Yeckel Catherine W, Gulanski Barbara, Zgorski Melinda L, Dziura James, Parish Rebecca, Sherwin Robert S
John B. Pierce Laboratory, New Haven, CT 06519, USA.
Med Sci Sports Exerc. 2009 Mar;41(3):505-15. doi: 10.1249/MSS.0b013e31818afa2f.
Exercise HR recovery (HRR) has proven an effective clinical means to assess parasympathetic dysfunction linked to all-cause mortality, but an analogous functional assessment for sympathetic dysfunction has not been developed.
We investigated whether exercise recovery provides additional cardiorespiratory information, beyond the initial HRR period, to index sympathetic overactivity associated with insulin resistance.
Young people (N = 20) with diverse percent body fat (9%-52%) were studied using fasting, oral glucose tolerance test (OGTT), and high-carbohydrate meal measurements. Participants also completed a graded fitness test (oxygen consumption peak test on cycle ergometer) after which HR and oxygen consumption (V x O2) measurements were continued for 3 min into recovery. The first, rapid phase of exercise recovery was used as the clinical measurement for parasympathetic control (HRR = HR2 min - HRmax). The second, initial plateau phase of exercise recovery was used to calculate a novel functional index for sympathetic overactivity (the plateau value for the ratio of HR normalized for V x O2 (HR/V x O2 plat)).
As expected, parasympathetic function (HRR) was within the normal range in these young people (-58 +/- 2 bpm). The index for sympathetic overactivity varied over a wide range from 9 to 34 bpm/(mL x kg x min(-1)), with obese adolescents having values in the highest 25th percentile. We found that this simple index was correlated to both the OGTT-derived whole-body insulin sensitivity index (r = -0.74, P < 0.001) and Homeostasis Assessment Model for Insulin Resistance (r = 0.76, P < 0.001), independent of percent body fat and parasympathetic function. Meal-induced thermogenesis was also associated with HR/V x O2 plat (r = -0.64, P < 0.01) but not with HRR.
In young individuals, recovery from intense exercise may provide a simple means to quantify both parasympathetic and sympathetic function. The exercise recovery index for sympathetic overactivity was linked to insulin resistance.
运动心率恢复（HRR）已被证明是评估与全因死亡率相关的副交感神经功能障碍的有效临床手段，但尚未开发出用于评估交感神经功能障碍的类似功能评估方法。
我们研究了运动恢复是否能在初始HRR期之外提供额外的心肺信息，以指示与胰岛素抵抗相关的交感神经过度活动。
对身体脂肪百分比不同（9%-52%）的年轻人（N = 20）进行空腹、口服葡萄糖耐量试验（OGTT）和高碳水化合物餐测量。参与者还完成了分级体能测试（在自行车测力计上进行耗氧量峰值测试），之后在恢复过程中持续测量心率和耗氧量（V̇O₂）3分钟。运动恢复的第一个快速阶段用作副交感神经控制的临床测量指标（HRR = HR2分钟 - HR最大值）。运动恢复的第二个初始平台期用于计算交感神经过度活动的新功能指标（V̇O₂标准化心率的比值（HR/V̇O₂平台）的平台值）。
正如预期的那样，这些年轻人的副交感神经功能（HRR）在正常范围内（-58±2次/分钟）。交感神经过度活动指数在9至34次/分钟/（毫升·千克·分钟⁻¹）的范围内变化很大，肥胖青少年的值处于最高的第25百分位。我们发现这个简单的指数与OGTT衍生的全身胰岛素敏感性指数（r = -0.74，P < 0.001）和胰岛素抵抗稳态评估模型（r = 0.76，P < 0.001）均相关，且独立于身体脂肪百分比和副交感神经功能。进餐诱导的产热也与HR/V̇O₂平台相关（r = -0.64，P < 0.01），但与HRR无关。
在年轻人中，剧烈运动后的恢复可能提供一种简单的方法来量化副交感神经和交感神经功能。交感神经过度活动的运动恢复指数与胰岛素抵抗有关。
