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心率升高可作为人类肥胖症的交感神经生物标志物。

Elevated heart rate as sympathetic biomarker in human obesity.

机构信息

IRCCS Istituto Auxologico Italiano, Cardiology Department, St Luca Hospital, Piazza Brescia Milan, Italy.

Clinica Medica, Department of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy.

出版信息

Nutr Metab Cardiovasc Dis. 2022 Oct;32(10):2367-2374. doi: 10.1016/j.numecd.2022.07.011. Epub 2022 Jul 20.

DOI:10.1016/j.numecd.2022.07.011
PMID:35970685
Abstract

BACKGROUND AND AIM

The present study was aimed at determining whether and to what extent a specific heart rate (HR) cutoff value allows to identify in obeses a more pronounced level of adrenergic overdrive.

METHODS AND RESULTS

In 86 obese subjects aged 44.7 ± 0.9 (mean ± SEM) years and in 45 heathy lean controls of similar age we evaluated muscle sympathetic nerve traffic (MSNA, microneurography) and venous plasma norepinephrine (NE, HPLC assay), subdividing the subjects in 3 different groups according to their resting clinic and 24-h HR values (<70, 70-79 and 80-89 beats/minute). MSNA and plasma NE values detected in the three obese groups were almost superimposable each other, no significant difference between groups being observed. A similar behavior was observed when HR values were assessed during the 24-h Holter monitoring. In the group as a whole no significant relationship was detected between MSNA, plasma NE and clinic HR, this being the case also when 24-h HR replaced clinic HR in the correlation analysis. In contrast lean controls displayed a progressive significant increase in MSNA values form the group with clinic (and 24 Holter) values below 70 beats/minute to the ones with HR values between 70 and 79 and above 80 beats/minute.

CONCLUSIONS

In the obese state measurement of resting HR may allow to provide some general information on the functional status of the adrenergic cardiovascular drive. When the information required, however, are more subtle the sensitivity of the approach appears to be reduced and HR cannot be regarded as a faithful sympathetic biomarker.

摘要

背景与目的

本研究旨在确定特定心率(HR)临界值是否以及在何种程度上可以识别肥胖者中更明显的肾上腺素能过度驱动。

方法和结果

在 86 名年龄为 44.7±0.9 岁(平均值±SEM)的肥胖受试者和 45 名年龄相似的健康瘦对照者中,我们评估了肌肉交感神经流量(MSNA,微神经记录)和静脉血浆去甲肾上腺素(NE,HPLC 测定),根据他们的静息临床和 24 小时 HR 值将受试者分为 3 个不同组(<70、70-79 和 80-89 次/分钟)。在三个肥胖组中检测到的 MSNA 和血浆 NE 值彼此几乎重叠,组间无显著差异。当在 24 小时 Holter 监测期间评估 HR 值时,观察到类似的行为。在整个组中,MSNA、血浆 NE 和临床 HR 之间未检测到显著相关性,当在相关性分析中用 24 小时 HR 代替临床 HR 时也是如此。相比之下,瘦对照组显示出 MSNA 值从临床(和 24 小时 Holter)值低于 70 次/分钟的组逐渐显著增加到 HR 值在 70-79 次/分钟之间和高于 80 次/分钟的组。

结论

在肥胖状态下,静息 HR 的测量可以提供一些关于肾上腺素能心血管驱动功能状态的一般信息。然而,当需要更微妙的信息时,该方法的敏感性似乎降低,并且 HR 不能被视为可靠的交感神经生物标志物。

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