OBJECTIVE Impaired baroreflex function is an early indicator of cardiovascular autonomic imbalance. Patients with type 2 diabetes mellitus (T2D) have decreased baroreflex sensitivity (BRS), however, whether the neural BRS (nBRS) and mechanical component of the BRS is altered in those with high metabolic risk (HMR, impaired fasting glucose and metabolic syndrome) or with overt T2D, is unknown. We examined this in a community-based observational study, the Paris Prospective Study III (PPS3). Approach and Results: In 7626 adults aged 50 to 75 years, resting nBRS (estimated by low-frequency gain, from carotid distension rate and RR [time elapsed between two successive R waves] intervals) and mechanical BRS were measured by high-precision carotid echotracking. The associations between overt T2D or HMR as compared with subjects with normal glucose metabolism and nBRS or mechanical BRS were quantified using multivariable linear regression analysis. There were 319 subjects with T2D (61±6 years, 77% male), 1450 subjects with HMR (60±6 years, 72% male), and 5857 subjects with normal glucose metabolism (59±6 years, 57% male). Compared with normal glucose metabolism, nBRS was significantly lower in HMR subjects (β=-0.07 [95% CI, -0.12 to -0.01]; P=0.029) and in subjects with T2D (β=-0.18 [95% CI, -0.29 to -0.07]; P=0.002) after adjustment for confounding and mediating factors. Subgroup analysis suggests significant and independent alteration in mechanical BRS only among HMR patients who had both impaired fasting glucose and metabolic syndrome. CONCLUSIONS In this community-based study of individuals aged 50 to 75, a graded decrease in nBRS was observed in HMR subjects and patients with overt T2D as compared with normal glucose metabolism subjects.

中文翻译：

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2型糖尿病与神经压力反射敏感性降低独立相关：巴黎前瞻性研究III。

目的压力感受器反射功能受损是心血管自主神经失调的早期指标。2型糖尿病（T2D）患者的压力反射敏感性（BRS）降低，但是，在那些具有高代谢风险（HMR，空腹血糖和代谢综合征受损）的患者中，神经BRS（nBRS）和机械成分是否发生了改变还是公开的T2D未知。我们在基于社区的观察性研究巴黎前瞻性研究III（PPS3）中对此进行了研究。方法和结果：在7626名50至75岁的成年人中，静息nBRS（通过颈动脉扩张率和RR（两次连续R波之间的间隔时间）间隔的低频增益估计）和机械性BRS通过高精度颈动脉测量回声跟踪。使用多变量线性回归分析定量了与正常葡萄糖代谢正常的受试者相比，明显的T2D或HMR与nBRS或机械性BRS之间的关联。共有319名T2D患者（61±6岁，男性77％），1450名HMR患者（60±6岁，男性72％）和5857名糖代谢正常的受试者（59±6岁，男性57％）。与正常的葡萄糖代谢相比，HMR受试者（β= -0.07 [95％CI，-0.12至-0.01]； P = 0.029）和患有T2D的受试者（β= -0.18 [95％CI，- 0.29至-0.07]； P = 0.002），然后调整混杂因素和中介因素。亚组分析表明，仅在空腹血糖和代谢综合征均受损的HMR患者中，机械BRS发生了明显且独立的改变。