Sympathetic Changes through the Menstrual Cycle are Absent in Women with Diabetes

다국어 초록 (Multilingual Abstract)

Glycemic variability (GV) can contribute to autonomic dysfunction in diabetes (Jaiswal et al. 2014), and autonomic dysfunction can be apparent as early as childhood (Metwalley et al. 2018). In women with diabetes, GV can differ throughout the menstrual cycle where hyperglycemia and decreased insulin sensitivity are often present in the luteal phase (Brown et al. 2015). Therefore, we investigated the role of the menstrual cycle in autonomic control in women with diabetes.
Women with diabetes (n=7; age 23.6 ± 1.0years; BMI 24.4 ± 1.1kg/m2) were tested in the early follicular (EF; day 2–5) and mid‐luteal (ML; day 18–24) phases of the menstrual cycle. Blood glucose was 8.6 ± 1.1mmol/L in the EF phase and 8.1 ± 0.7mmol/L in the ML phase (P=0.71). Trials included resting heart rate variability (HRV), paced deep breathing, Valsalva, and 10 minutes of 70‐degree upright tilt. Heart rate (HR), stroke volume index (SVi), and mean arterial pressure (MAP) were measured. Frequency domain analysis of HRV was conducted on 5 minutes of resting ECG (low frequency power (LF) and high frequency power (HF)).
The expiration to inspiration HR ratio during paced deep breathing (EF: 1.40 ± 0.06, ML: 1.43 ± 0.05, P=0.39) and the Valsalva HR ratio (EF: 2.29 ± 0.16, ML: 2.16 ± 0.13, P=0.48) were similar between the phases. During the Valsalva maneuver, the increase in MAP from Phase II minimum to the end of Phase II was similar between phases (EF: +18.6 ± 3.8mmHg, ML: +18.4 ± 1.5mmHg, P=0.64). Upright tilt resulted in higher HR (P=0.005) and lower SVi (P=0.011) with no interaction effects between tilt and menstrual phase (P≥0.64). The maximum HR response to tilt was similar between the phases (EF: 101.2 ± 5.7bpm, ML: 99.5 ± 5.9bpm, P=0.69). There were no differences between phases in resting heart rate variability (LF(nu): EF: 37.5 ± 6.0, ML: 40.2 ± 6.8, P=0.68; HF(nu): EF: 45.0 ± 8.3 ML: 58.0 ± 6.3, P=0.66).
Abidi et al. (2017) found a strong tendency for a greater MAP response to Valsalva in the ML phase compared to the EF phase in healthy women. They also found higher heart rate and cardiac output in the ML phase compared to the EF phase throughout 10min of standing supporting greater sympathetic output in the ML phase. Further, in healthy participants, Brar et al. (2015) and Carter et al. (2013) found higher LF control of HR and higher resting muscle sympathetic nerve activity in the ML phase, respectively. Therefore, we suggest that the expected increase of sympathetic activity in the ML phase is absent in women with diabetes.
Support or Funding Information
Faculty of Health, York University Canadian Foundation for Innovation ‐ Infrastructure Operating Fund Natural Sciences and Engineering Research Council of Canada
This abstract is from the Experimental Biology 2019 Meeting. There is no full text article associated with this abstract published in The FASEB Journal.