表面健康的青少年的代谢综合征负担与心脏自主神经调节存在负相关——宾夕法尼亚州立大学儿童队列研究
Metabolic syndrome burden in apparently healthy adolescents is adversely associated with cardiac autonomic modulation--Penn State Children Cohort.
作者信息
Rodríguez-Colón Sol M, He Fan, Bixler Edward O, Fernandez-Mendoza Julio, Vgontzas Alexandros N, Calhoun Susan, Zheng Zhi-Jie, Liao Duanping
机构信息
Department of Public Health Sciences Penn State University College of Medicine, Hershey, PA, 17033.
Sleep Research &Treatment Center, Department of Psychiatry, Penn State University College of Medicine, Hershey, PA, 17033.
出版信息
Metabolism. 2015 May;64(5):626-32. doi: 10.1016/j.metabol.2015.01.018. Epub 2015 Feb 3.
BACKGROUND
Reduced cardiac autonomic modulation (CAM) has been associated with metabolic syndrome (MetS) in adults. However, the association between MetS component cluster and CAM has not been examined in adolescents.
METHODS
We conducted a cross-sectional analysis using data from the Penn State Child Cohort follow-up examination. CAM was assessed by heart rate variability (HRV) analysis of 39-h RR intervals, including frequency (high frequency, HF; low frequency, LF; and LF/HF ratio) and time (SDNN, standard deviation of all RR intervals; RMSSD, square root of the mean of the sum of the squares of differences between adjacent RR intervals; and HR, heart rate) domain variables. To assess the MetS burden, we used continuous MetS score (cMetS)--sum of the age and sex-adjusted standardized residual (Z-score) of five established MetS components. Linear mixed-effect models were used to analyze the association between cMetS and CAM in the entire population and stratified by gender.
RESULTS
After adjusting for age, sex, and race, cMetS was significantly associated with reduced HRV and higher HR. With 1 standard deviation increase in cMetS, there was a significant decrease in HF (-0.10 (SE = 0.02)), LF (-0.07 (SE = 0.01)), SDNN (-1.97 (SE = 0.50)), and RMSSD (-1.70 (SE = 0.72)), and increase in LF/HF (0.08 (SE = 0.02)) and HR (1.40 (SE = 0.26)). All cMetS components, with the exception of high-density lipoprotein (HDL), were associated with significantly decreased HRV and increased HR. High blood pressure (MAP) and triglyceride (TG) levels were also associated with an increase in LF/HF and decrease in RMSSD. An increase in high-density lipoprotein was only associated with higher LF and SDNN. Moreover, cMetS and HRV associations were more pronounced in males than in females. The associations between HRV and. MAP, TG, and HDL were more pronounced in females.
CONCLUSIONS
cMetS score is associated with lower HRV, suggesting an adverse impact on CAM, even in apparently healthy adolescents.
背景
心脏自主神经调节（CAM）降低与成年人的代谢综合征（MetS）有关。然而，MetS成分聚类与CAM之间的关联尚未在青少年中进行研究。
方法
我们使用宾夕法尼亚州立大学儿童队列随访检查的数据进行了横断面分析。通过对39小时RR间期进行心率变异性（HRV）分析来评估CAM，包括频率（高频，HF；低频，LF；以及LF/HF比值）和时间（SDNN，所有RR间期的标准差；RMSSD，相邻RR间期差值平方和均值的平方根；以及HR，心率）域变量。为了评估MetS负担，我们使用连续MetS评分（cMetS）——五个已确定的MetS成分的年龄和性别调整标准化残差（Z评分）之和。线性混合效应模型用于分析整个人群以及按性别分层后cMetS与CAM之间的关联。
结果
在调整年龄、性别和种族后，cMetS与HRV降低和心率升高显著相关。cMetS每增加1个标准差，HF（-0.10（标准误 = 0.02））、LF（-0.07（标准误 = 0.01））、SDNN（-1.97（标准误 = 0.50））和RMSSD（-1.70（标准误 = 0.72））显著降低，LF/HF（0.08（标准误 = 0.02））和HR（1.40（标准误 = 0.26））升高。除高密度脂蛋白（HDL）外，所有cMetS成分均与HRV显著降低和心率升高相关。高血压（MAP）和甘油三酯（TG）水平也与LF/HF升高和RMSSD降低相关。高密度脂蛋白升高仅与较高的LF和SDNN相关。此外，cMetS与HRV的关联在男性中比在女性中更明显。HRV与MAP、TG和HDL之间的关联在女性中更明显。
结论
cMetS评分与较低的HRV相关，表明即使在明显健康的青少年中，对CAM也有不利影响。
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