Articles Tập 67 Số CĐ14-HNKH Hội Hóa sinh Y học Việt Nam 17/09/2026

HEART RATE VARIABILITY AS A WEARABLE MARKER FOR ALBUMINURIA-ASSOCIATED RENAL IMPAIRMENT IN TYPE 2 DIABETES

Tran Ngoc Hien, Le Quoc Tuan, Duong Thi Ngoc Linh, Mai Phuong Thao
DOI: 10.52163/yhc.v67iCD14.6592
0 Views
0 Downloads
Abstract

Objectives: This study investigated whether frequency-domain heart rate variability (HRV) analysis could detect autonomic dysfunction linked to incipient renal impairment.

Methods: Cross-sectional study of 82 adults with type 2 diabetes. RR intervals were captured using the Polar H10 sensor and processed via Kubios HRV software. LF power (0.04-0.15 Hz) was log-transformed (lnLF). Participants were stratified by uACR ≥ 30 mg/g.

Results: The 82 patients were divided into two groups (38 patients normoalbuminuria, 44 patients microalbuminuria) were comparable in age (p = 0.588), BMI (p = 0.535), and HbA1c (p = 0.198). eGFR was lower in the microalbuminuria group (median 40.5 vs. 52.5 mL/min/1.73 m², p = 0.028). Time-domain (SDNN, RMSSD) and nonlinear indices (SD1, SD2) did not differ significantly between groups. In contrast, lnLF was significantly lower in the microalbuminuria group (3.24 ± 1.78 vs. 2.23 ± 2.02, p = 0.019); the LF/HF ratio was also significantly lower (p = 0.042). Spearman correlation confirmed an inverse association between lnLF and uACR (ρ = -0.249, p = 0.024).

Conclusion: Frequency-domain HRV, specifically lnLF, was the only HRV domain significantly associated with albuminuria. Wearable sensor-derived LF-HRV may serve as a non-invasive biomarker warranting validation in longitudinal studies.

Keywords
Heart rate variability, low-frequency power, diabetic kidney disease, albuminuria, uACR.
References
[1]
[1] Eleftheriadou A, Spallone V, Tahrani A.A, Alam U. Cardiovascular autonomic neuropathy in diabetes: an update with a focus on management. Diabetologia, 2024, 67 (12): 2611-2625. doi: 10.1007/s00125-024-06242-0. Google Scholar
[2]
[2] Kidney Disease: Improving Global Outcomes (KDIGO) CKD Work Group. KDIGO 2024 clinical practice guideline for the management of diabetes in chronic kidney disease. Kidney Int, 2024, 106 (5S): S117-S314. doi: 10.1016/j.kint.2023.10.018. Google Scholar
[3]
[3] Tang Y, Ang L, Jaiswal M et al. Cardiovascular autonomic neuropathy and risk of kidney function decline in type 1 and type 2 diabetes: findings from the PERL and ACCORD cohorts. Diabetes, 2024, 73 (5): 751-762. doi: 10.2337/db23-0247. Google Scholar
[4]
[4] Task Force of the European Society of Cardiology and the North American Society of Pacing and Electrophysiology. Heart rate variability: standards of measurement, physiological interpretation and clinical use. Circulation, 1996, 93 (5): 1043-1065. Google Scholar
[5]
[5] Gilgen-Ammann R, Schweizer T, Wyss T. RR interval signal quality of a heart rate monitor and an ECG Holter at rest and during exercise. Eur J Appl Physiol, 2019, 119 (7): 1525-1532. doi: 10.1007/s00421-019-04142-5. Google Scholar
[6]
[6] American Diabetes Association Professional Practice Committee. Diagnosis and classification of diabetes: Standards of Care in Diabetes-2024. Diabetes Care, 2024, 47 (Suppl_1): S20-S42. doi: 10.2337/dc24-S002 Google Scholar
[7]
[7] Inker L.A, Schmid C.H, Tighiouart H et al. Estimating glomerular filtration rate from serum creatinine and cystatin C. N Engl J Med, 2012, 367 (1): 20-29. doi: 10.1056/NEJMoa1114248. Google Scholar
[8]
[8] Tarvainen M.P, Niskanen J.P, Lipponen J.A, Ranta-Aho P.O, Karjalainen P.A. Kubios HRV-heart rate variability analysis software. Comput Methods Programs Biomed, 2014, 113 (1): 210-220. doi: 10.1016/j.cmpb.2013.07.024. Google Scholar
[9]
[9] Zeng H, Liu J, Chen Z, Yu P, Liu J. Cardiac autonomic dysfunction is associated with risk of diabetic kidney disease progression in type 2 diabetes mellitus. Front Endocrinol (Lausanne), 2022, 13: 900465. doi: 10.3389/fendo.2022.900465 Google Scholar
[10]
[10] Brotman D.J, Bash L.D, Qayyum R, Crews D, Whitsel E.A, Astor B.C, Coresh J. Heart rate variability predicts ESRD and CKD-related hospitalization. J Am Soc Nephrol, 2010, 21 (9): 1560-1570. doi: 10.1681/ASN.2009111112. Google Scholar