thromboembolism (VTE) is higher among adults with MetSyn and further, that associations are stronger for idiopathic than secondary VTE.

METHODS: A total of 20 374 middle-aged and elderly adults were followed for over 12 years for incident VTE in the Longitudinal Investigation of Thromboembolism Etiology (LITE). All hospitalizations were identified and VTEs validated by chart review. Baseline MetSyn was defined using ATP III guidelines, including >or=3 of the following components: abdominal obesity, elevated blood pressure, low HDL-cholesterol, high triglycerides and high glucose. Because sex modified the relation between MetSyn and VTE (p(interaction) = 0.001), proportional hazards regression analyses were stratified by sex to assess the associations of MetSyn and its components with risk of incident non-cancer-related VTE, adjusting for potential confounders.

RESULTS: Incident VTE (n = 358) included 196 idiopathic events. Baseline MetSyn was associated with risk of total VTE (hazard ratio (HR) = 1.84, 95\% CI = 1.30, 2.59) and idiopathic VTE (HR = 1.59, 95\% CI = 1.02, 2.47) among men, but not women. The association was largely attributable to abdominal obesity (HR of VTE = 2.10, 95\% CI = 1.51, 2.93, in men; HR of VTE = 1.70, 95\% CI = 1.24, 2.34, in women), with no additional contribution by the other MetSyn components.

CONCLUSION: Although abdominal obesity was associated with increased risk of VTE in both men and women, MetSyn and its other components do not seem important in VTE etiology.

}, keywords = {Blood Coagulation Factors, Blood Glucose, Blood Pressure, Body Mass Index, Cohort Studies, Female, Fibrinogen, Humans, Lipids, Longitudinal Studies, Male, Metabolic Syndrome, Proportional Hazards Models, Risk Factors, Venous Thromboembolism}, issn = {1538-7836}, doi = {10.1111/j.1538-7836.2009.03295.x}, author = {Steffen, L M and Cushman, M and Peacock, J M and Heckbert, S R and Jacobs, D R and Rosamond, W D and Folsom, A R} }