Mustafa Gulgun, Kursat Fidanci Muzaffer, Ahmet Tas, Alparslan Genc Fatih, Omer Gunes, Sertoglu Erdem, Erkan Sarı, Ediz Yesilkaya, Turker Turker, Ayhan Kılıc
Gulhane Education and Research Hospital, Department of Pediatric Cardiology, Ankara, Turkey.
Gulhane Education and Research Hospital, Department of Pediatric Cardiology, Ankara, Turkey.
Rev Port Cardiol. 2017 Jul-Aug;36(7-8):499-508. doi: 10.1016/j.repc.2016.10.013. Epub 2017 Jul 4.
Childhood obesity is a worldwide health concern. Studies have shown autonomic dysfunction in obese children. The exact mechanism of this dysfunction is still unknown. The aim of this study was to assess the relationship between erythrocyte membrane fatty acid (EMFA) levels and cardiac autonomic function in obese children using heart rate variability (HRV).
A total of 48 obese and 32 healthy children were included in this case-control study. Anthropometric and biochemical data, HRV indices, and EMFA levels in both groups were compared statistically.
HRV parameters including standard deviation of normal-to-normal R-R intervals (NN), root mean square of successive differences, the number of pairs of successive NNs that differ by >50 ms (NN50), the proportion of NN50 divided by the total number of NNs, high-frequency power, and low-frequency power were lower in obese children compared to controls, implying parasympathetic impairment. Eicosapentaenoic acid and docosahexaenoic acid levels were lower in the obese group (p<0.001 and p=0.012, respectively). In correlation analysis, in the obese group, body mass index standard deviation and linoleic acid, arachidonic acid, triglycerides, and high-density lipoprotein levels showed a linear correlation with one or more HRV parameter, and age, eicosapentaenoic acid, and systolic and diastolic blood pressure correlated with mean heart rate. In linear regression analysis, age, dihomo-gamma-linolenic acid, linoleic acid, arachidonic acid, body mass index standard deviation, systolic blood pressure, triglycerides, low-density lipoprotein and high-density lipoprotein were related to HRV parameters, implying an effect on cardiac autonomic function.
There is impairment of cardiac autonomic function in obese children. It appears that levels of EMFAs such as linoleic acid, arachidonic acid and dihomo-gamma-linolenic acid play a role in the regulation of cardiac autonomic function in obese children.
儿童肥胖是一个全球性的健康问题。研究表明肥胖儿童存在自主神经功能障碍。这种功能障碍的确切机制尚不清楚。本研究的目的是利用心率变异性(HRV)评估肥胖儿童红细胞膜脂肪酸(EMFA)水平与心脏自主神经功能之间的关系。
本病例对照研究共纳入48名肥胖儿童和32名健康儿童。对两组的人体测量和生化数据、HRV指标及EMFA水平进行统计学比较。
与对照组相比,肥胖儿童的HRV参数包括正常到正常R-R间期(NN)的标准差、逐次差值的均方根、相差>50毫秒的连续NN对的数量(NN50)、NN50除以NN总数的比例、高频功率和低频功率较低,这意味着副交感神经功能受损。肥胖组的二十碳五烯酸和二十二碳六烯酸水平较低(分别为p<0.001和p=0.012)。在相关性分析中,在肥胖组中,体重指数标准差与亚油酸、花生四烯酸、甘油三酯和高密度脂蛋白水平与一个或多个HRV参数呈线性相关, 年龄、二十碳五烯酸以及收缩压和舒张压与平均心率相关。在线性回归分析中,年龄、二高-γ-亚麻酸、亚油酸、花生四烯酸、体重指数标准差、收缩压、甘油三酯、低密度脂蛋白和高密度脂蛋白与HRV参数相关,这意味着对心脏自主神经功能有影响。
肥胖儿童存在心脏自主神经功能损害。亚油酸、花生四烯酸和二高-γ-亚麻酸等EMFA水平似乎在肥胖儿童心脏自主神经功能的调节中起作用。