Heart rate variability and HbA1c predict plasma interleukin-6 response to psychosocial stress challenge in trauma-exposed women with type 2 diabetes.

• Type of Material: Article
• Authors: Julia B. Merker, McLean Hospital; H. Drew Dixon, Emory University; Rachel Gluck, Emory University; Ye Ji Kim, Emory University; Abigail Powers, Emory University; Ann C. Schwartz, Emory University; Tanja Jovanovic, Emory University; Guillermo Umpierrez, Emory University; Kerry Ressler, Emory University; Vasiliki Michopoulos, Emory University; Thaddeus W. W. Pace, University of Arizona; Charles Gillespie, Emory University; Antonia V. Seligowski, McLean Hospital
• Language: English
• Date: 2022-02
• Publisher: Elsevier
• Publication Version: Final Published Version
• Copyright Statement: © 2021 The Authors
• License: Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.1016/j.bbih.2021.100400
• Title of Journal or Parent Work: Brain Behav Immun Health
• Volume: 19
• Start Page: 100400
• End Page: 100400
• Grant/Funding Information: This study was supported by the National Center for Advancing Translational Sciences of the National Institutes of Health under Award Number UL1TR002378. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. CFG also supported by MH099211, the Georgia Clinical and Translational Science Alliance (Georgia CTSA), the NIH National Centers for Research Resources (M01 RR00039), the Woodruff Health Sciences IT Division (UL1 TR000424) and the Emory University General Clinical Research Center at Grady Hospital. AVS supported by NIH K23MH125920 and AHA 20CDA35310031.
• Keywords: Type II diabetes mellitus; Inflammation; Blood glucose control; Trauma; Heart rate variability
• Research Categories: Health Sciences, Medicine and Surgery; Psychology, Social

Abstract

Background: Type 2 diabetes mellitus (T2DM) is a major public health problem in the United States. Although cardiovascular autonomic functioning, blood glucose control, and inflammation are known to play a role in T2DM, the interaction between these variables remains largely unexplored, particularly in the context of stress. To address this gap, we examined the relationship between these variables in a sample that is uniquely vulnerable to the health consequences of T2DM. Methods: Participants were 37 trauma-exposed Black women with a diagnosis of T2DM. High frequency heart rate variability (HF-HRV), blood glucose control (HbA1c), and a stressor-evoked biomarker of inflammation (interleukin 6; IL-6) were obtained as part of a larger study of the genetic risk factors for and consequences of trauma exposure. Results: The interaction of HbA1c and HF-HRV was significantly associated with IL-6 response calculated as area under the curve with respect to ground. Post-hoc simple slopes analyses revealed HbA1c, rather than HF-HRV, as the moderator in this association such that higher HF-HRV conferred higher circulating levels of IL-6 only in the presence of lower HbA1c, (β ​= ​0.60, t ​= ​3.51, p ​= ​.001). Conclusions: Cardiovascular autonomic functioning and blood glucose control were significantly associated with stressor-evoked IL-6 responses when controlling for BMI and age. Moreover, the association between cardiovascular autonomic functioning and inflammation varied at different levels of HbA1c. This highlights the possibility that individuals with trauma exposure and T2DM may benefit from stratification by HbA1c levels for research analysis and treatment decision making.