Richter W O, Geiss H C, Aleksic S, Schwandt P
Department of Internal Medicine II, University of Munich, Klinikum Grosshadern, Germany.
Int J Obes Relat Metab Disord. 1996 Oct;20(10):966-9.
To investigate whether obesity influences cardiac autonomic nerve function.
Comparing two groups of subjects with different degrees of obesity to normal weight controls.
19 healthy controls (mean age 33 y, BMI 21.7 +/- 0.2 kg/m2) and 17 obese non-diabetic subjects (mean age 39 y, BMI 33.7 +/- 1.8 kg/m2).
Insulin sensitivity was calculated by an oral glucose tolerance test. Autonomic nerve function was evaluated by analysing the variation of the heart frequency at rest (coefficient variation of R-R intervals, REST 1), during deep respiration, at a Valsalva maneuver (longest/shortest R-R interval during inspiration hold) and by the Ewing test (ratio between the 30th and 15th R-R interval after reaching up-right position).
The obese showed a lower insulin sensitivity than healthy controls (3.09 vs 4.60 mg x l2/mmol x mU x min, P < 0.001). Their variation in heart frequency was reduced (REST 1: 1.95 vs 2.9, P < 0.01, Valsalva: 1.30 vs 1.52 and Ewing test: 1.03 vs 1.14, P < 0.05). However, patients with moderate (BMI 31.7 kg/m2) or severe obesity (39.0 kg/m2) with identical insulin sensitivity had no significant difference in autonomic nerve function. Except for the Ewing test all measured parameters for the evaluation of cardiac autonomic nerve function correlated with the degree of diminished insulin sensitivity (REST 1: r = 0.475, P < 0.001).
Moderate obesity with significantly decreased insulin sensitivity is associated with impaired cardiac autonomic nerve function.
研究肥胖是否会影响心脏自主神经功能。
将两组不同肥胖程度的受试者与正常体重对照组进行比较。
19名健康对照者（平均年龄33岁，体重指数21.7±0.2kg/m²）和17名肥胖非糖尿病受试者（平均年龄39岁，体重指数33.7±1.8kg/m²）。
通过口服葡萄糖耐量试验计算胰岛素敏感性。通过分析静息时心率的变化（R-R间期的变异系数，REST 1）、深呼吸时、瓦尔萨尔瓦动作时（吸气屏气时最长/最短R-R间期）以及尤因试验（直立位后第30个与第15个R-R间期之比）来评估自主神经功能。
肥胖者的胰岛素敏感性低于健康对照者（3.09对4.60mg·l²/mmol·mU·min，P<0.001）。他们的心率变异性降低（REST 1：1.95对2.9，P<0.01；瓦尔萨尔瓦动作：1.30对1.52；尤因试验：1.03对1.14，P<0.05）。然而，胰岛素敏感性相同的中度肥胖（体重指数31.7kg/m²）或重度肥胖（39.0kg/m²）患者的自主神经功能无显著差异。除尤因试验外，所有用于评估心脏自主神经功能的测量参数均与胰岛素敏感性降低程度相关（REST 1：r = 0.475，P<0.001）。
胰岛素敏感性显著降低的中度肥胖与心脏自主神经功能受损有关。
