肥胖个体中心脏自主调节的相关危险因素。
Risk Factors Associated with Cardiac Autonomic Modulation in Obese Individuals.
机构信息
Medicine Faculty, Health Science Post-Graduation Program, Universidade Federal de Goiás, Goiânia, Goiás, Brazil.
Medicine Faculty, Coordinator of the Severe Obesity Study Group, Federal University of Goiás, Goiânia, Brazil.
出版信息
J Obes. 2020 Mar 26;2020:7185249. doi: 10.1155/2020/7185249. eCollection 2020.
Obesity leads to an imbalance in the autonomic nervous system, especially in increased sympathetic modulation and decreased vagal tone, and some anthropometric, metabolic, and lifestyle variables may increase the risk of developing cardiovascular disease. . To analyze the association between cardiovascular autonomic modulation and biochemical and anthropometric markers, food intake, and physical activity level in severely obese individuals. . The present study is a cutout of a randomized clinical trial "Effect of nutritional intervention and olive oil in severe obesity" (DieTBra Trial), where the baseline data were analyzed. Anthropometric data, biochemical exams, heart rate variability (HRV), accelerometry, and 24 h recall (R24H) of obese patients (body mass index BMI ≥35 kg/m) were collected. . 64 obese patients were analyzed, with a mean age of 39.10 ± 7.74 years (27 to 58 years). By HRV analysis, in the frequency domain, the obese had a higher predominance of sympathetic autonomic modulation (low frequency (LF) 56.44 ± 20.31 nu) and lower parasympathetic modulation (high frequency (HF) 42.52 ± 19.18 nu). A negative association was observed between the variables Homeostasis Evaluation Model (HOMA-IR) and HF ( = 0.049). In the physical activity analysis, there was a negative association between moderate to vigorous physical activity and the sympathetic component ( = 0.043), and for sedentary time (ST), there was a negative association with HF ( = 0.049) and LF/HF ( = 0.036) and a positive association with LF ( = 0.014). For multiple linear regression, waist circumference (WC) and HOMA-IR values were negatively associated with HF ( = -0.685, = 0.010; = -14.989, = 0.010; respectively). HOMA-IR ( = 0.141, = 0.003) and the percentage of lipids ingested ( = -0.030, = 0.043) were negatively associated with LF/HF. . Among the cardiovascular risk variables studied, insulin resistance and central adiposity showed the greatest influence on cardiac autonomic modulation of obese, increasing the risk for cardiovascular disease.
肥胖会导致自主神经系统失衡，尤其是交感神经调节增加和迷走神经张力降低，一些人体测量学、代谢和生活方式变量可能会增加患心血管疾病的风险。为了分析严重肥胖个体中心血管自主调节与生化和人体测量标志物、食物摄入和身体活动水平之间的关系。本研究是一项随机临床试验“营养干预和橄榄油对严重肥胖的影响”（DieTBra 试验）的随机分组研究，对基线数据进行了分析。收集了肥胖患者（体重指数 BMI≥35kg/m）的人体测量学数据、生化检查、心率变异性（HRV）、加速度计和 24 小时回忆（R24H）。共分析了 64 名肥胖患者，平均年龄为 39.10±7.74 岁（27 至 58 岁）。通过 HRV 分析，在频域中，肥胖者交感自主调节优势更高（低频（LF）56.44±20.31nu），迷走神经调节较低（高频（HF）42.52±19.18nu）。HOMA-IR 与 HF 呈负相关（=0.049）。在身体活动分析中，中等至剧烈身体活动与交感成分呈负相关（=0.043），而久坐时间（ST）与 HF 呈负相关（=0.049），与 LF/HF 呈正相关（=0.036），与 LF 呈正相关（=0.014）。对于多元线性回归，腰围（WC）和 HOMA-IR 值与 HF 呈负相关（=−0.685，=0.010；=−14.989，=0.010）。HOMA-IR（=0.141，=0.003）和摄入脂肪的百分比（=−0.030，=0.043）与 LF/HF 呈负相关。在研究的心血管风险变量中，胰岛素抵抗和中心性肥胖对肥胖患者的心脏自主调节影响最大，增加了患心血管疾病的风险。
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