The association and predictive value analysis of metabolic syndrome combined with resting heart rate on cardiovascular autonomic neuropathy in the general Chinese population

Yu Lu, Zi-Hui Tang, Fangfang Zeng, Yiming Li, Linuo Zhou, Yu Lu, Zi-Hui Tang, Fangfang Zeng, Yiming Li, Linuo Zhou

Abstract

Background: The purpose of this study was to explore the extent of associations of cardiovascular autonomic neuropathy (CAN) with metabolic syndrome (MetS) and resting heart reate (HR), and to evaluate the predictive value of MetS combined with HR on CAN in a large sample derived from a Chinese population.

Materials and methods: We conducted a large-scale, population-based, cross-sectional study to explore the relationships of CAN with MetS and resting HR. This study included 2092 participants aged 30-80 years, and a total of 387 subjects were diagnosed with CAN in our dataset. The associations of CAN with MetS and resting HR were assessed by a multivariate logistic regression (MLR) analysis (using subjects without CAN as a reference group) after controlling for potential confounding factors. The predictive performance of resting HR and MetS was evaluated using the area under the receiver-operating characteristic curve (AUC).

Results: A tendency toward increased CAN prevalence with increasing resting HR was reported (p for trend < 0.001). MLR analysis showed that MetS and resting HR were very significantly and independently associated with CAN (β = 0.495 for MetS and β = 0.952 for HR, P < 0.001 for both). Resting HR alone and combined with MetS (MetS-HR) strongly predicted CAN (AUC = 0.719, P < 0.001 for resting HR and AUC = 0.735, P < 0.001 for MetS-HR).

Conclusion: Our findings signify that MetS and resting HR were very significantly and independently associated with CAN in the general Chinese population. Resting HR and MetS-HR both have a high value in predicting CAN in the general population.

Figures

Figure 1
Figure 1
Cardiovascular autonomic neuropathy (CAN) prevalence according to metabolic syndrome (MetS). The CAN prevalence was 14.54% and 24.49% in respective groups according to MetS. P value for trend was less then 0.001.
Figure 2
Figure 2
Cardiovascular autonomic neuropathy (CAN) prevalence according to resting heart rate (HR). The CAN prevalence was 5.92%, 12.93%, 23.94% and 53.67% in respective groups according to HR. P value for trend was less then 0.001.
Figure 3
Figure 3
Cardiovascular autonomic neuropathy (CAN) prevalence according to the variable of metabolic syndrome (MetS) combined with resting heart rate (MetS-HR). The CAN prevalence was 5.32%, 7.23%, 9.8%, 17.81%, 21.15%, 27.38%, 45.87% and 61.46% in respective groups according to MetS-HR. P value for trend was less then 0.001.
Figure 4
Figure 4
Receiver operating characteristic curves showed the performance of resting heart rate (HR), metabolic syndrome (MetS) and categorical variable of MetS + HR in predicting cardiovascular autonomic neuropathy (CAN) prevalence in this dataset. The 95% confidence interval (CI) is given in parentheses. AUC represents area under the curve. HR: AUC = 0.719 (95% CI : 0.690-0.748), P < 0.001; MetS: AUC = 0.579 (95% CI: 0.547-0.611), P < 0.001; MetS-HR: AUC = 0.735 (95% CI: 0.707-0.763), P < 0.001.

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