Normative data on cardiovascular autonomic function in Greenlandic Inuit

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  • Marie Mathilde Bjerg Christensen
  • Christian Stevns Hansen
  • Jesper Fleischer
  • Dorte Vistisen
  • Stine Byberg
  • Trine Larsen
  • Jens Christian Laursen
  • Marit Eika Jørgensen

Introduction Diabetes is increasing among Greenlandic Inuit; however, the prevalence of cardiovascular autonomic neuropathy (CAN) is yet unknown. The assessment of CAN requires an ability to differentiate between normal and abnormal. The aim was to establish normative reference data of cardiovascular autonomic function in Greenlandic Inuit. Research design and methods In this cross-sectional study, cardiovascular autonomic function was evaluated in participants without diabetes during the Greenlandic Population Study 2018 and in the town Qasigiannguit in 2020. Assessment included cardiovascular autonomic reflex tests (CARTs) and power spectral analysis of heart rate variability (HRV). Normative reference limits were estimated by applying piecewise linear quantile regression models at the fifth percentile. Models were adjusted for age and sex. Results Based on examinations of 472 participants (61.7% females), normative reference data was established for all outcomes. Mean age was 54 years (SD 13.1). Higher age was inversely associated with all outcomes of CARTs and HRV. A linear fall in cardiovascular autonomic function tended to level off beyond age of 60 or 70 years for supine-to-upright position ratio and low frequency power. However, the number of observations in subjects older than 60 or 70 years was limited, which may have caused a flattening of the curve around that age. No other associations were found. Conclusions The general level of the CARTs and HRV for all age groups is notably lower than in previous studies from other nationalities. We speculate that sociodemographic and cultural aspects of the Greenlandic Inuit population including body mass index, smoking, physical activity and alcohol consumption may have affected the cardiovascular autonomic function.

Original languageEnglish
Article numbere002121
JournalBMJ Open Diabetes Research and Care
Volume9
Issue number1
ISSN2052-4897
DOIs
Publication statusPublished - 30 Sep 2021

Bibliographical note

Funding Information:
Competing interests JF holds stocks in Medicus Engineering. MEJ has received research grants from Astra Zeneca, AMGEN, Sanofi Aventis and Boehringer Ingelheim. MEJ holds shares in Novo Nordisk A/S. No other potential conflicts of interest relevant to this article were reported.

Funding Information:
Funding This work was supported by the Novo Nordisk Foundation (NNF 17SH0027192 and NNF 17OC0028136), Department of Public Health, Aarhus University, Aarhus, Denmark and Steno Diabetes Center Aarhus, which is partially funded by an unrestricted donation from the Novo Nordisk Foundation.

Publisher Copyright:
© Author(s) (or their employer(s)) 2021.

    Research areas

  • diabetes complications, diabetic neuropathies, heart rate variability, indigenous peoples

ID: 306683540