: Autonomic nervous system regulation of heartbeat variability is often disrupted among patients with diabetes. Moreover, reduced heart rate variability has been associated with increased Cardiovascular Disease (CVD) mortality among diabetic and non-diabetic populations. CVD mortality rates differ greatly among many ethnic groups. In Hawaii, Native Hawaiians have been shown to have disproportionately higher CVD mortality than Asian and Caucasian groups. Preliminary data from the Native Hawaiian Health Research Project suggest that conventional risk factors associated with Atherosclerosis may not fully account for ethnic disparities in heart disease and stroke mortality rates in Hawaii. Insulin resistance has been associated with increased CVD incidence and mortality, and has also been associated with reduced heart rate variability. The proposed study will investigate the relationship between insulin resistance and autonomic regulation of cardiac function in a multi-ethnic population. The proposed research will also provide baseline data for future longitudinal studies that will investigate the extent to which these novel risk factors explain ethnic disparities in CVD mortality in Hawaii. The findings of the proposed study may have important implications with regards to the treatment of insulin resistance as an independent CVD risk factor. ? ? Specific Aims: Collaborator component (Aim #1). Establish a collaborative laboratory in Hawaii for the evaluation of autonomic function in a multiethnic population. Principal Investigator component (Aim #2). Investigate the relationship between insulin resistance, body-fat distribution, and autonomic function.
(Aim #3) Establish a cohort with baseline measures of autonomic function and insulin resistance that will serve as a study population for R01-supported longitudinal studies. Hypotheses: By fulfilling these specific aims, we propose to test the following specific research hypotheses: (1.) Autonomic function will differ significantly by ethnicity, after adjustment for age, gender, body-mass index, and central obesity. (2.) Insulin resistance is independently associated with autonomic function, after an adjustment for age, gender, body-mass index, and central obesity. Secondary Questions: Does insulin resistance and plasma glucose interact, in their effects on autonomic function? What role do plasma lipids, blood pressure, diet, and physical activity have in explaining any observed ethnic disparities in autonomic function? Is the questionnaire-derived Composite Autonomic Symptom Scale (COMPASS) correlated with autonomic function in Hawaii's multiethnic population? ? ?

Agency
National Institute of Health (NIH)
Institute
National Institute of Neurological Disorders and Stroke (NINDS)
Type
Minority Biomedical Research Support Thematic Project Grants (S11)
Project #
5S11NS043364-04
Application #
7120483
Study Section
National Institute of Neurological Disorders and Stroke Initial Review Group (NSD)
Program Officer
Benson, Richard T
Project Start
2003-09-15
Project End
2008-07-31
Budget Start
2006-08-01
Budget End
2007-07-31
Support Year
4
Fiscal Year
2006
Total Cost
$322,079
Indirect Cost
Name
University of Hawaii
Department
Type
Organized Research Units
DUNS #
965088057
City
Honolulu
State
HI
Country
United States
Zip Code
96822
Kimpinski, Kurt; Iodice, Valeria; Sandroni, Paola et al. (2012) Sudomotor dysfunction in autoimmune autonomic ganglionopathy: a follow-up study. Clin Auton Res 22:131-6
Geser, F; Malunda, J A; Hurtig, H I et al. (2011) TDP-43 pathology occurs infrequently in multiple system atrophy. Neuropathol Appl Neurobiol 37:358-65
Grandinetti, Andrew; Chow, Dominic C; Miyasaki, Marc et al. (2010) Association of increased QTc interval with the cardiometabolic syndrome. J Clin Hypertens (Greenwich) 12:315-20
Kimpinski, Kurt; Iodice, Valeria; Sandroni, Paola et al. (2010) Effect of pregnancy on postural tachycardia syndrome. Mayo Clin Proc 85:639-44
Figueroa, Juan J; Basford, Jeffrey R; Low, Phillip A (2010) Preventing and treating orthostatic hypotension: As easy as A, B, C. Cleve Clin J Med 77:298-306
Kimpinski, Kurt; Iodice, Valeria; Low, Phillip A (2010) Postural Tachycardia Syndrome associated with peripartum cardiomyopathy. Auton Neurosci 155:130-1
Sletten, David M; Kimpinski, Kurt; Weigand, Stephen D et al. (2010) Comparison of a gel versus solution-based vehicle for the delivery of acetylcholine in QSART. Auton Neurosci 158:123-6
Sletten, David M; Weigand, Stephen D; Low, Phillip A (2010) Relationship of Q-sweat to quantitative sudomotor axon reflex test (QSART) volumes. Muscle Nerve 41:240-6
Kim, Dong Hwee; Zeldenrust, Steven R; Low, Phillip A et al. (2009) Quantitative sensation and autonomic test abnormalities in transthyretin amyloidosis polyneuropathy. Muscle Nerve 40:363-70
Kimpinski, Kurt; Iodice, Valeria; Vernino, Steve et al. (2009) Association of N-type calcium channel autoimmunity in patients with autoimmune autonomic ganglionopathy. Auton Neurosci 150:136-9

Showing the most recent 10 out of 37 publications