心率变异性作为酒精使用障碍的潜在生物标志物：系统评价和荟萃分析。
Heart rate variability as a potential biomarker for alcohol use disorders: A systematic review and meta-analysis.
机构信息
Department of Psychiatry, Taoyuan Psychiatric Center Ministry of Health and Welfare, 71, Longshou Street, Taoyuan District, Taoyuan City 33058, Taiwan, ROC; Department of Public Health and Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, No. 17, Xu-Zhou Road, Taipei 10055, Taiwan, ROC; Research Center of Big Data and Meta-Analysis, Wan Fang Hospital, Taipei Medical University, No. 250 Wuxing St., Taipei 11031, Taiwan, ROC.
Research Center of Big Data and Meta-Analysis, Wan Fang Hospital, Taipei Medical University, No. 250 Wuxing St., Taipei 11031, Taiwan, ROC; Department of Dermatology, Wan Fang Hospital, Taipei Medical University, 111, Hsing-Long Road Sec. 3, Wenshan District, Taipei City 11696, Taiwan, ROC; Department of Dermatology, School of Medicine and College of Medicine, Taipei Medical University, No. 250 Wuxing St., Taipei 11031, Taiwan, ROC.
出版信息
Drug Alcohol Depend. 2019 Nov 1;204:107502. doi: 10.1016/j.drugalcdep.2019.05.030. Epub 2019 Aug 29.
BACKGROUND
Alcohol use disorders (AUDs) have been found to be associated with elevated cardiovascular risk. The autonomic nervous system is considered to play a role in this association. Heart rate variability (HRV) has been employed to measure parasympathetic activity in AUDs patients in some studies; however, the results are not consistent, and the adopted HRV indices vary across studies. A meta-analysis should be helpful for clarifying this topic.
METHODS
We gathered studies about measuring HRV in AUDs patients and healthy participants from databases. HRV was analyzed in several ways: parasympathetic function in hierarchical order (main analysis), total variability, and specific parasympathetic indices. Specific parasympathetic indices were further separated into high-frequency power (HF) and root mean square of the successive differences (RMSSD). For comparing the above values in patients with AUDs and in healthy individuals, we adopted the random effects model to calculate the standardized mean difference.
RESULTS
Of the 144 screened studies, 15 were included in the quantitative analysis. In the comparison of parasympathetic function in hierarchical order, HRV in AUDs patients was significantly lower than in healthy individuals (Hedges'g = -0.4301, 95% CI [-0.7601 to -0.1000], p=0.0106, I = 83.8%). Regarding total variability and RMSSD, AUDs patients also had significantly lower values than healthy controls. However, the differences of specific parasympathetic indices and HF were not significantly different.
CONCLUSION
Our results support the view that AUDs patients have reduced parasympathetic activity. Total variability and RMSSD are suitable indices for presenting reduced HRV in patients with AUDs.
背景
酒精使用障碍（AUD）与心血管风险升高有关。自主神经系统被认为在这种关联中起作用。心率变异性（HRV）已被用于测量一些研究中 AUD 患者的副交感神经活动；然而，结果并不一致，所采用的 HRV 指标在不同的研究中也有所不同。荟萃分析应该有助于澄清这个问题。
方法
我们从数据库中收集了关于 AUD 患者和健康参与者测量 HRV 的研究。HRV 以多种方式进行分析：按层次顺序分析副交感神经功能（主要分析）、总变异性和特定的副交感神经指数。特定的副交感神经指数进一步分为高频功率（HF）和连续差值的均方根（RMSSD）。为了比较 AUD 患者和健康个体的上述值，我们采用随机效应模型计算标准化均数差。
结果
在筛选出的 144 项研究中，有 15 项被纳入定量分析。在按层次顺序比较副交感神经功能时，AUD 患者的 HRV 明显低于健康个体（Hedges'g = -0.4301，95%CI [-0.7601 至 -0.1000]，p=0.0106，I = 83.8%）。关于总变异性和 RMSSD，AUD 患者也明显低于健康对照组。然而，特定副交感神经指数和 HF 的差异没有统计学意义。
结论
我们的结果支持 AUD 患者副交感神经活动降低的观点。总变异性和 RMSSD 是表示 AUD 患者 HRV 降低的合适指标。
Zotero 插件