Zhang Yunqiu, Han Lei, Shi Luqian, Gao Meiyang, Chen Jun, Ding Yingying
Department of Epidemiology, School of Public Health, And Key Laboratory of Public Health Safety of Ministry of Education, Fudan University, Shanghai, China.
Jing'an District Center for Disease Control and Prevention, Shanghai, China.
Brain Behav Immun Health. 2024 Sep 7;41:100858. doi: 10.1016/j.bbih.2024.100858. eCollection 2024 Nov.
We compared heart rate variability (HRV) indices between people living with HIV (PLWH) and HIV-negative individuals to ascertain the independent association between HIV infection and reduced HRV, and further investigated whether distinct clinical laboratory profiles exist between PLWH with and without reduced HRV.
This cross-sectional analysis included 304 PLWH and 147 HIV-negative individuals with comparable age and sex. Thirty-two routine clinical laboratory indices (including hematology and biochemistry) closest to the survey were extracted from the Electronic Medical Record System. HRV indices were divided into two categories: low (lowest quartile, Q1) and moderate-to-high (combined, Q2‒Q4).
The time domain indices, ln(SDNN), ln(RMSSD), and ln(PNN50), as well as the frequency domain indices, ln(HF), ln(LF), and ln(VLF), were all significantly reduced in PLWH versus HIV-negative individuals (all < 0.05). These associations remained for ln(SDNN), ln(PNN50), ln(HF) and ln(LF) even after adjusting for potential confounders in multivariable models. PLWH with low HRV indices exhibited distinct clinical laboratory profiles that were characterized by an elevation in fasting plasma glucose, white blood cell count, neutrophil count, neutrophil%, and a reduction in albumin, total protein, urine creatinine, lymphocyte%, red blood cell count (RBC) and nadir CD4 count. The final stepwise logistic regression models for low SDNN included older age, decreased total cholesterol levels, elevated neutrophil count, and the use of antidiabetic medications, whereas the final model for low LF included older age, reduced RBC and the use of antidiabetic medications.
PLWH exhibit impaired parasympathetic activity, as evidenced by reduced SDNN, PNN50, LF and HF. Furthermore, PLWH who have reduced HRV indices exhibits distinct clinical laboratory profiles that are related to systematic inflammatory response and diabetes.
我们比较了人类免疫缺陷病毒感染者（PLWH）和HIV阴性个体之间的心率变异性（HRV）指标，以确定HIV感染与HRV降低之间的独立关联，并进一步研究HRV降低和未降低的PLWH之间是否存在不同的临床实验室特征。
这项横断面分析纳入了304名PLWH和147名年龄和性别匹配的HIV阴性个体。从电子病历系统中提取了最接近调查时间的32项常规临床实验室指标（包括血液学和生物化学指标）。HRV指标分为两类：低（最低四分位数，Q1）和中到高（合并，Q2-Q4）。
与HIV阴性个体相比，PLWH的时域指标ln(SDNN)、ln(RMSSD)和ln(PNN50)以及频域指标ln(HF)、ln(LF)和ln(VLF)均显著降低（均P<0.05）。即使在多变量模型中对潜在混杂因素进行调整后，ln(SDNN)、ln(PNN50)、ln(HF)和ln(LF)的这些关联仍然存在。HRV指标低的PLWH表现出不同的临床实验室特征，其特点是空腹血糖、白细胞计数、中性粒细胞计数、中性粒细胞百分比升高，白蛋白、总蛋白、尿肌酐、淋巴细胞百分比、红细胞计数（RBC）和CD4细胞计数最低点降低。低SDNN的最终逐步逻辑回归模型包括年龄较大、总胆固醇水平降低、中性粒细胞计数升高和使用抗糖尿病药物，而低LF的最终模型包括年龄较大、RBC降低和使用抗糖尿病药物。
PLWH表现出副交感神经活动受损，表现为SDNN、PNN50、LF和HF降低。此外，HRV指标降低的PLWH表现出与系统性炎症反应和糖尿病相关的不同临床实验室特征。
