基于对肥胖老年人静息脉搏率的短期测量，身体能力与心率变异性的关联
Association of physical capacity with heart rate variability based on a short-duration measurement of resting pulse rate in older adults with obesity.
作者信息
Liao Chun-De, Tsauo Jau-Yih, Hsiao Dun-Jen, Liou Tsan-Hon, Huang Shih-Wei, Lin Li-Fong
机构信息
School and Graduate Institute of Physical Therapy, College of Medicine, National Taiwan University, Taipei, Taiwan.
Department of Physical Medicine and Rehabilitation, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan.
出版信息
PLoS One. 2017 Dec 21;12(12):e0189150. doi: 10.1371/journal.pone.0189150. eCollection 2017.
BACKGROUND
Obesity can limit physical capacity and lower physical activity levels in elderly people. Low physical activity levels may be mediated by autonomic dysfunction with decreased heart rate variability (HRV). However, the relationship between autonomic dysfunction and low physical capability remains unclear. This cross-sectional study investigated the association of low physical capability with HRV in older adults with obesity.
MATERIALS AND METHODS
We recruited 231 old man and 210 old women with a mean (range) age of 65.5 (51-78) and 62.9 (52-76) years, respectively. Physical capability was measured using mobility tasks, including functional reach, single-leg stance (SLS), gait speed (GS), timed up and go, and timed chair rise (TCR), and the scores on these tasks were merged and transformed into a global physical capability score (GPCS). HRV was measured using a 7-min resting pulse-based technique, and the time- and frequency-domain indices of HRV were obtained including standard deviation of normal-to-normal intervals (SDNN), root mean square of successive differences at rest (rMSSD), and high-frequency (HF) power. All HRV indices were natural log (ln) transformed for analysis. Participants were divided into high, moderate, and low physical-capability groups according to their physical performance. Multivariate analysis of covariance was performed to test differences in HRV indices among physical-capability groups with participants' characteristics serving as covariates. A stepwise regression model was established to identify the determinants of HRV indices. We used hierarchical regression analysis to identify the association of the GPCS with HRV indices.
RESULTS
In both men and women, the low physical-capability group exhibited significantly increased heart rate (P <0.05) and decreased HRV in terms of a decreased ln[SDNN] (P <0.001), ln[rMSSD] (P <0.05) and ln[HF] (P <0.05), compared with the high physical-capability group. GS positively predicted ln[SDNN], whereas SLS, GS, and TCR were determinants of ln[HF], regardless of gender. The GPCS in older men and women independently accounted for 29.9% (P <0.001) and 23.7% (P <0.001), respectively, in variance in ln[SDNN].
CONCLUSIONS
A low physical-capability level is an independent determinant of decreased HRV in older adults with obesity.
背景
肥胖会限制老年人的身体能力并降低其身体活动水平。低身体活动水平可能由自主神经功能障碍介导，伴有心率变异性（HRV）降低。然而，自主神经功能障碍与低身体能力之间的关系仍不清楚。这项横断面研究调查了肥胖老年人中低身体能力与HRV之间的关联。
材料与方法
我们招募了231名老年男性和210名老年女性，他们的平均（范围）年龄分别为65.5（51 - 78）岁和62.9（52 - 76）岁。使用移动任务测量身体能力，包括功能性伸展、单腿站立（SLS）、步速（GS）、计时起立行走和计时从椅子上起身（TCR），并将这些任务的得分合并并转换为全球身体能力得分（GPCS）。使用基于7分钟静息脉搏的技术测量HRV，并获得HRV的时域和频域指标，包括正常到正常间隔的标准差（SDNN）、静息时连续差值的均方根（rMSSD）和高频（HF）功率。所有HRV指标均进行自然对数（ln）转换以进行分析。根据参与者的身体表现将其分为高、中、低身体能力组。进行多变量协方差分析，以参与者特征作为协变量，检验身体能力组之间HRV指标的差异。建立逐步回归模型以确定HRV指标的决定因素。我们使用层次回归分析来确定GPCS与HRV指标之间的关联。
结果
在男性和女性中，与高身体能力组相比，低身体能力组的心率显著增加（P <0.05），且HRV降低，表现为ln[SDNN]降低（P <0.001）、ln[rMSSD]降低（P <0.05）和ln[HF]降低（P <0.05）。无论性别如何，GS正向预测ln[SDNN]，而SLS、GS和TCR是ln[HF]的决定因素。老年男性和女性的GPCS分别独立解释了ln[SDNN]方差的29.9%（P <0.001）和23.7%（P <0.001）。
结论
低身体能力水平是肥胖老年人HRV降低的独立决定因素。
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