心肺适能、肥胖与心率变异性：年轻人冠状动脉风险发展研究。
Cardiorespiratory Fitness, Adiposity, and Heart Rate Variability: The Coronary Artery Risk Development in Young Adults Study.
机构信息
Cardiovascular Division, Department of Medicine, University of Minnesota Medical School, Minneapolis, MN.
Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN.
出版信息
Med Sci Sports Exerc. 2019 Mar;51(3):509-514. doi: 10.1249/MSS.0000000000001796.
PURPOSE
The importance of cardiorespiratory fitness versus adiposity in determining heart rate variability (HRV) is unclear.
METHODS
From the Coronary Artery Risk Development in Young Adults study, an observational cohort study, we included 2316 participants (mean age = 45.2 ± 3.6 yr at year 20, 57% female, 43% Black) with HRV measured in 2005-2006 (year 20) and graded exercise test duration (GXTd) and adiposity measures (body mass index and waist circumference) obtained in 1985-1986 (baseline) and 2005-2006. HRV measures (SD of all normal RR intervals [SDNN] and square root of the mean value of the squares of differences between all successive RR intervals [RMSSD]) were obtained from resting 30-s 12-lead ECG. Cross-sectional associations between GXTd, adiposity, and HRV were assessed at year 20. Longitudinal changes in GXTd and adiposity measures were categorized as ≥10% increase, <10% change (no change), or ≥10% decrease. We used multivariable logistic regression to assess associations of GXTd and adiposity measures with unfavorable versus more favorable HRV (lower 25th percentile vs upper 75th percentile).
RESULTS
A 1-SD increment in GXTd was associated with 22% and 32% lower odds of unfavorable SDNN and RMSSD, respectively; associations remained significant after adjustment for adiposity. A 1-SD increment in adiposity measures was associated with 16%-28% higher odds of unfavorable RMSSD; associations were not significant after adjustment for GXTd. Compared with no change/increase in GXTd, longitudinal decrease in GXTd was significantly associated with 55% and 94% higher odds of unfavorable SDNN and RMSSD, respectively, at year 20. These associations remained significant after adjusting for adiposity.
CONCLUSION
Cardiorespiratory fitness may be a stronger determinant of HRV than adiposity. Intervention studies are needed to better determine the differential effects of improved cardiorespiratory fitness versus weight loss on HRV.
目的
心肺适能与肥胖在决定心率变异性（HRV）方面的重要性尚不清楚。
方法
我们纳入了来自于冠状动脉风险发展青年研究的 2316 名参与者（20 年时的平均年龄为 45.2±3.6 岁，57%为女性，43%为黑人），这些参与者在 2005-2006 年（20 年）进行了 HRV 测量，并在 1985-1986 年（基线）和 2005-2006 年进行了心肺适能测试持续时间（GXTd）和肥胖指标（体重指数和腰围）的测量。HRV 指标（所有正常 RR 间隔的标准差 [SDNN]和所有连续 RR 间隔差值的均方根 [RMSSD]）是从静息 30 秒 12 导联心电图中获得的。在 20 年时评估 GXTd、肥胖与 HRV 的横断面相关性。将 GXTd 和肥胖指标的纵向变化分为增加≥10%、无变化（无变化）或减少≥10%。我们使用多变量逻辑回归来评估 GXTd 和肥胖指标与不良 HRV（较低的 25 百分位与较高的 75 百分位）之间的关联。
结果
GXTd 增加 1 个标准差与 SDNN 和 RMSSD 不良的可能性分别降低 22%和 32%相关；在调整肥胖因素后，相关性仍然显著。肥胖指标增加 1 个标准差与 RMSSD 不良的可能性增加 16%-28%相关；在调整 GXTd 后，相关性不显著。与 GXTd 无变化/增加相比，GXTd 的纵向减少与 SDNN 和 RMSSD 的不良可能性分别增加 55%和 94%显著相关，在 20 年时仍有显著相关性。在调整肥胖因素后，这些相关性仍然显著。
结论
心肺适能可能是 HRV 的一个更强决定因素，而不是肥胖。需要进行干预研究，以更好地确定改善心肺适能与减肥对 HRV 的差异影响。
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