Liao D, Sloan R P, Cascio W E, Folsom A R, Liese A D, Evans G W, Cai J, Sharrett A R
Department of Health Evaluation Sciences, Penn State Medical College, Hershey 17033, USA.
Diabetes Care. 1998 Dec;21(12):2116-22. doi: 10.2337/diacare.21.12.2116.
To test at the population level whether people with multiple metabolic syndrome (MMS) disorders have reduced cardiac autonomic activity (CAA).
We examined the association between the level of CAA and MMS disorders, at the degree of clustering and the segregate combination levels, using a random sample of 2,359 men and women aged 45-64 years from the biracial, population-based Atherosclerosis Risk in Communities (ARIC) Study. Supine resting 2-min beat-to-beat heart rate data were collected. High-frequency (HF) (0.15-0.35 Hz) and low-frequency (LF) (0.025-0.15 Hz) spectral powers, the ratio of LF to HF, and the SD of all normal R-R intervals (SDNN) were used as the conventional indices of heart rate variability (HRV) to measure CAA. The MMS disorders included hypertension, type 2 diabetes, and dyslipidemia.
HRV indices were significantly lower in individuals with MMS disorders. The multivariable adjusted mean HF was 0.85 (beat/min)2 in subjects with all three MMS disorders, in contrast to 1.31 (beat/min)2 in subjects without any MMS disorder. At the segregated combination level, the multivariable adjusted means +/- SEM of HF were 1.34 +/- 0.05, 1.16 +/- 0.05, 1.01 +/- 0.17, and 1.34 +/- 0.05 (beat/min)2, respectively, for subjects without any MMS disorder, with hypertension only, with diabetes only, and with dyslipidemia only, and the means +/- SEM of HF were 0.93 +/- 0.04, 0.70 +/- 0.15, and 1.20 +/- 0.05 (beat/min)2, respectively, for subjects with diabetes and hypertension, diabetes and dyslipidemia, and hypertension and dyslipidemia. An increase in fasting insulin of 1 SD was associated with 88% higher odds of having a lower HF. The pattern of associations was similar for LF and SDNN.
These findings suggest that MMS disorders adversely affect cardiac autonomic control and a reduced cardiac autonomic control may contribute to the increased risk of subsequent cardiovascular events in individuals who exhibit MMS disorders.
在人群水平上测试患有多种代谢综合征（MMS）疾病的人是否存在心脏自主神经活动（CAA）降低的情况。
我们使用了来自以社区为基础的双种族动脉粥样硬化风险（ARIC）研究中2359名年龄在45 - 64岁的男性和女性的随机样本，在聚类程度和单独组合水平上，研究了CAA水平与MMS疾病之间的关联。收集了仰卧位静息2分钟逐搏心率数据。高频（HF）（0.15 - 0.35Hz）和低频（LF）（0.025 - 0.15Hz）谱功率、LF与HF的比值以及所有正常R - R间期的标准差（SDNN）被用作心率变异性（HRV）的传统指标来测量CAA。MMS疾病包括高血压、2型糖尿病和血脂异常。
患有MMS疾病的个体的HRV指标显著更低。患有所有三种MMS疾病的受试者的多变量调整后平均HF为0.85（次/分钟）²，而没有任何MMS疾病的受试者为1.31（次/分钟）²。在单独组合水平上，没有任何MMS疾病、仅患有高血压、仅患有糖尿病以及仅患有血脂异常的受试者的HF的多变量调整后均值±标准误分别为1.34±0.05、1.16±0.05、1.01±0.17和1.34±0.05（次/分钟）²，而患有糖尿病和高血压、糖尿病和血脂异常以及高血压和血脂异常的受试者的HF的均值±标准误分别为0.93±0.04、0.70±0.15和1.20±0.
