Rastović Marina, Srdić-Galić Biljana, Barak Oto, Stokić Edita
Department of Internal Medicine, General Hospital Subotica, Subotica, Serbia.
Department of Anatomy, Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia.
Nutr Diet. 2017 Feb;74(1):51-60. doi: 10.1111/1747-0080.12280. Epub 2016 Apr 4.
Impaired autonomic function could be the mechanism for the development of cardiometabolic diseases in obesity. Hence, simple anthropometric measures of overall and central obesity could be screening markers for autonomic imbalance. We analysed the relationship between heart rate variability (HRV) parameters and obesity indicators.
Sixty-three obese women underwent blood pressure, lipids and anthropometric measurements, body composition assessment, HOMA (homeostasis model assessment) index calculation and short-term HRV analysis.
The correlation between obesity indicators and HRV parameters was influenced by age. In the multiple regression model, sagittal abdominal diameter (SAD) was a significant negative predictor of lnLF/HF (logarithmically transformed ratio of low to high frequencies) and lnLFnorm, and positive predictor of HFnorm (normalized high frequencies); the significant relationship remained even after adjustment for age, HOMA, blood pressure, lipid profile, menopause, body mass index (BMI) and body fat percentage (FAT). Anterior forearm skinfold showed inverse association with HRV. Correlation between waist circumference and waist-to-height ratio (WHtR) with lnLF/HF, as well as between anterior thigh skinfold with lnLF/HF, LFnorm (normalised low frequencies) and HFnorm was lost after further adjustments.
Among all anthropometric measures, SAD and anterior forearm skinfold thickness showed the highest predictive ability for HRV. Markers of lower sympathetic and higher cardiac parasympathetic activity corresponded with indicator of central obesity, while indicators of peripheral obesity showed completely opposite relationship with markers of cardiac autonomic activity.
自主神经功能受损可能是肥胖患者发生心脏代谢疾病的机制。因此,简单的总体肥胖和中心性肥胖人体测量指标可能是自主神经失衡的筛查标志物。我们分析了心率变异性(HRV)参数与肥胖指标之间的关系。
63名肥胖女性接受了血压、血脂和人体测量、身体成分评估、HOMA(稳态模型评估)指数计算以及短期HRV分析。
肥胖指标与HRV参数之间的相关性受年龄影响。在多元回归模型中,腹矢状径(SAD)是lnLF/HF(低频与高频对数转换比值)和lnLFnorm的显著负向预测因子,以及HFnorm(标准化高频)的正向预测因子;即使在调整年龄、HOMA、血压、血脂谱、绝经状态、体重指数(BMI)和体脂百分比(FAT)后,这种显著关系仍然存在。前臂前侧皮褶厚度与HRV呈负相关。进一步调整后,腰围与腰高比(WHtR)与lnLF/HF之间的相关性,以及大腿前侧皮褶厚度与lnLF/HF、LFnorm(标准化低频)和HFnorm之间的相关性消失。
在所有人体测量指标中,SAD和前臂前侧皮褶厚度对HRV的预测能力最强。较低的交感神经活动和较高的心脏副交感神经活动标志物与中心性肥胖指标相对应,而外周性肥胖指标与心脏自主神经活动标志物呈完全相反的关系。