Sympathetic Changes through the Menstrual Cycle are Absent in Women with Diabetes
Bibliographic record
Abstract
Background 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. Methods Women with diabetes (n=7; age 23.6 ± 1.0years; BMI 24.4 ± 1.1kg/m 2 ) 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)). Results 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). Conclusion 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 .
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".