Potential Correlation Between Heart Rate Variability With Cardiovascular Risk at Different Stages of Metabolic Syndrome

Recruiting

Brief Summary: The study aims to assess the beat-to-beat Heart rate variability (HRV) in different stages of metabolic diseases, including pre-diabetic and diabetic patients, compared to non-diabetic individuals.

Heart rate variability will be compared for some antidiabetic drugs used in different stages of metabolic diseases and correlated to different metabolic and inflammatory mediators.

Recruitment & Eligibility

Inclusion Criteria

Non-diabetic individuals: adults (18-70 Years) with glycated hemoglobin (HBA1C)<5.7 and/or Fasting blood glucose <100 mg/L and with no classic symptoms of hyperglycemia
Pre-diabetic: adults (18-70 Years) who fulfil one of the American Diabetes Association (ADA) criteria :
- glycated hemoglobin (HBA1C) =5.7-6.4%
- Fasting blood glucose level = 100 mg/dL to 125 mg/dL. Fasting is deﬁned as no caloric intake for at least 8 hours.
Diabetic patients: adults (18-70 Years) who fulfil one of the American Diabetes Association (ADA) criteria:
- glycated hemoglobin (HBA1C) ≥6.5%
- Fasting blood glucose ≥126 mg/dL.
- A random plasma glucose ≥200 mg/dL. Random is any time of the day without regard to the meals.

Exclusion Criteria

Pediatric and elderly subjects
Pregnant subjects
Those with active Myocardial infarction
Those with acute decompensated heart failure
Patients with pacemaker
Patients with persistent Atrial fibrillation, long-standing persistent and permanent Atrial fibrillation

Arm && Interventions

Group	Intervention	Description
Non-diabetic individuals	heart rate variability test	adults (18-70 Years) with glycated hemoglobin (HBA1C) \<5.7 and/or Fasting blood glucose \<100 mg/L and with no classic symptoms of hyperglycemia
Pre-diabetic:	heart rate variability test	adults (18-70 Years) who fulfil one of the American Diabetes Association (ADA) criteria : * glycated hemoglobin (HBA1C) =5.7-6.4% * Fasting blood glucose 100 mg/dL to 125 mg/dL. Fasting is deﬁned as no caloric intake for at least 8 hours.
Diabetic patients :	heart rate variability test	adults (18-70 Years) who fulfil one of the American Diabetes Association (ADA) criteria: * glycated hemoglobin (HBA1C) ≥6.5% * Fasting blood glucose ≥126 mg/dL. * A random plasma glucose ≥200 mg/dL. Random is any time of the day without regard to the meals.

Primary Outcome Measures

Name	Time	Method
body mass index	one year	Measuring body weight in kilograms (kg) and height in centimeters (cm) to calculate the Body Mass Index (BMI) in kg/m\^2, a key indicator of healthy weight that can help identify potential health risks.
Valsalva ratio	one year	The Valsalva ratio is the proportion of the highest and lowest heart rate during and immediately after performing a Valsalva maneuver. A value of 1.21 or more is defined as a normal response
Beat-to-beat Heart rate variability	one year	•It will be measured Different stages of metabolic diseases among non-diabetic, diabetic and prediabetic subjects
Stand 30:15 ratio	one year	The Stand 30:15 ratio is the ratio of the highest heart rate during (occurring approximately 15 sec after the initiation of standing) and immediately following standing up from a supine position (occurring approximately 30 sec after the initiation of standing).
deep breath test interpretation	one year	The heart rate response to deep breathing test was calculated as the difference between maximum heart rate during inhalation and minimum heart rate during exhalation. A difference of 15 beats/min or more is considered parasympathetic activation.

Secondary Outcome Measures

Name	Time	Method
Framingham risk score (FRS)	one year	The Framingham risk score predicts cardiovascular disease risk in asymptomatic patients. The risk is considered low if Framingham Risk Score is less than 10%, moderate if it is 10% to 19%, and high if it is higher than 20%. Heart rate variability (HRV) may be correlated with the Framingham risk score when analyzing the effects of different anti-diabetic drugs. It is expected that if the Heart Rate Variability decreases, the Framingham score will increase, indicating a higher risk of Atherosclerotic Cardiovascular disease risk in the next 10 years. Conversely, if Heart Rate Variability increases, the Framingham score may decrease, indicating a reduced risk of Atherosclerotic cardiovascular disease risk.