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Threshold-based artefact correction methods influence heart rate variability measurements in individuals with type 2 diabetes mellitus
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  • Published: 28 February 2026

Threshold-based artefact correction methods influence heart rate variability measurements in individuals with type 2 diabetes mellitus

  • Daniela Bassi-Dibai1,2,
  • Aldair Darlan Santos-de-Araújo3,4,
  • Daniel Santos Rocha5,
  • Lucivalda Viegas de Almeida1,
  • José Kléber Figueiredo1,
  • Louise Aline Romão Gondim6,
  • Marinete Rodrigues de Farias Diniz7,
  • Victória Pereira Frutuoso8,
  • Mariana Campos Maia8,
  • Patrícia Martins Santos8 &
  • …
  • Audrey Borghi-Silva3 

Scientific Reports , Article number:  (2026) Cite this article

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We are providing an unedited version of this manuscript to give early access to its findings. Before final publication, the manuscript will undergo further editing. Please note there may be errors present which affect the content, and all legal disclaimers apply.

Subjects

  • Biomarkers
  • Diseases
  • Endocrinology
  • Health care
  • Medical research

Abstract

Heart rate variability (HRV) is a clinical marker used to assess autonomic function, and the application of filtering algorithms may significantly influence data quantification and interpretation. Although HRV has been extensively studied in individuals with type 2 diabetes mellitus (T2DM), the impact of artefact correction methods remains underexplored. To evaluate the effects of different artefact correction filters in Kubios software on short-term HRV parameters in individuals with T2DM. This cross-sectional, descriptive, and observational study included adults (≥ 18 years) diagnosed with T2DM. Anthropometric and metabolic data were collected, including fasting blood samples for glucose, insulin, and lipid profiles. HRV indices were analyzed across time-domain, frequency-domain, nonlinear, and global metrics. Statistical analysis was performed using ANOVA or Friedman tests according to data distribution, with significance set at p < 0.05. The sample consisted of 52 individuals (67% male, mean age 52 ± 8 years, mean BMI 29.65 ± 5.50 kg/m²). The median duration of T2DM was 3 years (IQR 1.5–10). Median metabolic parameters were insulin 12.50 µU/mL, triglycerides 141.50 mg/dL, fasting glucose 149.50 mg/dL, and HbA1c 8.65% (IQR 7.20–10.00). Application of the most restrictive artefact correction setting (“very strong”) in Kubios significantly modified overall HRV as well as time-domain, frequency-domain, and nonlinear parameters (p < 0.05), highlighting its influence on HRV quantification. This study demonstrates that artefact correction filters, particularly the “very strong” setting, substantially affect HRV analysis in individuals with T2DM. Excessively restrictive filtering may distort autonomic metrics and potentially bias interpretation. Standardization of artefact correction methods is essential to ensure accurate and reproducible HRV assessment in clinical and research settings.

Data availability

The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request.

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Acknowledgements

To the Foundation to Support Research and Scientific Development and Maranhão Technology (FAPEMA), Coordination for the Improvement of Higher Education Personnel (CAPES), and the National Council for Scientific and Technological Development (CNPq) for their support and commitment to maintaining postgraduate programs in Brazil. Professor Ph.D. Audrey Borghi-Silva is CNPq Research Productivity Scholarship - Level 1B. Professor Ph.D. Daniela Bassi-Dibai is FAPEMA Research Productivity Scholarship.

Funding

This study was funded by a research productivity grant granted by the Foundation to Support Research and Scientific Development and Maranhão Technology (FAPEMA) (process number BEPP-02544/23), and National Council for Scientific and Technological Development (CNPq) (process number: 402329/2023-6).

Author information

Authors and Affiliations

  1. Postgraduate in Health Programs and Services, CEUMA University, Rua Josué Montello, 1, Jardim Renascença, São Luís, MA, 65075- 120, Brazil

    Daniela Bassi-Dibai, Lucivalda Viegas de Almeida & José Kléber Figueiredo

  2. Laboratory for Clinical and Functional Research in Chronic Non-Communicable Diseases (LABICLIN), State University of Maranhão, Itapecuru-Mirim Campus, Itapecuru-Mirim, MA, Brazil

    Daniela Bassi-Dibai

  3. Cardiopulmonary Physiotherapy Laboratory, Department of Physiotherapy, Federal University of São Carlos (UFSCar), São Carlos, SP, Brazil

    Aldair Darlan Santos-de-Araújo & Audrey Borghi-Silva

  4. Paranaense University, Francisco Beltrão Campus, Umuarama, PR, Brazil

    Aldair Darlan Santos-de-Araújo

  5. Postgraduate in Physical Education, Federal University of Maranhão, São Luís, MA, Brazil

    Daniel Santos Rocha

  6. Postgraduate in Environmental, CEUMA University, São Luís, MA, Brazil

    Louise Aline Romão Gondim

  7. Postgraduate in Dentistry, CEUMA University, São Luís, MA, Brazil

    Marinete Rodrigues de Farias Diniz

  8. Department of Physiotherapy, CEUMA University, São Luís, MA, Brazil

    Victória Pereira Frutuoso, Mariana Campos Maia & Patrícia Martins Santos

Authors
  1. Daniela Bassi-Dibai
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  2. Aldair Darlan Santos-de-Araújo
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Contributions

Conceptualization: DB, ADS, AB; Data curation: ADS, DB, AB; Formal Analysis: ADS, DB, DSR, LVA, JKF, LARG, MRFD, VPF, MCM, PMS, AB; Validation: ADS, DB, AB; Visualization: ADS, DB, DSR, LVA, JKF, LARG, MRFD, VPF, MCM, PMS, AB; Writing – original draft: ADS, DB; Writing – review & editing: ADS, DB, DSR, LVA, JKF, LARG, MRFD, VPF, MCM, PMS, AB.

Corresponding author

Correspondence to Daniela Bassi-Dibai.

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Competing interests

The authors declare no competing interests.

Ethical approval and consent to participate

Approval by the Research Ethics Committee of the Ceuma University (protocol number 4.179.747), and conducted according to Declaration of Helsinki. All participants who voluntarily agreed to participate signed a consent form.

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Bassi-Dibai, D., Santos-de-Araújo, A.D., Rocha, D.S. et al. Threshold-based artefact correction methods influence heart rate variability measurements in individuals with type 2 diabetes mellitus. Sci Rep (2026). https://doi.org/10.1038/s41598-026-42255-y

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  • Received: 12 July 2025

  • Accepted: 25 February 2026

  • Published: 28 February 2026

  • DOI: https://doi.org/10.1038/s41598-026-42255-y

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Keywords

  • Diabetes mellitus
  • Cardiac autonomic function
  • Heart rate variability
  • Data processing
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