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腹型肥胖男性中心脏自主神经功能与肥胖指数、代谢参数和年龄的关系。

Influence of obesity indices, metabolic parameters and age on cardiac autonomic function in abdominally obese men.

机构信息

Centre de Recherche de l'Institut Universitaire de Cardiologie et de Pneumologie de Québec, Québec, Canada.

出版信息

Metabolism. 2012 Sep;61(9):1270-9. doi: 10.1016/j.metabol.2012.02.006. Epub 2012 Mar 22.

Abstract

Heart rate variability (HRV) is affected by age, hyperglycemia and accumulation of body fat. This study compares the predictive value of four measurements of adiposity/obesity on HRV and investigates the specific role of age, metabolic contributors and degree/distribution of fat in HRV alterations. The sample consisted of 97 non-diabetic and non-medicated men with features of the metabolic syndrome (50±8 years of age, body mass index [BMI] 31±3 kg/m(2), waist circumference [WC] 107±9 cm, triglycerides 2.3±0.7 mmol/L, fasting glucose 6.0±0.5 mmol/L, insulin 156±71 pmol/L; mean±SD). WC, BMI, percent body fat (% fat, from dual energy X-ray absorptiometry) and visceral adipose tissue volume (VAT, from computed tomography) were used as measures of adiposity/obesity. HRV measures were obtained from 24-h, day- and night-time segments of Holter recordings. BMI presented no independent association with HRV. Percentage fat was the strongest obesity index to be associated with HRV: 24-h pNN50, rMSSD, HF and daytime pNN50, rMSSD, HF and LF (-0.27≤std β≤-0.20, P<.05). VAT was associated with 24-h SDNN, LF (std β=-0.25 and -0.20, P<.05, respectively) and daytime SDNN (std β=-0.24, P<.05) while WC was associated with nighttime SDNN and SDANN (std β=0.22 and 0.32, P<.05). In addition, age, fasting glucose, 2-h oral glucose tolerance test and triglycerides presented independent association with HRV. Adiposity/obesity measurements seem to be differently associated with HRV. An approach considering the combination of age, obesity and glucose metabolism factors could be helpful in the global cardiovascular risk management in abdominally obese men.

摘要

心率变异性(HRV)受年龄、高血糖和体脂肪堆积的影响。本研究比较了四种肥胖/肥胖测量方法对 HRV 的预测价值,并探讨了年龄、代谢因素以及脂肪的程度/分布在 HRV 改变中的特定作用。该样本包括 97 名非糖尿病和未用药的男性,具有代谢综合征的特征(年龄 50±8 岁,体重指数[BMI] 31±3kg/m2,腰围[WC] 107±9cm,甘油三酯 2.3±0.7mmol/L,空腹血糖 6.0±0.5mmol/L,胰岛素 156±71pmol/L;平均值±标准差)。WC、BMI、体脂肪百分比(% fat,来自双能 X 射线吸收法)和内脏脂肪组织体积(VAT,来自计算机断层扫描)被用作肥胖/肥胖的测量指标。HRV 测量值来自动态心电图记录的 24 小时、白天和夜间片段。BMI 与 HRV 无独立相关性。体脂肪百分比是与 HRV 相关性最强的肥胖指标:24 小时 pNN50、rMSSD、HF 和白天 pNN50、rMSSD、HF 和 LF(-0.27≤std β≤-0.20,P<.05)。VAT 与 24 小时 SDNN、LF(std β=-0.25 和 -0.20,P<.05)和白天 SDNN(std β=-0.24,P<.05)相关,而 WC 与夜间 SDNN 和 SDANN(std β=0.22 和 0.32,P<.05)相关。此外,年龄、空腹血糖、2 小时口服葡萄糖耐量试验和甘油三酯与 HRV 有独立相关性。肥胖/肥胖的测量方法与 HRV 的相关性似乎不同。考虑到年龄、肥胖和葡萄糖代谢因素的综合方法可能有助于管理腹型肥胖男性的整体心血管风险。

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