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Eiswerth M, Mathur P, Rashed H, Greenway F, Ravussin E, Johnson W, Jirapinyo P, Thompson CC, Kehdy F, Sarker S, Naing LY, Daniels MW, Abell T. Autonomic and Enteric Profiling May Help Predict Response to Diverse Obesity Therapies. Obes Surg 2024:10.1007/s11695-024-07360-9. [PMID: 39046627 DOI: 10.1007/s11695-024-07360-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2024] [Revised: 06/07/2024] [Accepted: 06/07/2024] [Indexed: 07/25/2024]
Abstract
PURPOSE Changes in autonomic (ANS) and enteric nervous systems (ENS) may be involved in pathogenesis of obesity. We hypothesized that baseline autonomic and enteric parameters may predict outcomes of diverse obesity therapies. MATERIAL AND METHODS We studied ANS and ENS physiology in 37 patients (8 male, 29 female, age 45 years, weight 129.7 kg) at 4 centers in patients undergoing medical (9: low-calorie diet) versus invasive (22: 16 sleeve, 6 bypass) and semi-invasive (6: 2 band, 2 high energy stimulation, 2 aspiration) weight loss therapies. Weight loss was reported as percent weight loss from baseline to latest values at 1 year and in some up to 5 years; classified as < or > /= 20% for each group. ANS testing included sympathetic adrenergic function by measuring reflex vasoconstriction and postural adjustment ratio. ENS was measured non-invasively using cutaneous low-resolution electrogastrogram. RESULTS Percent weight loss was greater with the invasive (28.5%) than semi-invasive (9.1%) or non-invasive low-calorie diet (4.4%) (p < .001). Percent weight loss at 1 year (and up to 5 years) corresponded to the adrenergic measure of postural adjustment ratio (r = .42, p = .012), total pulse amplitude at rest (r = .56, p < .001), and electrogastrogram standing-to-rest difference (r = .33, p = .056). CONCLUSION Baseline autonomic and enteric function measures correspond to percentage with loss in this pilot study using diverse weight loss methods. Autonomic and enteric profiling has potential clinical use for evaluation and treatment of obesity but needed larger controlled trials.
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Affiliation(s)
- Michael Eiswerth
- Division of Gastroenterology, Hepatology, and Nutrition, GI Motility Research, University of Louisville, 8 Frazier, 220 Abraham Flexner Dr, Louisville, KY, 40202, USA
| | - Prateek Mathur
- Division of Gastroenterology, Hepatology, and Nutrition, GI Motility Research, University of Louisville, 8 Frazier, 220 Abraham Flexner Dr, Louisville, KY, 40202, USA
| | - Hani Rashed
- Vanderbilt University Medical Center, Nashville, TN, 37235, USA
| | - Frank Greenway
- Pennington Biomedical Research Center, Baton Rouge, LA, 70808, USA
| | - Eric Ravussin
- Vanderbilt University Medical Center, Nashville, TN, 37235, USA
| | - William Johnson
- Vanderbilt University Medical Center, Nashville, TN, 37235, USA
| | | | | | - Farid Kehdy
- Division of Gastroenterology, Hepatology, and Nutrition, GI Motility Research, University of Louisville, 8 Frazier, 220 Abraham Flexner Dr, Louisville, KY, 40202, USA
| | - Shabnam Sarker
- Vanderbilt University Medical Center, Nashville, TN, 37235, USA
| | - Le Yu Naing
- Division of Gastroenterology, Hepatology, and Nutrition, GI Motility Research, University of Louisville, 8 Frazier, 220 Abraham Flexner Dr, Louisville, KY, 40202, USA
| | - Michael W Daniels
- Division of Gastroenterology, Hepatology, and Nutrition, GI Motility Research, University of Louisville, 8 Frazier, 220 Abraham Flexner Dr, Louisville, KY, 40202, USA
| | - Thomas Abell
- Division of Gastroenterology, Hepatology, and Nutrition, GI Motility Research, University of Louisville, 8 Frazier, 220 Abraham Flexner Dr, Louisville, KY, 40202, USA.
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Putra IGNE, Daly M, Sutin A, Steptoe A, Scholes S, Robinson E. Obesity, psychological well-being related measures, and risk of seven non-communicable diseases: evidence from longitudinal studies of UK and US older adults. Int J Obes (Lond) 2024:10.1038/s41366-024-01551-1. [PMID: 38824226 DOI: 10.1038/s41366-024-01551-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Revised: 05/14/2024] [Accepted: 05/21/2024] [Indexed: 06/03/2024]
Abstract
BACKGROUND We examined the role of psychological well-being related measures in explaining the associations between obesity and increased risk of non-communicable diseases (NCDs: hypertension, heart disease, stroke, diabetes, arthritis, cancer, and memory-related disease) in older adults. METHODS Data were from the English Longitudinal Study of Ageing (ELSA), UK (baseline: Wave 4-2008/2009; n = 8127) and the Health and Retirement Study (HRS), US (baseline: Waves 9 and 10-2008/2010; n = 12,477). Objective body mass index was used to define obesity. A range of psychological well-being related measures (e.g., depressive symptoms, life satisfaction) was available in ELSA (n = 7) and HRS (n = 15), and an index of overall psychological well-being was developed separately in each study. NCDs were from a self-reported doctor diagnosis and/or other assessments (e.g., biomarker data) in both studies; and in ELSA, NCDs from linked hospital admissions data were examined. Longitudinal associations between obesity status, psychological well-being measures, and NCDs were examined using Cox proportional hazard models (individual NCDs) and Poisson regression (a cumulative number of NCDs). Mediation by psychological well-being related measures was assessed using causal mediation analysis. RESULTS Obesity was consistently associated with an increased prospective risk of hypertension, heart disease, diabetes, arthritis, and a cumulative number of NCDs in both ELSA and HRS. Worse overall psychological well-being (index measure) and some individual psychological well-being related measures were associated with an increased prospective risk of heart disease, stroke, arthritis, memory-related disease, and a cumulative number of NCDs across studies. Findings from mediation analyses showed that neither the index of overall psychological well-being nor any individual psychological well-being related measures explained (mediated) why obesity increased the risk of developing NCDs in both studies. CONCLUSION Obesity and psychological well-being may independently and additively increase the risk of developing NCDs.
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Affiliation(s)
- I Gusti Ngurah Edi Putra
- Department of Psychology, Institute of Population Health, University of Liverpool, Liverpool, UK.
| | - Michael Daly
- Department of Psychology, Maynooth University, Maynooth, Ireland
| | - Angelina Sutin
- Department of Behavioral Sciences and Social Medicine, Florida State University College of Medicine, Tallahassee, FL, USA
| | - Andrew Steptoe
- Department of Epidemiology and Health, Institute of Epidemiology and Health Care, Faculty of Population Health Sciences, University College London, London, UK
| | - Shaun Scholes
- Department of Epidemiology and Health, Institute of Epidemiology and Health Care, Faculty of Population Health Sciences, University College London, London, UK
| | - Eric Robinson
- Department of Psychology, Institute of Population Health, University of Liverpool, Liverpool, UK
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Cruz CJ, Yeater TD, Griffith JL, Allen KD. Vagotomy accelerates the onset of symptoms during early disease progression and worsens joint-level pathogenesis in a male rat model of chronic knee osteoarthritis. OSTEOARTHRITIS AND CARTILAGE OPEN 2024; 6:100467. [PMID: 38655014 PMCID: PMC11035058 DOI: 10.1016/j.ocarto.2024.100467] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Accepted: 04/03/2024] [Indexed: 04/26/2024] Open
Abstract
Objective Low vagal tone is common in osteoarthritis (OA) comorbidities and results in greater peripheral inflammation. Characterizing vagal tone's role in OA pathogenesis may offer insights into OA's influences beyond the articular joint. We hypothesized that low vagal tone would accelerate onset of OA-related gait changes and worsen joint damage in a rat knee OA model. Methods Knee OA was induced in male Sprague Dawley rats by transecting the medial collateral ligament and medial meniscus. Then, left cervical vagus nerve transection (VGX, n = 9) or sham VGX (non-VGX, n = 6) was performed. Gait and tactile sensitivity were assessed at baseline and across 12 weeks, with histology and systemic inflammation evaluated at endpoint. Results At week 4, VGX animals showed limping gait characteristics through shifted stance times from their OA to non-OA limb (p = 0.055; stance time imbalance = 1.6 ± 1.6%) and shifted foot strike locations (p < 0.001; spatial symmetry = 48.4 ± 0.835%), while non-VGX animals walked with a balanced and symmetric gait. Also at week 4, while VGX animals had a mechanical sensitivity (50% withdrawal threshold) of 13.97 ± 7.70 compared to the non-VGX animal sensitivity of 29.74 ± 9.43, this difference was not statistically significant. Histologically, VGX animals showed thinner tibial cartilage and greater subchondral bone area than non-VGX animals (p = 0.076; VGX: 0.80 ± 0.036 mm2; non-VGX: 0.736 ± 0.066 mm2). No group differences in systemic inflammation were observed at endpoint. Conclusions VGX resulted in quicker onset of OA-related symptoms but remained unchanged at later timepoints. VGX also had thinner cartilage and abnormal bone remodeling than non-VGX. Overall, low vagal tone had mild effects on OA symptoms and joint remodeling, and not at the level seen in common OA comorbidities.
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Affiliation(s)
- Carlos J. Cruz
- J. Crayton Pruitt Family Department of Biomedical Engineering, University of Florida, Gainesville, FL, USA
- Pain Research and Intervention Center of Excellence, University of Florida, Gainesville, FL, USA
| | - Taylor D. Yeater
- J. Crayton Pruitt Family Department of Biomedical Engineering, University of Florida, Gainesville, FL, USA
- Pain Research and Intervention Center of Excellence, University of Florida, Gainesville, FL, USA
| | - Jacob L. Griffith
- J. Crayton Pruitt Family Department of Biomedical Engineering, University of Florida, Gainesville, FL, USA
- Pain Research and Intervention Center of Excellence, University of Florida, Gainesville, FL, USA
| | - Kyle D. Allen
- J. Crayton Pruitt Family Department of Biomedical Engineering, University of Florida, Gainesville, FL, USA
- Department of Orthopaedic Surgery and Sports Medicine, College of Medicine, University of Florida, Gainesville, FL, USA
- Pain Research and Intervention Center of Excellence, University of Florida, Gainesville, FL, USA
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Patel D, Avesani M, Johnson MR, Di Salvo G, Savvidou MD. Maternal cardiovascular adaptation to pregnancy in obese pregnant women. Acta Obstet Gynecol Scand 2024; 103:907-916. [PMID: 38238936 PMCID: PMC11019532 DOI: 10.1111/aogs.14777] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Revised: 11/23/2023] [Accepted: 12/22/2023] [Indexed: 04/17/2024]
Abstract
INTRODUCTION Obesity is known to be associated with cardiovascular compromise and a major risk factor for the development of hypertensive disorders in pregnancy. However, little is known about the effect of obesity on maternal cardiac function. The aim of this study was to investigate the effect of obesity on the maternal cardiovascular system. MATERIAL AND METHODS This was a prospective, observational, longitudinal study. Pregnant women with booking body mass index (BMI) ≥30 kg/m2 were compared with pregnant women with normal booking BMI 20-24.9 kg/m2. Participants were seen at three time points during pregnancy; 12-14, 20-24 and 30-32 weeks. At all visits, maternal blood pressure (BP) was measured, and cardiac geometry and function were assessed using two-dimensional trans-thoracic echocardiography. Multilevel linear mixed-effects models were used for all the comparisons. RESULTS Fifty-nine pregnant women with obesity were compared with 14 pregnant women with normal BMI. In women with obesity, the maternal BP, heart rate and cardiac output were higher and peripheral vascular resistance was lower (p < 0.01 for all comparisons) compared with normal BMI women. Women with obesity had altered cardiac geometry with higher left ventricular end diastolic diameter, intraventricular septal thickness, posterior wall diameter, relative wall thickness and left ventricular mass (p < 0.001 for all comparisons). There was also evidence of impaired diastolic indices in the obese group with a lower E/A ratio, tissue Doppler imaging E' lateral and medial and higher left atrial volume (p < 0.01 for all comparisons). Finally, women with obesity had reduced longitudinal function, as assessed by mitral plane annular systolic excursion, between the second and third trimester of pregnancy, indicating possible early cardiac dysfunction in this group. CONCLUSIONS Obesity is associated with maternal hyperdynamic circulation, altered cardiac geometry and suboptimal diastolic function, compared with normal BMI pregnant women, and these factors may contribute to the increased risk of complications in obese pregnant women.
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Affiliation(s)
- Deesha Patel
- Academic Department of Obstetrics and Gynaecology, Chelsea & Westminster Hospital, Department of MetabolismDigestion and Reproduction, Imperial CollegeLondonUK
| | - Martina Avesani
- Royal Brompton HospitalRoyal Brompton and Harefield NHS Foundation trustLondonUK
| | - Mark R. Johnson
- Academic Department of Obstetrics and Gynaecology, Chelsea & Westminster Hospital, Department of MetabolismDigestion and Reproduction, Imperial CollegeLondonUK
| | - Giovanni Di Salvo
- Royal Brompton HospitalRoyal Brompton and Harefield NHS Foundation trustLondonUK
| | - Makrina D. Savvidou
- Academic Department of Obstetrics and Gynaecology, Chelsea & Westminster Hospital, Department of MetabolismDigestion and Reproduction, Imperial CollegeLondonUK
- Fetal Medicine UnitChelsea & Westminster HospitalLondonUK
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Zhu T, Chen Q, Chen H, You L, Liu D, Zhang X, Li F, Wu H, Tang J, Lin D, Sun K, Yan L, Ren M. Independent and interactive associations of heart rate and obesity with type 2 diabetes mellites: A population-based study. J Diabetes 2024; 16:e13529. [PMID: 38599825 PMCID: PMC11006609 DOI: 10.1111/1753-0407.13529] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Revised: 12/13/2023] [Accepted: 12/25/2023] [Indexed: 04/12/2024] Open
Abstract
BACKGROUND Although obesity and heart rate (HR) were closely related to the prevalence and development of type 2 diabetes mllitus (T2DM), few studies have shown a co-association effect of them on T2DM. We aimed at assessing the interactive effects of HR and obesity with prevalence of T2DM in Chinese population, providing the exact cutpoint of the risk threshold for blood glucose with high HR. MATERIALS AND METHODS In the Risk Evaluation of cAncers in Chinese diabeTic Individuals: a lONgitudinal study (REACTION) cohorts (N = 8398), the relationship between HR and T2DM was explored by linear regression, logistic regression, and restricted cubic spline, and odds ratios (ORs) and 95% confidence intervals (CIs) were calculated. Interaction terms between HR and body mass index (BMI) and HR and waist circumference (WC) were introduced into the logistic regression model. RESULTS In those with HR > 88.0 beats/min, fasting plasma glucose and oral glucose tolerance tests were significantly correlated with HR, and the prevalence of T2DM was highly correlated with HR (all p < .05). There were interactive associations of HR and obesity in patients with T2DM with HR < 74 beats/min. CONCLUSION High HR was in interaction with obesity, associating with prevalence of T2DM. The newly subdivided risk threshold for HR with T2DM might be HR > 88 beats/minute.
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Affiliation(s)
- Tianxin Zhu
- Department of Endocrinology, Sun Yat‐sen Memorial HospitalSun Yat‐sen UniversityGuangzhouChina
| | - Qingyu Chen
- Health Examination Center, Sun Yat‐sen Memorial HospitalSun Yat‐sen UniversityGuangzhouChina
| | - Hongxing Chen
- Department of Endocrinology, Sun Yat‐sen Memorial HospitalSun Yat‐sen UniversityGuangzhouChina
| | - Lili You
- Department of Endocrinology, Sun Yat‐sen Memorial HospitalSun Yat‐sen UniversityGuangzhouChina
| | - Dan Liu
- Department of Endocrinology, Sun Yat‐sen Memorial HospitalSun Yat‐sen UniversityGuangzhouChina
| | - Xiaoyun Zhang
- Department of Endocrinology, Sun Yat‐sen Memorial HospitalSun Yat‐sen UniversityGuangzhouChina
| | - Feng Li
- Department of Endocrinology, Sun Yat‐sen Memorial HospitalSun Yat‐sen UniversityGuangzhouChina
| | - Hongshi Wu
- Department of Endocrinology, Sun Yat‐sen Memorial HospitalSun Yat‐sen UniversityGuangzhouChina
| | - Juying Tang
- Department of Endocrinology, Sun Yat‐sen Memorial HospitalSun Yat‐sen UniversityGuangzhouChina
| | - Diaozhu Lin
- Department of Endocrinology, Sun Yat‐sen Memorial HospitalSun Yat‐sen UniversityGuangzhouChina
| | - Kan Sun
- Department of Endocrinology, Sun Yat‐sen Memorial HospitalSun Yat‐sen UniversityGuangzhouChina
| | - Li Yan
- Department of Endocrinology, Sun Yat‐sen Memorial HospitalSun Yat‐sen UniversityGuangzhouChina
| | - Meng Ren
- Department of Endocrinology, Sun Yat‐sen Memorial HospitalSun Yat‐sen UniversityGuangzhouChina
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Sangeetha RP, Chakrabarti D, Sriganesh K, Mahendranath M, Sathyaprabha TN, Srinivas D. Prevalence and predictors of preoperative cardiac autonomic dysfunction among elective neurosurgical patients: A prospective observational study. Indian J Anaesth 2024; 68:380-386. [PMID: 38586253 PMCID: PMC10993939 DOI: 10.4103/ija.ija_722_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Revised: 01/24/2024] [Accepted: 01/26/2024] [Indexed: 04/09/2024] Open
Abstract
Background and Aims The autonomic nervous system (ANS) is cardinal for systemic homeostasis. Autonomic dysfunction is prevalent in as high as 65% of patients presenting for cardiac surgery in the Indian scenario. Pre-existing cardiac autonomic dysfunction (CAD) in surgical patients can accentuate perioperative haemodynamic fluctuations during stressful intraoperative events, predispose to adverse cardiac events, and contribute to morbidity and mortality. The prevalence and predictors of CAD in the elective neurosurgical population are unknown in the Indian scenario. The current study was conducted to bridge this knowledge gap. Methods In this single-centre prospective observational study conducted at a tertiary care neurosciences centre, among 400 consenting adult patients of either gender, between 18 and 80 years of age, undergoing elective neurosurgery, the preoperative ANS function at the bedside was assessed as the primary outcome measure. The ANS status was evaluated using ANSiscope™-derived indices of heart rate variability. The diagnosis of CAD was made when the ANS index exceeded a threshold of 13.5. Data regarding predictors of CAD were collected from patient records as the secondary outcome measure. Statistical analysis was done using the R software. A P-value of <0.05 was considered statistically significant. Results The prevalence of preoperative CAD in our study population was 79.7% (319/400 patients). None of the demographic and baseline clinical characteristics we studied predicted CAD in our study. Conclusion We observed a significant prevalence of preoperative CAD among elective neurosurgical patients. None of the parameters we evaluated predicted CAD in our study.
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Affiliation(s)
- RP Sangeetha
- Department of Neuroanesthesia and Neurocritical Care, NIMHANS, Bangalore, Karnataka, India
| | - Dhritiman Chakrabarti
- Department of Neuroanesthesia and Neurocritical Care, NIMHANS, Bangalore, Karnataka, India
| | - Kamath Sriganesh
- Department of Neuroanesthesia and Neurocritical Care, NIMHANS, Bangalore, Karnataka, India
| | - Musumur Mahendranath
- Department of Neuroanesthesia and Neurocritical Care, NIMHANS, Bangalore, Karnataka, India
| | - TN Sathyaprabha
- Department of Neurophysiology, NIMHANS, Bangalore, Karnataka, India
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Palma MR, Tebar WR, Beretta VS, Vanderlei LCM, Fregonesi CEPT, Ribeiro FE, Caldeira DT, Ramos EMC, Cucato GG, Ferrari G, Ritti-Dias RM, Christofaro DGD. Effect of physical activity on the relationship between adiposity and cardiac autonomic modulation in female breast cancer survivors: a longitudinal study. Women Health 2024; 64:165-174. [PMID: 38229419 DOI: 10.1080/03630242.2024.2305342] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Accepted: 01/08/2024] [Indexed: 01/18/2024]
Abstract
This longitudinal study aimed to analyze the influence of physical activity (PA) on the relationship between body adiposity and cardiac autonomic modulation (CAM) in women survivors of breast cancer. We collected body adiposity through electrical bioimpedance considering body fat percentage (BFP), CAM through heart rate variability (considering RMSSD, SDNN, PNN50, LF (m2), HF (m2), SD1 indexes and SD1/SD2 ratio) and PA through a questionnaire in 64 participants (58.0 ± 9.6 years), recruited through the local association of support for breast cancer and by direct indications from city mastologists. After insertion of PA into the multivariate statistical model, significant attenuation was observed in the relationship between body adiposity and CAM for the indices: SDNN (β = -0.94; 95 percent CI: -1.93; 0.04; p = .060) and SD1/SD2 (β = -0.01;95 percent CI = -0.02; 0.001; p = .065). In conclusion, it was observed that PA was able to mitigate the relationships between BFP and CAM (considering SDNN index and SD1/SD2 ratio) in breast cancer survivors.
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Affiliation(s)
- Mariana R Palma
- School of Technology and Sciences, Department of Physiotherapy, São Paulo State University (Unesp), Presidente Prudente, Brazil
| | - William R Tebar
- School of Technology and Sciences, Department of Physical Education, São Paulo State University (Unesp), Presidente Prudente, Brazil
| | - Victor S Beretta
- School of Technology and Sciences, Department of Physical Education, São Paulo State University (Unesp), Presidente Prudente, Brazil
| | - Luiz Carlos M Vanderlei
- School of Technology and Sciences, Department of Physiotherapy, São Paulo State University (Unesp), Presidente Prudente, Brazil
| | - Cristina E P T Fregonesi
- School of Technology and Sciences, Department of Physiotherapy, São Paulo State University (Unesp), Presidente Prudente, Brazil
| | - Fernanda E Ribeiro
- School of Technology and Sciences, Department of Physiotherapy, São Paulo State University (Unesp), Presidente Prudente, Brazil
| | - Daniela T Caldeira
- School of Technology and Sciences, Department of Physiotherapy, São Paulo State University (Unesp), Presidente Prudente, Brazil
| | - Ercy M C Ramos
- School of Technology and Sciences, Department of Physiotherapy, São Paulo State University (Unesp), Presidente Prudente, Brazil
| | - Gabriel G Cucato
- Department of Sport, Exercise and Rehabilitation, Northumbria University, Newcastle, UK
| | - Gerson Ferrari
- Faculty of Health Sciences, Universidad Autónoma de Chile, Providencia, Chile
| | | | - Diego G D Christofaro
- School of Technology and Sciences, Department of Physical Education, São Paulo State University (Unesp), Presidente Prudente, Brazil
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Cai J, Hu W, Yang Y, Chen S, Si A, Zhang Y, Jing H, Gong L, Liu S, Mi B, Ma J, Yan H, Chen F. Healthy life expectancy for 202 countries up to 2030: Projections with a Bayesian model ensemble. J Glob Health 2023; 13:04185. [PMID: 38146817 PMCID: PMC10750449 DOI: 10.7189/jogh.13.04185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2023] Open
Abstract
Background Healthy life expectancy (HLE) projections are required for optimising social and health service management in the future. Existing studies on the topic were usually conducted by selecting a single model for analysis. We thus aimed to use an ensembled model to project the future HLE for 202 countries/region. Methods We obtained data on age-sex-specific HLE and the sociodemographic index (SDI) level of 202 countries from 1990 to 2019 from the Global Burden of Disease (GBD) database and used a probabilistic Bayesian model comprised of 21 forecasting models to predict their HLE in 2030. Results In general, HLE is projected to increase in all 202 countries, with the least probability of 82.4% for women and 81.0% for men. Most of the countries with the lowest projected HLE would be located in Africa. Women in Singapore have the highest projected HLE in 2030, with a 94.5% probability of higher than 75.2 years, which is the highest HLE in 2019 across countries. Maldives, Kuwait, and China are projected to have a probability of 49.3%, 41.2% and 31.6% to be the new entries of the top ten countries with the highest HLE for females compared with 2019. Men in Singapore are projected to have the highest HLE at birth in 2030, with a 93.4% probability of higher than 75.2 years. Peru and Maldives have a probability of 48.7% and 35.3% being new top ten countries in male's HLE. The female advantage in HLE will shrink by 2030 in 117 countries, especially in most of the high SDI and European countries. Conclusions HLE will likely continue to increase in most countries and regions worldwide in the future. More attention needs to be paid to combatting obesity, chronic diseases, and specific infectious diseases, especially in African and some Pacific Island countries. Although gender gaps may not be fully bridged, HLE could partially mitigate and even eliminate them through economic development and improvements in health care.
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Affiliation(s)
- Jiaxin Cai
- Department of Epidemiology and Biostatistics, School of Public Health, Xi’an Jiaotong University, Xi’an, Shaanxi, China
| | - Weiwei Hu
- Department of Epidemiology and Biostatistics, School of Public Health, Xi’an Jiaotong University, Xi’an, Shaanxi, China
| | - Yuhui Yang
- Department of Epidemiology and Biostatistics, School of Public Health, Xi’an Jiaotong University, Xi’an, Shaanxi, China
| | - Shiyu Chen
- Department of Epidemiology and Biostatistics, School of Public Health, Xi’an Jiaotong University, Xi’an, Shaanxi, China
| | - Aima Si
- Department of Epidemiology and Biostatistics, School of Public Health, Xi’an Jiaotong University, Xi’an, Shaanxi, China
| | - Yuxiang Zhang
- Department of Epidemiology and Biostatistics, School of Public Health, Xi’an Jiaotong University, Xi’an, Shaanxi, China
| | - Hui Jing
- Department of Epidemiology and Biostatistics, School of Public Health, Xi’an Jiaotong University, Xi’an, Shaanxi, China
| | - Lingmin Gong
- Department of Epidemiology and Biostatistics, School of Public Health, Xi’an Jiaotong University, Xi’an, Shaanxi, China
| | - Sitong Liu
- Department of Epidemiology and Biostatistics, School of Public Health, Xi’an Jiaotong University, Xi’an, Shaanxi, China
| | - Baibing Mi
- Department of Epidemiology and Biostatistics, School of Public Health, Xi’an Jiaotong University, Xi’an, Shaanxi, China
- Key Laboratory for Disease Prevention and Control and Health Promotion of Shaanxi Province, Xi’an Jiaotong University, Xi’an, Shaanxi, China
| | - Jiaojiao Ma
- Department of Neurology, Xi’an Gaoxin Hospital, Xi’an, Shaanxi, China
| | - Hong Yan
- Department of Epidemiology and Biostatistics, School of Public Health, Xi’an Jiaotong University, Xi’an, Shaanxi, China
- Key Laboratory for Disease Prevention and Control and Health Promotion of Shaanxi Province, Xi’an Jiaotong University, Xi’an, Shaanxi, China
| | - Fangyao Chen
- Department of Epidemiology and Biostatistics, School of Public Health, Xi’an Jiaotong University, Xi’an, Shaanxi, China
- Key Laboratory for Disease Prevention and Control and Health Promotion of Shaanxi Province, Xi’an Jiaotong University, Xi’an, Shaanxi, China
- Department of Radiology, First Affiliate Hospital of Xi’an Jiaotong University, Xi’an, Shaanxi, China
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Clayton TL. Obesity and hypertension: Obesity medicine association (OMA) clinical practice statement (CPS) 2023. OBESITY PILLARS (ONLINE) 2023; 8:100083. [PMID: 38125655 PMCID: PMC10728712 DOI: 10.1016/j.obpill.2023.100083] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/06/2023] [Accepted: 08/06/2023] [Indexed: 12/23/2023]
Abstract
Background This Obesity Medicine Association (OMA) Clinical Practice Statement (CPS) provides an overview of the mechanisms and treatment of obesity and hypertension. Methods The scientific support for this CPS is based upon published citations, clinical perspectives of OMA authors, and peer review by the Obesity Medicine Association leadership. Results Mechanisms contributing to obesity-related hypertension include unhealthful nutrition, physical inactivity, insulin resistance, increased sympathetic nervous system activity, renal dysfunction, vascular dysfunction, heart dysfunction, increased pancreatic insulin secretion, sleep apnea, and psychosocial stress. Adiposopathic factors that may contribute to hypertension include increased release of free fatty acids, increased leptin, decreased adiponectin, increased renin-angiotensin-aldosterone system activation, increased 11 beta-hydroxysteroid dehydrogenase type 1, reduced nitric oxide activity, and increased inflammation. Conclusions Increase in body fat is the most common cause of hypertension. Among patients with obesity and hypertension, weight reduction via healthful nutrition, physical activity, behavior modification, bariatric surgery, and anti-obesity medications mostly decrease blood pressure, with the greatest degree of weight reduction generally correlated with the greatest degree of blood pressure reduction.
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Affiliation(s)
- Tiffany Lowe Clayton
- Diplomate of American Board of Obesity Medicine, WakeMed Bariatric Surgery and Medical Weight Loss USA
- Campbell University School of Osteopathic Medicine, Buies Creek, NC 27546, Levine Hall Room 170 USA
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Vecchiato M, Quinto G, Neunhaeuserer D, Battista F, Bettini S, Gasperetti A, Vettor R, Busetto L, Ermolao A. The incidence of cardiac arrhythmias during exercise stress testing: a focus on patients with severe obesity undergoing sleeve gastrectomy. Int J Obes (Lond) 2023; 47:175-180. [PMID: 36593390 DOI: 10.1038/s41366-022-01252-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Revised: 12/09/2022] [Accepted: 12/22/2022] [Indexed: 01/04/2023]
Abstract
INTRODUCTION Obesity is associated with a higher risk of cardiac arrhythmias. Sleeve gastrectomy (SG) is a common bariatric surgery with beneficial effects on weight loss and comorbidities. The study aimed to investigate the prevalence of arrhythmias during maximal exercise testing in patients with moderate-severe obesity and to evaluate the impact of SG on these arrhythmic events. METHODS All patients with moderate or severe obesity who were considered suitable candidates for SG between June 2015 and September 2020 were recruited. Each patient underwent three incremental, maximal, ECG-monitored cardiopulmonary exercise test 1 month before and 6 and 12 months after SG; the frequency and complexity of ventricular premature beats (VPBs) and atrial premature beats (APBs) have been evaluated during rest, exercise and recovery phases. RESULTS Fifty patients with severe obesity (BMI 46.39 ± 7.89 kg/m2) were included in the study. After SG, patients presented a decreased BMI (34.15 ± 6.25 kg/m2 at 6 months post-SG and 31.87 ± 5.99 kg/m2 at 12 months post-SG). At 6 months post-SG, an increase in VPBs, mainly during the recovery phase, was observed. At 12 months post-SG, a reduction in VPBs compared with the 6 months evaluation was showed. CONCLUSION Although in the early post-surgical phase the risk of exercise-induced arrhythmias may be higher, SG does not seem to increase the occurrence of arrhythmias in the long-term. No life-threating arrhythmias were found during post-SG evaluations.
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Affiliation(s)
- Marco Vecchiato
- Sports and Exercise Medicine Division, Department of Medicine, University Hospital of Padova, Via Giustiniani 2, 35128, Padova, Italy
- Clinical Network of Sports and Exercise Medicine of the Veneto Region, Padova, Italy
| | - Giulia Quinto
- Sports and Exercise Medicine Division, Department of Medicine, University Hospital of Padova, Via Giustiniani 2, 35128, Padova, Italy
- Clinical Network of Sports and Exercise Medicine of the Veneto Region, Padova, Italy
| | - Daniel Neunhaeuserer
- Sports and Exercise Medicine Division, Department of Medicine, University Hospital of Padova, Via Giustiniani 2, 35128, Padova, Italy.
- Clinical Network of Sports and Exercise Medicine of the Veneto Region, Padova, Italy.
| | - Francesca Battista
- Sports and Exercise Medicine Division, Department of Medicine, University Hospital of Padova, Via Giustiniani 2, 35128, Padova, Italy
- Clinical Network of Sports and Exercise Medicine of the Veneto Region, Padova, Italy
| | - Silvia Bettini
- Center for the Study and Integrated Treatment of Obesity (CeSTIO), Internal Medicine 3, Department of Medicine, University Hospital of Padova, Veneto Region, Padova, Italy
| | - Andrea Gasperetti
- Sports and Exercise Medicine Division, Department of Medicine, University Hospital of Padova, Via Giustiniani 2, 35128, Padova, Italy
- Clinical Network of Sports and Exercise Medicine of the Veneto Region, Padova, Italy
| | - Roberto Vettor
- Center for the Study and Integrated Treatment of Obesity (CeSTIO), Internal Medicine 3, Department of Medicine, University Hospital of Padova, Veneto Region, Padova, Italy
| | - Luca Busetto
- Center for the Study and Integrated Treatment of Obesity (CeSTIO), Internal Medicine 3, Department of Medicine, University Hospital of Padova, Veneto Region, Padova, Italy
| | - Andrea Ermolao
- Sports and Exercise Medicine Division, Department of Medicine, University Hospital of Padova, Via Giustiniani 2, 35128, Padova, Italy
- Clinical Network of Sports and Exercise Medicine of the Veneto Region, Padova, Italy
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11
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Sinha MK, K V, Maiya AG, K N S, U S, N RS. Association of physical activity and heart rate variability in people with overweight and obesity: A systematic review. F1000Res 2023; 12:156. [PMID: 36875496 PMCID: PMC9982191 DOI: 10.12688/f1000research.124707.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/28/2022] [Indexed: 02/12/2023] Open
Abstract
Background: Obesity is a major public health issue globally which is intrinsically linked to reduced heart rate variability (HRV). Physical inactivity and reduced resting HRV are linked to an increased risk of coronary heart disease, while athletes have a greater HRV. However, the exact correlation between physical activity and HRV remains uncertain. This systematic review aims to collect, report, and critically assess the current scientific literature about the association between physical activity and HRV in individuals with higher weight and obesity. Methods: A systematic search was carried out in electronic databases (Medline/PubMed, SCOPUS and CINAHL Plus) to retrieve studies that evaluated the relationship between physical activity and HRV in individuals with higher weight and obesity. Case-control, longitudinal/cohort, cross-sectional and observational studies were included. Using a critical narrative approach, information about the HRV, and physical activity was extracted and synthesized. The study was registered in PROSPERO: CRD42020208018 on October 9 2020. Results: After removing duplicates, 980 title/abstract records were checked for eligibility, and 12 papers were finally included in the narrative synthesis. The included studies contained physical activity as well as HRV in adults with higher weight or obesity with or without comorbidities. A negative relationship between moderate to vigorous physical activity and HRV indices had been found in two studies. There was also a negative relationship between sedentary time and HF (p = 0.049) and LF/HF (p = 0.036), as well as a positive relationship between sedentary time and LF (p = 0.014). Also dose-response association was found between vigorous exercise and higher SDNN, LF power, and HF power in one of the studies. Conclusions: This systematic review revealed a wide range of responses to physical activity and HRV; however, the current evidence uses a variety of approaches to objectively assess physical activity and measure HRV with different equipment.
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Affiliation(s)
- Mukesh Kumar Sinha
- Department of Physiotherapy, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, Karnataka, 576104, India
| | - Vaishali K
- Department of Physiotherapy, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, Karnataka, 576104, India
| | - Arun G Maiya
- Department of Physiotherapy, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, Karnataka, 576104, India
| | - Shivashankar K N
- Department of Medicine, Kasturba Medical college, Manipal Academy of Higher Education, Manipal, Karnataka, 576104, India
| | - Shashikiran U
- Department of Medicine, Dr. TMA Pai Hospital, Udupi, MMMC, Manipal Academy of Higher Education, Manipal, Karnataka, 576104, India
| | - Ravi Shankar N
- Department of Biostatistics, Vallabhbhai Patel Chest Institute, University of Delhi, Delhi, Delhi, India
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12
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Neuromodulation as a Potential Disease-Modifying Therapy for Osteoarthritis. Curr Rheumatol Rep 2023; 25:1-11. [PMID: 36435890 DOI: 10.1007/s11926-022-01094-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/03/2022] [Indexed: 11/28/2022]
Abstract
PURPOSE OF REVIEW The following review discusses the therapeutic potential of targeting the autonomic nervous system (ANS) for osteoarthritis (OA) treatment and encourages the field to consider the candidacy of bioelectronic medicine as a novel OA treatment strategy. RECENT FINDINGS The study of OA pathogenesis has focused on changes occurring at the joint level. As such, treatments for OA have been aimed at the local joint environment, intending to resolve local inflammation and decrease pain. However, OA pathogenesis has shown to be more than joint wear and tear. Specifically, OA-related peripheral and central sensitization can prompt neuroplastic changes in the nervous system beyond the articular joint. These neuroplastic changes may alter physiologic systems, like the neuroimmune axis. In this way, OA and related comorbidities may share roots in the form of altered neuroimmune communication and autonomic dysfunction. ANS modulation may be able to modify OA pathogenesis or reduce the impact of OA comorbidities. Moreover, blocking chronic nociceptive drive from the joint may help to prevent maladaptive nervous system plasticity in OA.
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Lemus SA, Volz M, Tiozzo E, Perry A, Best TM, Travascio F. The effect of clinically elevated body mass index on physiological stress during manual lifting activities. PLoS One 2022; 17:e0278858. [PMID: 36576923 PMCID: PMC9797066 DOI: 10.1371/journal.pone.0278858] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Accepted: 11/25/2022] [Indexed: 12/29/2022] Open
Abstract
Individuals with a body mass index (BMI) classified as obesity constitute 27.7% of U.S. workers. These individuals are more likely to experience work-related injuries. However, ergonomists still design work tasks based on the general population and normal body weight. This is particularly true for manual lifting tasks and the calculation of recommended weight limits (RWL) as per National Institute of Occupational Safety & Health (NIOSH) guidelines. This study investigates the effects of BMI on indicators of physiological stress. It was hypothesized that, for clinically elevated BMI individuals, repeated manual lifting at RWL would produce physiological stress above safety limits. A repetitive box lifting task was designed to measure metabolic parameters: volume of carbon dioxide (VCO2) and oxygen (VO2), respiratory exchange ratio (RER), heart rate (HR), and energy expenditure rate (EER). A two-way ANOVA compared metabolic variables with BMI classification and gender, and linear regressions investigated BMI correlations. Results showed that BMI classification represented a significant effect for four parameters: VCO2 (p < 0.001), VO2 (p < 0.001), HR (p = 0.012), and EER (p < 0.001). In contrast, gender only had a significant effect on VO2 (p = 0.014) and EER (p = 0.017). Furthermore, significant positive relationships were found between BMI and VCO2 (R2 = 59.65%, p < 0.001), VO2 (R2 = 45.01%, p < 0.001), HR (R2 = 21.86%, p = 0.009), and EER (R2 = 50.83%, p < 0.001). Importantly, 80% of obese subjects exceeded the EER safety limit of 4.7 kcal/min indicated by NIOSH. Indicators of physiological stress are increased in clinically elevated BMI groups and appear capable of putting these individuals at increased risk for workplace injury.
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Affiliation(s)
- Sergio A. Lemus
- Department of Mechanical and Aerospace Engineering, University of Miami, Coral Gables, FL, United States of America
| | - Mallory Volz
- Department of Biomedical Engineering, University of Miami, Coral Gables, FL, United States of America
| | - Eduard Tiozzo
- Department of Physical Medicine and Rehabilitation, University of Miami, Miami, FL, United States of America
- * E-mail: (FT); (ET)
| | - Arlette Perry
- Department of Kinesiology and Sport Sciences, University of Miami, Coral Gables, FL, United States of America
- Laboratory of Clinical and Applied Physiology, University of Miami, Coral Gables, FL, United States of America
- School of Education and Human Development, University of Miami, Coral Gables, FL, United States of America
| | - Thomas M. Best
- Department of Biomedical Engineering, University of Miami, Coral Gables, FL, United States of America
- Department of Orthopaedics, University of Miami, Miami, FL, United States of America
- UHealth Sports Medicine Institute, Coral Gables, FL, United States of America
| | - Francesco Travascio
- Department of Mechanical and Aerospace Engineering, University of Miami, Coral Gables, FL, United States of America
- Department of Orthopaedics, University of Miami, Miami, FL, United States of America
- Max Biedermann Institute for Biomechanics at Mount Sinai Medical Center, Miami Beach, FL, United States of America
- * E-mail: (FT); (ET)
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14
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Christensen KA, Feeling NR, Rienecke RD. Meta-Analysis and Systematic Review of Resting-State High-Frequency Heart Rate Variability in Binge-Eating Disorder. J PSYCHOPHYSIOL 2022. [DOI: 10.1027/0269-8803/a000307] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Abstract. Binge-eating disorder (BED) is associated with a greater risk for cardiac problems and co-occurring health conditions. Resting-state measures of high-frequency heart rate variability (HF-HRV), which is a physiological proxy of self-regulatory neural functioning, may aid understanding of health risks. We systematically reviewed and meta-analyzed the literature on HF-HRV in individuals with BED and without BED. Six studies were reviewed in the qualitative synthesis, and five studies assessing HRV in individuals with BED ( n = 153) and without BED ( n = 124) were included in the meta-analysis. A non-significant effect size (Hedges’ g = .08, SE = 0.36, 95% CI [−0.62, 0.78]; z = 0.23, p = .82) was found, suggesting no difference in HF-HRV between groups. Age, BMI, and BMI-matched control status were not significant covariates. Synthesizing the five studies with available data, we found no difference in resting-state HF-HRV between individuals with and without BED. There was high heterogeneity in the sample, suggesting potential moderators. We discuss potential mechanisms, methodological and demographic confounds, and future directions for study.
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Affiliation(s)
| | - Nicole R. Feeling
- Department of Physical Medicine and Rehabilitation, The Ohio State University Medical Center, Columbus, OH, USA
| | - Renee D. Rienecke
- Eating Recovery Center/Pathlight Mood and Anxiety Centers, Chicago, IL, USA
- Department of Psychiatry and Behavioral Sciences, Northwestern University, Chicago, IL, USA
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15
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Zhou D, Fu Y, Li F, Yang D, Wei L, Yue H, Dai Y, Jeon Y. Treatment of obese zebrafish with saringosterol acetate through AMP activated protein kinase pathway. Chem Biodivers 2022; 19:e202200495. [PMID: 35856892 DOI: 10.1002/cbdv.202200495] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Accepted: 07/18/2022] [Indexed: 11/06/2022]
Abstract
OBJECT Edible Brown Seaweed Sargassum fusiforme (Harvey) Setchell, 1931 abbreviated as Sargassum fusiforme was used for folk medical therapy in East Asia countries over five hundred years. Saringosterol acetate (SA) was isolated from S. fusiforme in our previous study and indicated various effects. However, anti-obesity activity of SA and its mechanism still unknown. Method: The inhibitory effect of SA, isolated from S. fusiforme , on adipogenesis in 3T3-L1 adipocytes was investigated in vitro and in zebrafish model. Cell toxicity, differentiation, signaling pathway, and lipid accumulation of SA treated 3T3-L1 adipocytes were determined. The body weight and triglyceride content of diet-induced obese (DIO) adult male zebrafish were measured from 12 to 17 weeks after fertilization. Result: SA attenuated the differentiation of cells and reduced lipid accumulation, and triglyceride content in the 3T3-L1 adipocytes. During the differentiation of adipocytes, SA suppressed fat accumulation and decreased the expression of signal factors responsible for adipogenesis. In SA-treated adipocytes, while fatty acid synthetase was downregulated, AMP-activated protein kinase (AMPK) was upregulated. Furthermore, SA suppressed body weight and triglyceride content in DIO zebrafish. CONCLUSION SA is a potential therapeutic agent in the management of metabolic disorders, such as obesity.
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Affiliation(s)
- DongYue Zhou
- Changchun University of Chinese Medicine, Jilin Ginseng Academy, Changchun 130117, Changchun, CHINA
| | - YunHua Fu
- Changchun University of Chinese Medicine, Jilin Ginseng Academy, Changchun 130117, Changchun, CHINA
| | - FangTong Li
- Changchun University of Chinese Medicine, Jilin Ginseng Academy, Changchun 130117, Changchun, CHINA
| | - Di Yang
- Changchun University of Chinese Medicine, Jilin Ginseng Academy, Changchun 130117, Changchun, CHINA
| | - LiNa Wei
- Changchun University of Chinese Medicine, Jilin Ginseng Academy, Changchun 130117, Changchun, CHINA
| | - Hao Yue
- Changchun University of Chinese Medicine, Jilin Ginseng Academy, Changchun 130117, Changchun, CHINA
| | - Yulin Dai
- Changchun University of Chinese Medicine, jilin ginseng academy, 1035# boshuo raod, 130117, Changchun, CHINA
| | - YouJin Jeon
- Jeju National University, Marine Science Institute, Jeju 63333, Jeju, KOREA, REPUBLIC OF
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Kiernan R, Persand D, Maddie N, Cai W, Carrillo-Sepulveda MA. Obesity-related vascular dysfunction persists after weight loss and is associated with decreased vascular glucagon-like peptide (GLP-1) receptor in female rats. Am J Physiol Heart Circ Physiol 2022; 323:H301-H311. [PMID: 35749717 PMCID: PMC9291415 DOI: 10.1152/ajpheart.00031.2022] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Obesity-related cardiovascular complications are a major health problem worldwide. Overconsumption of the Western diet is a well-known culprit for the development of obesity. While short-term weight loss through switching from a Western diet to a normal diet is known to promote metabolic improvement, its short-term effects on vascular parameters are not well-characterized. Glucagon-like peptide 1 (GLP-1), an incretin with vasculo-protective properties, is decreased in plasma from obese patients. We hypothesize that obesity causes persistent vascular dysfunction in association with downregulation of vascular GLP-1R. Female Wistar rats were randomized into three groups: lean received a chow diet for 28 weeks, obese received a Western diet for 28 weeks, and reverse obese received a Western diet for 18 weeks followed by 12 weeks of standard chow diet. The obese group exhibited increased body weight and body mass index, while the reverse obese group lost weight. Weight loss failed to reverse impaired vasodilation and high systolic blood pressure in obese rats. Strikingly, our results show that obese rats exhibit decreased serum levels of GLP-1 accompanied by decreased vascular GLP-1R expression. Weight loss recovered GLP-1 serum levels, however GLP-1R expression remained downregulated. Decreased Akt phosphorylation was observed in the obese and reverse obese group, suggesting that GLP-1/Akt signaling is persistently downregulated. Our results support that GLP-1 signaling is associated with obesity-related vascular dysfunction in females and short-term weight loss does not guarantee recovery of vascular function. This study suggests that GLP-1R may be a potential target for therapeutic intervention in obesity-related hypertension in females.
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Affiliation(s)
- Risa Kiernan
- Department of Biomedical Sciences, New York Institute of Technology, Old Westbury, New York, United States
| | - Dhandevi Persand
- Department of Biomedical Sciences, New York Institute of Technology, Old Westbury, New York, United States
| | - Nicole Maddie
- Department of Biomedical Sciences, New York Institute of Technology, Old Westbury, New York, United States
| | - Weikang Cai
- Department of Biomedical Sciences, New York Institute of Technology, Old Westbury, New York, United States
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van Ede E, Scheerhoorn J, Bonomi A, Buise M, Bouwman R, Nienhuijs S. “Continuous remote monitoring in post bariatric surgery patients: development of an early warning protocol”. Surg Obes Relat Dis 2022; 18:1298-1303. [DOI: 10.1016/j.soard.2022.06.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Revised: 06/02/2022] [Accepted: 06/12/2022] [Indexed: 10/31/2022]
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Nataraj M, Sinha MK, Bhat A, Vaishali K. Correlation between physical activity, cardiorespiratory fitness and heart rate variability among young overweight adults. J Taibah Univ Med Sci 2022; 17:304-310. [PMID: 35592811 PMCID: PMC9073868 DOI: 10.1016/j.jtumed.2021.11.011] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Revised: 11/19/2021] [Accepted: 11/26/2021] [Indexed: 11/26/2022] Open
Abstract
Objective Cardiac autonomic function assessed by heart rate variability (HRV) is a non-invasive, quantitative, and reliable marker of measurement. An altered cardiac autonomic function among overweight individuals predisposes them to a greater risk of developing cardiovascular diseases. The present study aims to determine the correlation between physical activity, cardiorespiratory fitness and heart rate variability among young overweight adults. Methods A total of 45 participants (23 men and 22 women) were enrolled in the cross-sectional study with inclusion criteria as follows: aged between 18–30 years, body mass index (kg/m2) between 25–29.9 kg/m2, and without any known or diagnosed medical condition. Physical activity level and cardiorespiratory fitness were measured using the Global Physical Activity Questionnaire and Bruce treadmill protocol test, respectively. Cardiac autonomic function was measured using a 5-min short-term heart rate variability recording. The time and frequency domain measures of HRV were used for analysis. Results The mean age of study participants was 22.53 ± 1.58 years and mean body mass index was 27.38 ± 1.51 kg/m2. Among young overweight adults, cardiorespiratory fitness and physical activity were not correlated with Root mean square of successive RR interval differences, Percentage of successive RR intervals that differ by more than 50 ms, and Ratio of LF [ms2]/HF [ms2]. Conclusion The study found no correlation between physical activity and cardiorespiratory fitness with heart rate variability among young overweight individuals.
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Castillo-Aguilar M, Valdés-Badilla P, Herrera-Valenzuela T, Guzmán-Muñoz E, Delgado-Floody P, Andrade DC, Moraes MM, Arantes RME, Núñez-Espinosa C. Cardiac Autonomic Modulation in Response to Muscle Fatigue and Sex Differences During Consecutive Competition Periods in Young Swimmers: A Longitudinal Study. Front Physiol 2021; 12:769085. [PMID: 34867474 PMCID: PMC8637437 DOI: 10.3389/fphys.2021.769085] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Accepted: 10/19/2021] [Indexed: 11/18/2022] Open
Abstract
Objective: To study the differences in cardiac autonomic modulation in response to muscle fatigue caused by high-intensity exercise during two consecutive competition periods in young swimmers. Methods: Twenty-six competitive swimmers, selected by their training volume, were separated in two groups, females (n = 12 [46%], age: 13.5 ± 1.4 years) and males (n = 14 [54%], age: 13.9 ± 1.7 years), aged between 10 and 16 years, were evaluated five times as follow: (i) 21 days before the first competition (t-0); (ii) two days before (t-1; t-3); and (iii) two days after (t-2; t-4) of the first and second competitions. Morphological measurements (body mass, percentage of total body fat and height), blood pressure, power, and resting heart rate variability (RR with Polar band) were recorded before and after Wingate test at each time. Results: Body fat was higher in females compared to males. However, no differences were found in other morphological parameters. An intra-subject analysis grouped by sex in cardiovascular parameters shows longitudinal variations in systolic pressure and mean pressure among females. Additionally, females depicted higher, very low frequency (VLF, which is intrinsically generated by the heart and strongly associated with emotional stress) after physical fatigue compared to males at t-1. Further, before the competition, the high frequency (HF) component of HRV (parasympathetic drive) was higher in males than females at t-0 and t-4. Conclusion: Our data revealed that males displayed greater parasympathetic reactivity after an anaerobic muscle fatigue test during their competition periods. Contrarily, females had a less cardiac autonomic modulation when comparing the pre-post Wingate test after two consecutive competition periods.
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Affiliation(s)
- Matías Castillo-Aguilar
- Kinesiology Department, University of Magallanes, Punta Arenas, Chile
- Austral Integrative Neurophysiology Group, CADI-UMAG, Punta Arenas, Chile
| | - Pablo Valdés-Badilla
- Department of Physical Activity Sciences, Faculty of Education Sciences, Universidad Católica del Maule, Talca, Chile
- Carrera de Entrenador Deportivo, Escuela de Educación, Universidad Viña del Mar, Viña del Mar, Chile
| | - Tomás Herrera-Valenzuela
- Department of Sports Sciences and Physical Activity, Faculty of Health, Universidad Santo Tomás (UST), Santiago, Chile
- Department of Physical Activity, Sports and Health Sciences, Faculty of Medical Sciences, Universidad de Santiago de Chile (USACH), Santiago, Chile
| | - Eduardo Guzmán-Muñoz
- Escuela de Kinesiología, Facultad de Salud, Universidad Santo Tomás, Santiago, Chile
| | - Pedro Delgado-Floody
- Department of Physical Education, Sports and Recreation, Universidad de La Frontera, Temuco, Chile
| | - David Cristóbal Andrade
- Centro de Investigación en Fisiología y Medicina de Altura (MedAlt), Facultad de Ciencias de la Salud, Universidad de Antofagasta, Antofagasta, Chile
| | - Michele M. Moraes
- Department of Pathology, Institute of Biological Sciences, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
- Faculty of Medicine, Center for Newborn Screening and Genetics Diagnosis, Universidade Federal de Minas Gerais (NUPAD-FM/UFMG), Belo Horizonte, Brazil
| | - Rosa M. E. Arantes
- Department of Pathology, Institute of Biological Sciences, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
- Faculty of Medicine, Center for Newborn Screening and Genetics Diagnosis, Universidade Federal de Minas Gerais (NUPAD-FM/UFMG), Belo Horizonte, Brazil
| | - Cristian Núñez-Espinosa
- Austral Integrative Neurophysiology Group, CADI-UMAG, Punta Arenas, Chile
- School of Medicine, University of Magallanes, Punta Arenas, Chile
- Interuniversity Center for Healthy Aging, Chile
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Foshati S, Nouripour F, Sadeghi E, Amani R. The effect of grape (Vitis vinifera) seed extract supplementation on flow-mediated dilation, blood pressure, and heart rate: A systematic review and meta-analysis of controlled trials with duration- and dose-response analysis. Pharmacol Res 2021; 175:105905. [PMID: 34798267 DOI: 10.1016/j.phrs.2021.105905] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Revised: 09/12/2021] [Accepted: 09/14/2021] [Indexed: 12/28/2022]
Abstract
The objective of this systematic review and meta-analysis of controlled trials was to assess the long-term effect of grape seed extract (GSE) supplementation on flow-mediated dilation (FMD), systolic blood pressure (SBP), diastolic blood pressure (DBP), and heart rate (HR) in adults. Web of Science, Scopus, Medline, Cochrane Library, and Google Scholar were searched up to May 24, 2021. Nineteen trials were included in this study. Weighted mean difference (WMD) and 95% confidence interval (CI) were calculated using a random-effects model. GSE supplementation significantly reduced DBP (WMD: -2.20 mmHg, 95% CI: -3.79 to -0.60, I2 = 88.8%) and HR (WMD: -1.25 bpm, 95% CI: -2.32 to -0.19, I2 = 59.5%) but had no significant effects on FMD (WMD: 1.02%, 95% CI: -0.62 to 2.66, I2 = 92.0%) and SBP (WMD: -3.55 mmHg, 95% CI: -7.59 to 0.49, I2 = 97.4%). Subgroup analysis revealed that the dose and duration of GSE administration and the characteristics of study participants could be sources of between-study heterogeneity. Significant non-linear relationships were found between DBP and the duration of GSE supplementation (P = 0.044) and its dose (P = 0.007). In conclusion, GSE may be beneficial for individuals with or at risk of cardiovascular disease because it may have hypotensive and HR-lowering properties.
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Affiliation(s)
- Sahar Foshati
- Student Research Committee, Department of Clinical Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Fatemeh Nouripour
- Department of Clinical Nutrition, School of Nutrition and Food Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Erfan Sadeghi
- Department of Biostatistics and Epidemiology, Faculty of Health, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Reza Amani
- Department of Clinical Nutrition, School of Nutrition and Food Science, Food Security Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.
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Cai L, Huang J, Gao D, Zeng S, Tang S, Chang Z, Wen C, Zhang M, Hu M, Wei GX. Effects of mind-body practice on arterial stiffness, central hemodynamic parameters and cardiac autonomic function of college students. Complement Ther Clin Pract 2021; 45:101492. [PMID: 34638054 DOI: 10.1016/j.ctcp.2021.101492] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Revised: 08/26/2021] [Accepted: 10/03/2021] [Indexed: 11/17/2022]
Abstract
A substantial number of studies have shown the beneficial effects of mind-body practice on physical fitness among both the healthy middle-aged and elderly adults and patients with chronic diseases. However, its positive effects on college students remain poorly understood. This study aimed to systematically investigate the potential efficiency of the Baduanjin exercise on the maintenance of the homeostasis of body composition and the improvement of the cardiovascular function of the college students. The study revealed a promising efficacy of the Baduanjin exercise in the prevention of the loss of water, inorganic salts, protein, and muscle contents and the accumulation of body fat. Furthermore, the present study also demonstrated the positive efficacy of Baduanjin exercise in decreasing of peripheral and central arterial blood pressure and carotid and femoral artery pulse wave velocity (cfPWV) of the college students. Moreover, the heart rate variability (HRV) analysis was also performed using the assessment of time and frequency domain indices. The data showed that all of the time-domain indices and the high-frequency (HF) band of the HRV relatively increased, whereas the low-frequency (LF) band of the HRV relatively decreased after the long-term Baduanjin exercise. Collectively, the present study suggested that a 12-week Baduanjin exercise could maintain the body composition in a relatively healthy and stable range and improve blood pressure, central hemodynamics, and the arterial stiffness of the college students. The underlying mechanism might be due to the improvement of parasympathetic activity and the suppression of sympathetic activity of college students via Baduanjin exercise.
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Affiliation(s)
- Li Cai
- School of Wushu, Guangzhou Sport University, Guangzhou, Guangdong, China
| | - Junhao Huang
- Guangdong Provincial Key Laboratory of Physical Activity and Health Promotion, Scientific Research Center, Guangzhou Sport University, Guangzhou, Guangdong, China
| | - Dongdong Gao
- Guangdong Provincial Key Laboratory of Physical Activity and Health Promotion, Scientific Research Center, Guangzhou Sport University, Guangzhou, Guangdong, China
| | - Shujuan Zeng
- School of Wushu, Guangzhou Sport University, Guangzhou, Guangdong, China
| | - Songxin Tang
- Guangdong Provincial Key Laboratory of Physical Activity and Health Promotion, Scientific Research Center, Guangzhou Sport University, Guangzhou, Guangdong, China
| | - Zhengxiao Chang
- Guangdong Provincial Key Laboratory of Physical Activity and Health Promotion, Scientific Research Center, Guangzhou Sport University, Guangzhou, Guangdong, China
| | - Caosheng Wen
- School of Wushu, Guangzhou Sport University, Guangzhou, Guangdong, China
| | - Meina Zhang
- School of Wushu, Guangzhou Sport University, Guangzhou, Guangdong, China
| | - Min Hu
- Guangdong Provincial Key Laboratory of Physical Activity and Health Promotion, Scientific Research Center, Guangzhou Sport University, Guangzhou, Guangdong, China.
| | - Gao-Xia Wei
- Key Laboratory of Behavioral Science, Institute of Psychology, Chinese Academy of Sciences, Beijing, China.
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22
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Accardo A, Silveri G, Ajčević M, Miladinović A, Pascazio L. Influence of smoking and other cardiovascular risk factors on heart rate circadian rhythm in normotensive and hypertensive subjects. PLoS One 2021; 16:e0257660. [PMID: 34551022 PMCID: PMC8457489 DOI: 10.1371/journal.pone.0257660] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2020] [Accepted: 09/08/2021] [Indexed: 11/19/2022] Open
Abstract
Circadian heart rate (HR) is influenced by hypertension and other cardiovascular risk factors particularly smoking, obesity and dyslipidemia. Until now, to evaluate the HR changes due to presence of these risk factors, a single HR office measure or a mean evaluated on day time or night time or 24h was used. However, since HR shows a circadian behavior, a single value represents only a rough approximation of this behavior. In this study, we analyzed the influence of smoking, obesity and dyslipidemia on the circadian rhythm in normotensive and hypertensive subject groups presenting only one of these risk factors. The 24h HR recordings of 170 normotensive (83 without risk factors, 20 smokers, 44 with dyslipidemia, 23 obese) and 353 hypertensive (169 without risk factors, 32 smokers, 99 with dyslipidemia, 53 obese) subjects were acquired using a Holter Blood Pressure Monitor. Results highlighted a specific circadian behavior with three characteristic periods presenting different HR means and rates of HR change in the eight subject groups. The slopes could be used both to estimate the morning HR surge associated with acute cardiovascular effects in the awakening and to evaluate the decline during the night. Moreover, we suggest to use three HR mean values (one for each identified period of the day) rather than two HR values to better describe the circadian HR behavior. Furthermore, smoking increased and dyslipidemia decreased mean HR values from 10:00 to 04:00, both in normotensive and hypertensive subjects in comparison with subjects without risk factors. In this time interval, hypertensive obese subjects showed higher values while normotensive ones presented quite similar values than subjects without risk factors. During the awakening (05:00-10:00) the slopes were similar among all groups with no significant difference among the mean HR values.
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Affiliation(s)
- Agostino Accardo
- Department of Engineering and Architecture, University of Trieste, Trieste, Italy
| | - Giulia Silveri
- Department of Engineering and Architecture, University of Trieste, Trieste, Italy
| | - Milos Ajčević
- Department of Engineering and Architecture, University of Trieste, Trieste, Italy
| | | | - Lorenzo Pascazio
- Department of Medical, Surgical and Health Care, CS of Geriatrics, University of Trieste & ASUGI, Trieste, Italy
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23
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Debnath S, Levy TJ, Bellehsen M, Schwartz RM, Barnaby DP, Zanos S, Volpe BT, Zanos TP. A method to quantify autonomic nervous system function in healthy, able-bodied individuals. Bioelectron Med 2021; 7:13. [PMID: 34446089 PMCID: PMC8394599 DOI: 10.1186/s42234-021-00075-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2021] [Accepted: 07/20/2021] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND The autonomic nervous system (ANS) maintains physiological homeostasis in various organ systems via parasympathetic and sympathetic branches. ANS function is altered in common diffuse and focal conditions and heralds the beginning of environmental and disease stresses. Reliable, sensitive, and quantitative biomarkers, first defined in healthy participants, could discriminate among clinically useful changes in ANS function. This framework combines controlled autonomic testing with feature extraction during physiological responses. METHODS Twenty-one individuals were assessed in two morning and two afternoon sessions over two weeks. Each session included five standard clinical tests probing autonomic function: squat test, cold pressor test, diving reflex test, deep breathing, and Valsalva maneuver. Noninvasive sensors captured continuous electrocardiography, blood pressure, breathing, electrodermal activity, and pupil diameter. Heart rate, heart rate variability, mean arterial pressure, electrodermal activity, and pupil diameter responses to the perturbations were extracted, and averages across participants were computed. A template matching algorithm calculated scaling and stretching features that optimally fit the average to an individual response. These features were grouped based on test and modality to derive sympathetic and parasympathetic indices for this healthy population. RESULTS A significant positive correlation (p = 0.000377) was found between sympathetic amplitude response and body mass index. Additionally, longer duration and larger amplitude sympathetic and longer duration parasympathetic responses occurred in afternoon testing sessions; larger amplitude parasympathetic responses occurred in morning sessions. CONCLUSIONS These results demonstrate the robustness and sensitivity of an algorithmic approach to extract multimodal responses from standard tests. This novel method of quantifying ANS function can be used for early diagnosis, measurement of disease progression, or treatment evaluation. TRIAL REGISTRATION This study registered with Clinicaltrials.gov , identifier NCT04100486 . Registered September 24, 2019, https://www.clinicaltrials.gov/ct2/show/NCT04100486 .
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Affiliation(s)
- Shubham Debnath
- Institute of Bioelectronic Medicine, Feinstein Institutes for Medical Research, 350 Community Dr, Manhasset, NY, 11030, USA
| | - Todd J Levy
- Institute of Bioelectronic Medicine, Feinstein Institutes for Medical Research, 350 Community Dr, Manhasset, NY, 11030, USA
| | - Mayer Bellehsen
- Department of Psychiatry, Unified Behavioral Health Center and World Trade Center Health Program, Northwell Health, Bay Shore, NY, USA
| | - Rebecca M Schwartz
- Department of Occupational Medicine, Epidemiology and Prevention, Northwell Health, Feinstein Institutes for Medical Research, Manhasset, NY, USA
- Center for Disaster Health, Trauma, and Resilience, New York, NY, USA
- Northwell Health, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA
| | - Douglas P Barnaby
- Northwell Health, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA
- Northwell Health, Institute of Health Innovations and Outcomes Research, Feinstein Institutes for Medical Research, Manhasset, NY, USA
| | - Stavros Zanos
- Institute of Bioelectronic Medicine, Feinstein Institutes for Medical Research, 350 Community Dr, Manhasset, NY, 11030, USA
| | - Bruce T Volpe
- Northwell Health, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA
- Northwell Health, Institute of Molecular Medicine, Feinstein Institutes for Medical Research, Manhasset, NY, USA
| | - Theodoros P Zanos
- Institute of Bioelectronic Medicine, Feinstein Institutes for Medical Research, 350 Community Dr, Manhasset, NY, 11030, USA.
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24
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Al-Rashed F, Sindhu S, Al Madhoun A, Ahmad Z, AlMekhled D, Azim R, Al-Kandari S, Wahid MAA, Al-Mulla F, Ahmad R. Elevated resting heart rate as a predictor of inflammation and cardiovascular risk in healthy obese individuals. Sci Rep 2021; 11:13883. [PMID: 34230580 PMCID: PMC8260607 DOI: 10.1038/s41598-021-93449-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2021] [Accepted: 06/18/2021] [Indexed: 02/06/2023] Open
Abstract
The role of leukocyte inflammatory markers and toll like receptors (TLRs)2/4 in pathologies associated with elevated resting heart rate (RHR) levels in healthy obese (HO) individuals is not well elucidated. Herein, we investigated the relationship of RHR with expression of leukocyte-inflammatory markers and TLRs in HO individuals. 58-obese and 57-lean participants with no history of a major medical condition, were recruited in this study. In HO individuals, the elevated-RHR correlated positively with diastolic blood pressure, cholesterol, pro-inflammatory monocytes CD11b+CD11c+CD206− phenotype (r = 0.52, P = 0.0003) as well as with activated T cells CD8+HLA-DR+ phenotype (r = 0.27, P = 0.039). No association was found between RHR and the percentage of CD16+CD11b+ neutrophils. Interestingly, elevated RHR positively correlated with cells expressing TLR4 and TLR2 (CD14+TLR4+, r = 0.51, P ≤ 0.0001; and CD14+TLR2+, r = 0.42, P = 0.001). TLR4+ expressing cells also associated positively with the plasma concentrations of proinflammatory or vascular permeability/matrix modulatory markers including TNF-α (r = 0.36, P = 0.005), VEGF (r = 0.47, P = 0.0002), and MMP-9 (r = 0.53, P ≤ 0.0001). Multiple regression revealed that RHR is independently associated with CD14+TLR4+ monocytes and VEGF. We conclude that in HO individuals, increased CD14+TLR4+ monocytes and circulatory VEGF levels associated independently with RHR, implying that RHR monitoring could be used as a non-invasive clinical indicator to identify healthy obese individuals at an increased risk of developing inflammation and cardiovascular disease.
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Affiliation(s)
- Fatema Al-Rashed
- Immunology and Microbiology Department, Dasman Diabetes Institute, Al-Soor Street, P.O. Box 1180, 15462, Dasman, Kuwait
| | - Sardar Sindhu
- Animal and Imaging Core Facility, Dasman Diabetes Institute, Dasman, Kuwait
| | - Ashraf Al Madhoun
- Animal and Imaging Core Facility, Dasman Diabetes Institute, Dasman, Kuwait
| | - Zunair Ahmad
- Royal College of Surgeons in Ireland, Busaiteen, Bahrain
| | - Dawood AlMekhled
- School of Biomedical Sciences, Monash University, Melbourne, Australia
| | - Rafaat Azim
- Royal College of Surgeons in Ireland, Busaiteen, Bahrain
| | - Sarah Al-Kandari
- Immunology and Microbiology Department, Dasman Diabetes Institute, Al-Soor Street, P.O. Box 1180, 15462, Dasman, Kuwait
| | | | - Fahd Al-Mulla
- Genetics and Bioinformatics Department, Dasman Diabetes Institute, Dasman, Kuwait
| | - Rasheed Ahmad
- Immunology and Microbiology Department, Dasman Diabetes Institute, Al-Soor Street, P.O. Box 1180, 15462, Dasman, Kuwait.
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25
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Holter-Derived Autonomic Function, Arrhythmias and Carbohydrate Metabolism in Patients with Class III Obesity Treated with Laparoscopic Sleeve Gastrectomy. J Clin Med 2021; 10:jcm10102140. [PMID: 34063446 PMCID: PMC8156268 DOI: 10.3390/jcm10102140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Revised: 05/07/2021] [Accepted: 05/11/2021] [Indexed: 12/05/2022] Open
Abstract
The effects of weight loss following bariatric surgery on autonomic balance, arrhythmias and insulin resistance are still of interest. We prospectively investigated 50 patients with BMI > 40 kg/m2, aged 36.5 (18–56) years who underwent laparoscopic sleeve gastrectomy. Among other examinations, all subjects had 24-h Holter monitoring with heart rate variability (HRV) and heart rate turbulence (HRT) evaluation. After a median of 15 months, BMI decreased from 43.9 to 29.7 kg/m2, the incidence of hypertension decreased from 54 to 32% (p = 0.04) and any carbohydrate disorders decreased from 24 to 6% (p = 0.02). Fasting insulin concentration and insulin resistance index improved significantly (p < 0.001). Improvements in HRV parameters related to the sympathetic autonomic division were also observed (p < 0.001), while HRT evaluation was not conclusive. The enhancement of autonomic tone indices was correlated with reduction of BMI (SDNN-I r = 0.281 p = 0.04; SDNN r = 0.267 p = 0.05), but not with reduction of waist circumference, and it was also associated with decrease of mean heart rate (OR 0.02, 95%CI 0.0–0.1, p < 0.001). The incidence of arrhythmias was low and similar before and after follow-up. In conclusion, improvement of homeostasis of carbohydrate metabolism and autonomic function is observed in relatively young patients after weight loss due to laparoscopic sleeve gastrectomy.
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26
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Heubel AD, Kabbach EZ, Schafauser NS, Phillips SA, Pires Di Lorenzo VA, Borghi Silva A, Mendes RG. Noninvasive ventilation acutely improves endothelial function in exacerbated COPD patients. Respir Med 2021; 181:106389. [PMID: 33831730 DOI: 10.1016/j.rmed.2021.106389] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Revised: 03/11/2021] [Accepted: 03/29/2021] [Indexed: 10/21/2022]
Abstract
PURPOSE Acute exacerbation of chronic obstructive pulmonary disease (AECOPD) is associated with an elevated risk of cardiovascular events, which can be linked to endothelial dysfunction. In this study, we aimed to investigate whether noninvasive ventilation (NIV) acutely changes endothelial function in hospitalized AECOPD patients. METHODS Twenty-one AECOPD patients were assessed in a hospital ward setting from 24 to 48 h after admission. NIV was applied using a ventilator with bilevel pressure support. Before and after NIV protocol, patients were evaluated regarding (1) endothelium-dependent function, assessed non-invasively using the flow-mediated dilation (FMD) method; (2) arterial blood gas analysis. Other baseline evaluations included clinical and anthropometric data, and laboratory tests. RESULTS The total group showed a significant improvement in FMD as a result of NIV effect (P = 0.010). While arterial carbon dioxide and oxygen were not altered, oxygen saturation increased after NIV (P = 0.045). The subgroup comparison of responders (FMD ≥ 1%) and non-responders (FMD < 1%) showed significant baseline differences in body mass index (BMI) (P = 0.019) and predicted forced expiratory volume in one second (FEV1) (P = 0.007). In univariate and multivariate analyses, both BMI and FEV1 were determinant for endothelial response to NIV. CONCLUSION NIV acutely improves endothelial function in hospitalized AECOPD patients. Overweight and COPD severity may represent important characteristics for the magnitude of peripheral vascular response.
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Affiliation(s)
- Alessandro Domingues Heubel
- Cardiopulmonary Physiotherapy Laboratory, Department of Physical Therapy, Federal University of São Carlos, São Carlos, São Paulo, Brazil.
| | - Erika Zavaglia Kabbach
- Cardiopulmonary Physiotherapy Laboratory, Department of Physical Therapy, Federal University of São Carlos, São Carlos, São Paulo, Brazil.
| | - Nathany Souza Schafauser
- Cardiopulmonary Physiotherapy Laboratory, Department of Physical Therapy, Federal University of São Carlos, São Carlos, São Paulo, Brazil.
| | - Shane Aaron Phillips
- Department of Physical Therapy, University of Illinois at Chicago, Chicago, Illinois, United States of America.
| | - Valéria Amorim Pires Di Lorenzo
- Cardiopulmonary Physiotherapy Laboratory, Department of Physical Therapy, Federal University of São Carlos, São Carlos, São Paulo, Brazil.
| | - Audrey Borghi Silva
- Cardiopulmonary Physiotherapy Laboratory, Department of Physical Therapy, Federal University of São Carlos, São Carlos, São Paulo, Brazil.
| | - Renata Gonçalves Mendes
- Cardiopulmonary Physiotherapy Laboratory, Department of Physical Therapy, Federal University of São Carlos, São Carlos, São Paulo, Brazil.
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27
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Aein A, Omidi N, Khatami F, Samat S, Khorgami MR. Development, Implementation, and Evaluation of an Educational Package to Control the Biomedical Profile of Metabolic Syndrome. Int J Prev Med 2021; 12:31. [PMID: 34249280 PMCID: PMC8218797 DOI: 10.4103/ijpvm.ijpvm_434_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Revised: 08/29/2020] [Accepted: 11/27/2020] [Indexed: 11/19/2022] Open
Abstract
Background: Unhealthy lifestyle behaviors are a major concern in the development of metabolic syndrome (MetS). This study aimed to develop, implement, and evaluate a lifestyle education package as a strategy to control the biomedical components of MetS Methods: A total of 72 women and men (aged 18–68 y) with MetS were selected through randomized sampling. They were classified into 2 groups: an intervention group that received a lifestyle educational package with close follow-ups and a control group that received only usual care. Anthropometric indices, blood pressure, lipid profiles, and fasting blood sugar were assessed at baseline and after 3 months. Results: The lifestyle-modification program was associated with a modest weight loss (2 ± 0.4 kg; P < 0.001), a significant reduction in waist circumference (2.3 ± 0.9 cm; P < 0.001) and the hip circumference (1 ± 0.3 cm; P < 0.001), and a sharp decrease in diastolic blood pressure (5.3 ± 1.4 mm Hg; P < 0.001), compared with the baseline values in the intervention group. Additionally, according to the one-way MANOVA analysis, 33.8% of the changes in MetS components were attributable to the educational intervention (P < 0.001, F = 5.27). Conclusions: Improvement in lipid profile and anthropometric measures suggest that a lifestyle package based on multivariable health education is an acceptable method.
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Affiliation(s)
- Afsaneh Aein
- Department of Health Education and Health Promotion, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
| | - Negar Omidi
- Department of Cardiology, Tehran Heart Center, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Farnaz Khatami
- Department of Community Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Shahed Samat
- Department of Family Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Rafie Khorgami
- Department of Pediatric Cardiology, Rajaie Cardiovascular Medical and Research Center, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
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28
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Tricot GK, Novelli FII, Cambri LT. Obesity does not Impair Ambulatory Cardiovascular and Autonomic Responses Post-exercise. Int J Sports Med 2021; 42:1083-1091. [PMID: 33772502 DOI: 10.1055/a-1393-6184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
This study aimed to assess whether obesity and/or maximal exercise can change 24 h cardiac autonomic modulation and blood pressure in young men. Thirty-nine men (n: 20; 21.9±1.8 kg·m-2, and n: 19; 32.9±2.4 kg·m-2) were randomly assigned to perform a control (non-exercise) and an experimental day exercise (after maximal incremental test). Cardiac autonomic modulation was evaluated through frequency domain heart rate variability (HRV). Obesity did not impair the ambulatory HRV (p>0.05), however higher diastolic blood pressure during asleep time (p=0.02; group main effect) was observed. The 24 h and awake heart rate was higher on the experimental day (p<0.05; day main effect), regardless of obesity. Hypotension on the experimental day, compared to control day, was observed (p<0.05). Obesity indicators were significantly correlated with heart rate during asleep time (Rho=0.34 to 0.36) and with ambulatory blood pressure(r/Rho=0.32 to 0.53). Furthermore, the HRV threshold workload was significantly correlated with ambulatory heart rate (r/Rho=- 0.38 to-0.52). Finally, ambulatory HRV in obese young men was preserved; however, diastolic blood pressure was increased during asleep time. Maximal exercise caused heart rate increase and 24h hypotension, with decreased cardiac autonomic modulation in the first hour, regardless of obesity.
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Li L, Hu D, Zhang W, Cui L, Jia X, Yang D, Liu S, Deng F, Liu J, Guo X. Effect of short-term exposure to particulate air pollution on heart rate variability in normal-weight and obese adults. Environ Health 2021; 20:29. [PMID: 33726760 PMCID: PMC7968215 DOI: 10.1186/s12940-021-00707-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Accepted: 02/24/2021] [Indexed: 05/16/2023]
Abstract
BACKGROUND The adverse effects of particulate air pollution on heart rate variability (HRV) have been reported. However, it remains unclear whether they differ by the weight status as well as between wake and sleep. METHODS A repeated-measure study was conducted in 97 young adults in Beijing, China, and they were classified by body mass index (BMI) as normal-weight (BMI, 18.5-24.0 kg/m2) and obese (BMI ≥ 28.0 kg/m2) groups. Personal exposures to fine particulate matter (PM2.5) and black carbon (BC) were measured with portable exposure monitors, and the ambient PM2.5/BC concentrations were obtained from the fixed monitoring sites near the subjects' residences. HRV and heart rate (HR) were monitored by 24-h Holter electrocardiography. The study period was divided into waking and sleeping hours according to time-activity diaries. Linear mixed-effects models were used to investigate the effects of PM2.5/BC on HRV and HR in both groups during wake and sleep. RESULTS The effects of short-term exposure to PM2.5/BC on HRV were more pronounced among obese participants. In the normal-weight group, the positive association between personal PM2.5/BC exposure and high-frequency power (HF) as well as the ratio of low-frequency power to high-frequency power (LF/HF) was observed during wakefulness. In the obese group, personal PM2.5/BC exposure was negatively associated with HF but positively associated with LF/HF during wakefulness, whereas it was negatively correlated to total power and standard deviation of all NN intervals (SDNN) during sleep. An interquartile range (IQR) increase in BC at 2-h moving average was associated with 37.64% (95% confidence interval [CI]: 25.03, 51.51%) increases in LF/HF during wakefulness and associated with 6.28% (95% CI: - 17.26, 6.15%) decreases in SDNN during sleep in obese individuals, and the interaction terms between BC and obesity in LF/HF and SDNN were both statistically significant (p < 0.05). The results also suggested that the effects of PM2.5/BC exposure on several HRV indices and HR differed in magnitude or direction between wake and sleep. CONCLUSIONS Short-term exposure to PM2.5/BC is associated with HRV and HR, especially in obese individuals. The circadian rhythm of HRV should be considered in future studies when HRV is applied.
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Affiliation(s)
- Luyi Li
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing, 100191, China
| | - Dayu Hu
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing, 100191, China
| | - Wenlou Zhang
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing, 100191, China
| | - Liyan Cui
- Department of Laboratory Medicine, Peking University Third Hospital, Beijing, 100191, China
| | - Xu Jia
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing, 100191, China
| | - Di Yang
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing, 100191, China
| | - Shan Liu
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing, 100191, China
| | - Furong Deng
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing, 100191, China.
| | - Junxiu Liu
- Department of Otolaryngology Head and Neck Surgery, Peking University Third Hospital, Beijing, 100191, China.
| | - Xinbiao Guo
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing, 100191, China
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30
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Bienias P, Rymarczyk Z, Domienik-Karłowicz J, Lisik W, Sobieraj P, Pruszczyk P, Ciurzyński M. Assessment of arrhythmias and cardiac autonomic tone at a relatively young age patients with obesity class III. Clin Obes 2021; 11:e12424. [PMID: 33128430 DOI: 10.1111/cob.12424] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Revised: 10/17/2020] [Accepted: 10/19/2020] [Indexed: 11/30/2022]
Abstract
There is no sufficient data on arrhythmias occurrence in obesity class III. The influence of hyperinsulinemia and insulin resistance on arrhythmias and cardiac autonomic tone is also of ongoing interest in these subjects. We prospectively studied 81 selected patients with body mass index >40 kg/m2 , aged 34 (18-65) years. Among other examinations all subjects underwent electrocardiography and Holter monitoring with heart rate variability (HRV) and turbulence (HRT) evaluation. Controls consisted of 45 healthy, sex- and aged-matched lean volunteers. In patients median BMI was 44.5 kg/m2 (40.1-58.1), benign arterial hypertension was present in 43.2% and dysglycemia in 27.2% of cases. In the group with obesity longer PR interval (P < .001) and corrected QT interval (P < .001) were observed, while in Holter monitoring no significant differences in supraventricular or ventricular arrhythmias and also bradyarrhythmias prevalence were observed in comparison to controls. In individuals with obesity HRV indices associated with sympathetic tone were significantly impaired and also abnormal HRT values (21.9 vs 0%, P = .04) were more frequently observed. There were no significant correlations between anthropometric obesity parameters and fasting insulin concentration, insulin resistance index and also HRV/HRT parameters in studied individuals. Univariate regression analysis revealed that only age influenced abnormal HRT occurrence (OR 1.69, 95%CI 1.08-2.98, P = .04). In conclusions, patients with obesity class III at a relatively young age who reported they felt healthy, do not present increased prevalence of arrhythmias, including life-threatening ones. Cardiac autonomic dysfunction is observed in these patients, however it has not been shown to be associated with anthropometric measurements.
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Affiliation(s)
- Piotr Bienias
- Department of Internal Medicine and Cardiology, Medical University of Warsaw, Warsaw, Poland
| | - Zuzanna Rymarczyk
- Department of Internal Medicine and Cardiology, Medical University of Warsaw, Warsaw, Poland
| | | | - Wojciech Lisik
- Department of General Surgery and Transplantology, Medical University of Warsaw, Warsaw, Poland
| | - Piotr Sobieraj
- Department of Internal Medicine, Hypertension and Vascular Diseases, Medical University of Warsaw, Warsaw, Poland
| | - Piotr Pruszczyk
- Department of Internal Medicine and Cardiology, Medical University of Warsaw, Warsaw, Poland
| | - Michał Ciurzyński
- Department of Internal Medicine and Cardiology, Medical University of Warsaw, Warsaw, Poland
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31
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Tebar WR, Ritti-Dias RM, Mota J, Saraiva BTC, Damato TM, Delfino LD, Farah BQ, Vanderlei LCM, Christofaro DGD. Relationship of Cardiac Autonomic Modulation with Cardiovascular Parameters in Adults, According to Body Mass Index and Physical Activity. J Cardiovasc Transl Res 2021; 14:975-983. [PMID: 33483920 DOI: 10.1007/s12265-021-10101-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2020] [Accepted: 01/10/2021] [Indexed: 12/20/2022]
Abstract
This study aimed to analyze the relationship between cardiac autonomic modulation (CAM) and cardiovascular parameters (blood pressure and resting heart rate) in a sample of 256 adults, grouped by body mass index and sufficient moderate-to-vigorous physical activity (≥150 min/week). The sample showed different cardiovascular parameters and CAM according to body mass index, but not according to physical activity. Adults who are overweight and physically active presented higher relationship between CAM and blood pressure than those who are insufficiently active, similarly to normal weight groups. Recommended levels of physical activity may play an important role in the relationship of HRV with cardiovascular parameters in overweight adults, regardless of sex, age, socioeconomic level, and central fat. Trial registration: Registered at ClinicalTrials.gov (NCT03986879). Graphical abstract.
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Affiliation(s)
- William R Tebar
- Universidade Estadual Paulista - Unesp, Roberto Simonsen street, number 305, 19060-900, Campus de Presidente Prudente, city of Presidente Prudente, State of Sao Paulo, Brazil.
| | | | - Jorge Mota
- Faculdade de Desporto da Universidade do Porto, Porto, Portugal
| | - Bruna T C Saraiva
- Universidade Estadual Paulista - Unesp, Roberto Simonsen street, number 305, 19060-900, Campus de Presidente Prudente, city of Presidente Prudente, State of Sao Paulo, Brazil
| | - Tatiana M Damato
- Universidade Estadual Paulista - Unesp, Roberto Simonsen street, number 305, 19060-900, Campus de Presidente Prudente, city of Presidente Prudente, State of Sao Paulo, Brazil
| | - Leandro D Delfino
- Universidade Estadual Paulista - Unesp, Roberto Simonsen street, number 305, 19060-900, Campus de Presidente Prudente, city of Presidente Prudente, State of Sao Paulo, Brazil
| | - Breno Q Farah
- Universidade Federal Rural de Pernambuco, Recife, Brazil
| | - Luiz Carlos M Vanderlei
- Universidade Estadual Paulista - Unesp, Roberto Simonsen street, number 305, 19060-900, Campus de Presidente Prudente, city of Presidente Prudente, State of Sao Paulo, Brazil
| | - Diego G D Christofaro
- Universidade Estadual Paulista - Unesp, Roberto Simonsen street, number 305, 19060-900, Campus de Presidente Prudente, city of Presidente Prudente, State of Sao Paulo, Brazil
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Reduced Heart Rate Variability in Patients With Medically Unexplained Physical Symptoms: A Meta-Analysis of HF-HRV and RMSSD. Psychosom Med 2021; 83:2-15. [PMID: 33065584 DOI: 10.1097/psy.0000000000000874] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
OBJECTIVE Medically unexplained physical symptoms (MUPS) and related syndromes are common and place a substantial burden on both patients and society. Chronic psychological distress and dysregulation of the autonomic nervous system may be common factors associated with MUPS, although previous studies have reported mixed results. The aims of this meta-analysis are to provide an updated synthesis of studies investigating heart rate variability (HRV) indices associated with autonomic nervous system functioning in three common MUPS syndromes and to explain inconsistencies in previous study findings. METHODS Literature search yielded 58 studies comparing HRV indices of reduced parasympathetic activity of healthy individuals with those of patients with chronic fatigue syndrome (npatients = 271), irritable bowel syndrome (npatients = 1005), and fibromyalgia (npatients = 534). Separate random-effects meta-analyses were conducted on studies measuring root mean square of successive differences (RMSSD) and high-frequency HRV (HF-HRV). RESULTS Regardless of syndrome type, patients had significantly lower RMSSD (k = 22, Hedges g = -0.37 [-0.53 to -0.21], p < .001) and HF-HRV (k = 52, Hedges g = -0.69 [-1.03 to -0.36], p < .001) than did healthy individuals. Sample age and publication year explained a substantial variation in RMSSD, whereas controlling for confounders in statistical analyses explained variation in HF-HRV. CONCLUSIONS Lower RMSSD and HF-HRV in patients with MUPS versus healthy controls indicates that autonomic nervous system dysregulation, particularly lower parasympathetic activity, may play a role in patients with these conditions. This conclusion may have important implications for the underlying mechanisms and treatment of MUPS and related syndromes.
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Base LH, Oliveira JRDCE, Maia LCP, Antão JYFDL, Ferreira Filho C, Ferreira C. Effect of air pollution on the autonomic modulation of heart rate in overweight adults. EINSTEIN-SAO PAULO 2020; 18:eAO5100. [PMID: 33295424 PMCID: PMC7690934 DOI: 10.31744/einstein_journal/2020ao5100] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2019] [Accepted: 03/26/2020] [Indexed: 11/10/2022] Open
Abstract
Objective: To analyze the effect of air pollution on heart rate variability in overweight individuals. Methods: A total of 46 adult individuals, both sexes, aged between 18 and 49 years and with body mass index >25kg/m2 were analyzed. All volunteers were students from public schools of two cities in the state of São Paulo. The clinical, demographic and anthropometric data of each individual, as well as heart rate variability through time domain, geometric and frequency indices were collected. For the air quality analysis, the following variables were investigated: concentration of carbon dioxide, particulate matter, temperature and relative humidity. The analysis was carried out with descriptive and analytical statistics, adopting a level of significance of 5%. Results: There was a reduction in overall heart rate variability in overweight individuals by the following indices: mean standard deviation of all normal RR intervals, long-term standard deviation of continuous RR intervals, ratio of short-and long-term standard deviation of continuous RR intervals. In addition, the indices responsible for parasympathetic control showed a downward trend in their values, as well as the low frequency index, which represented sympathetic action, although not significant. Conclusion: Overweight individuals exposed to air pollution had lower heart rate variability than the Control Group.
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Affiliation(s)
| | | | | | | | | | - Celso Ferreira
- Universidade Federal de São Paulo, São Paulo, SP, Brazil
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Wojno O, Czarzasta K, Puchalska L, Kowalczyk M, Cudnoch-Jedrzejewska A. Central interaction between the apelinergic and vasopressinergic systems in the regulation of the haemodynamic parameters in rats maintained on a high-fat diet. Clin Exp Pharmacol Physiol 2020; 47:1902-1911. [PMID: 32687615 DOI: 10.1111/1440-1681.13381] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2020] [Revised: 07/09/2020] [Accepted: 07/10/2020] [Indexed: 11/29/2022]
Abstract
A high-fat diet can affect the central activity of the apelinergic and vasopressinergic systems, which can have a significant impact on cardiovascular regulation. The aim of the study was to investigate the role of the central interaction between apelin and vasopressin in the regulation of the cardiovascular system in Sprague Dawley rats maintained on a normal-fat diet (NFD) or on a high-fat diet (HFD). The animals were instrumented with a cannula implanted into the left cerebral ventricle for intracerebroventricular (ICV) infusions of saline (0.9% NaCl), apelin-13 (APLN-13), V1a receptor antagonist (V1aRANT) APJ receptor antagonist (F13A), vasopressin (AVP); and with a catheter placed within the femoral artery for mean arterial blood pressure and heart rate monitoring. Blood, the hypothalamus and the medulla oblongata were collected for biochemical analysis. The hypertensive effect of APLN-13 was blocked by a prior ICV infusion of V1aRANT, only in the NFD rats. However, the hypertensive effect of AVP was blocked by the prior ICV infusion of F13A in both the NFD and HFD rats. A HFD caused an increase in the protein level of APJ and V1a receptors, both in the hypothalamus and the medulla oblongata. This study confirms the presence of an interaction between both peptides in the central regulation of the cardiovascular system in rats on a NFD or a HFD.
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Affiliation(s)
- Olena Wojno
- Department of Experimental and Clinical Physiology, Laboratory of Centre for Preclinical Research, Medical University of Warsaw, Warsaw, Poland
| | - Katarzyna Czarzasta
- Department of Experimental and Clinical Physiology, Laboratory of Centre for Preclinical Research, Medical University of Warsaw, Warsaw, Poland
| | - Liana Puchalska
- Department of Experimental and Clinical Physiology, Laboratory of Centre for Preclinical Research, Medical University of Warsaw, Warsaw, Poland
| | - Malgorzata Kowalczyk
- Department of Experimental and Clinical Physiology, Laboratory of Centre for Preclinical Research, Medical University of Warsaw, Warsaw, Poland
| | - Agnieszka Cudnoch-Jedrzejewska
- Department of Experimental and Clinical Physiology, Laboratory of Centre for Preclinical Research, Medical University of Warsaw, Warsaw, Poland
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Berthoud D, Schwarzwald CC. Echocardiographic assessment of left ventricular size and systolic function in Warmblood horses using linear measurements, area-based indices, and volume estimates: A retrospective database analysis. J Vet Intern Med 2020; 35:504-520. [PMID: 33247461 PMCID: PMC7848374 DOI: 10.1111/jvim.15968] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2020] [Revised: 09/20/2020] [Accepted: 11/09/2020] [Indexed: 12/25/2022] Open
Abstract
Background Echocardiographic assessment of left ventricular (LV) size and function using area‐based indices and volumetric estimates is not well established in horses. Objective To report reference intervals and measurement variability for uni‐, 2‐, and 3‐dimensional echocardiographic indices of LV size and systolic function in Warmblood horses and to provide proof of concept for allometric scaling of variables to body weight. Unidimensional indices were to be compared to area‐based indices and LV volume estimates to establish their clinical use. Animals Thirty healthy Warmblood horses and 70 Warmblood horses with a primary diagnosis of mitral regurgitation or aortic regurgitation. Methods Echocardiographic indices of LV size and systolic function were measured using an existing echocardiography database. Weight‐related variables were scaled to body weight (BWT). Reference intervals and measurement variability were calculated, the influence of valvular regurgitation on LV size and function was investigated and agreement between different variables for detection of reduced, normal, and increased LV size and systolic function was assessed. Results Reference values for healthy Warmblood horses were reported. Measurement variability was sufficiently low for clinical use of all variables. Allometric scaling was effective to correct diastolic LV dimensions and cardiac output for differences in BWT. Various echocardiographic indices resulted in different conclusions regarding identification of LV enlargement and systolic dysfunction in healthy horses and horses with valvular regurgitation. Conclusions and Clinical Importance Echocardiographic assessment of LV size and systolic function should include joint assessment of multiple uni‐ and multidimensional indices. Area‐based or volumetric indices that reflect LV long‐axis motion should be included.
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Affiliation(s)
- Djamila Berthoud
- Equine Department, Vetsuisse Faculty, University of Zurich, Zurich, Switzerland
| | - Colin C Schwarzwald
- Equine Department, Vetsuisse Faculty, University of Zurich, Zurich, Switzerland
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AlShahrani AN, Al‐Asoom LI, Alsunni AA, Elbahai NS, Yar T. Assessment of baroreceptor reflex sensitivity in young obese Saudi males at rest and in response to physiological challenges. Physiol Rep 2020; 8:e14625. [PMID: 33190394 PMCID: PMC7666776 DOI: 10.14814/phy2.14625] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Revised: 10/03/2020] [Accepted: 10/05/2020] [Indexed: 11/24/2022] Open
Abstract
Autonomic imbalance in overweight/obese persons could lead to an increased risk of cardiovascular complications including hypertension and arrhythmias. Baroreceptor reflex sensitivity is a sensitive indicator to detect an altered sympathovagal balance in overweight/obese individuals. This study investigated the effects of overweight/obesity on baroreceptor sensitivity in young Saudi males at rest and in response to physiological challenges. SUBJECTS AND METHODS In this cross-sectional study, spontaneous baroreceptor sensitivity at rest and in response to deep breathing, isometric hand grip exercise and moderate intensity isotonic exercise were recorded in 20 normal weight and 20 overweight/obese subjects. Finger arterial blood pressure signal, recorded through Finometer, was used to calculate baroreceptor sensitivity through cross-correlation method. The baroreceptor sensitivity data were log transformed before application of parametric tests. RESULTS The spontaneous baroreceptor sensitivity was similar in both groups at baseline, but exhibited a significant increase during deep breathing only in normal weight (p < .001). Immediately after the isotonic exercise the baroreceptor sensitivity was significantly lower than baseline in both normal weight and overweight/obese and remained significantly lower in overweight/obese individuals compared to normal weight (p < .05) throughout the recovery period. There was a significant rise in baroreceptor sensitivity after isometric exercise in overweight/obese group only (p = .001). Pearson's correlation showed a significant negative correlation of baroreceptor sensitivity with body mass index during deep breathing (r = -.472, p = .004) and in post-isotonic exercise recovery period (r = -.414, p = .013). CONCLUSION A significantly reduced baroreceptor sensitivity response to deep breathing, reduced baroreceptor sensitivity recovery after isotonic exercise, and an exaggerated shoot up after isometric exercise in overweight/obese suggests an altered sympathovagal balance. Baroreceptor sensitivity measurements in response to physiological challenges, deep breathing, and isotonic exercise, may be more sensitive investigations for detection of early attenuation of cardiac autonomic function. This would enable timely intervention thereby delaying complications and improving the quality of life.
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Affiliation(s)
- Abdullah N. AlShahrani
- Department of PhysiologyCollege of MedicineImam Abdulrahman Bin Faisal UniversityDammamSaudi Arabia
| | - Lubna I. Al‐Asoom
- Department of PhysiologyCollege of MedicineImam Abdulrahman Bin Faisal UniversityDammamSaudi Arabia
| | - Ahmed A. Alsunni
- Department of PhysiologyCollege of MedicineImam Abdulrahman Bin Faisal UniversityDammamSaudi Arabia
| | - Nabil S. Elbahai
- Department of PhysiologyCollege of MedicineImam Abdulrahman Bin Faisal UniversityDammamSaudi Arabia
| | - Talay Yar
- Department of PhysiologyCollege of MedicineImam Abdulrahman Bin Faisal UniversityDammamSaudi Arabia
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Smoljo T, Stanić I, Sila S, Kovačić U, Crnošija L, Junaković A, Adamec I, Hojsak I, Skorić MK, Habek M. The Relationship between Autonomic Regulation of Cardiovascular Function and Body Composition. J Obes Metab Syndr 2020; 29:188-197. [PMID: 32930100 PMCID: PMC7539346 DOI: 10.7570/jomes20041] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Revised: 06/15/2020] [Accepted: 08/10/2020] [Indexed: 12/18/2022] Open
Abstract
Background We investigated whether the results of autonomic function tests correlate with body composition and shape in healthy young people. Methods We conducted cardiovascular reflex tests (heart rate [HR] and blood pressure [BP] responses to the Valsalva maneuver and HR response to deep breathing) and the tilt table test with 32 subjects (19 males; mean age, 22.1±1.9 years). Participants also completed an anthropometric measurement sequence (weight; height; upper arm, hips, and waist circumference; triceps and subscapular skinfold), bioelectric impedance testing, and hand grip strength measurements. Results Markers of obesity, other anthropometric measures, functional measures, and the basal metabolic rate (BMR) were significantly positively correlated with systolic BP (SBP) and diastolic BP (DBP) in both the supine and tilted positions. There was a positive correlation between the difference in HR (ΔHR) between the tilt and supine body positions and markers of obesity, the functional marker of dominant handgrip strength, and BMR. Participants with a body mass index (BMI) <25 kg/m2 had significantly lower median values of ΔHR, DBP in the tilt-test, SBP at rest, and SBP in the tilt-test than participants who had a BMI ≥25 kg/m2 (10.55 vs. 21.95 bpm, P=0.003; 77.55 vs. 90.05 mmHg, P=0.045; 113.45 vs. 140.55 mmHg, P=0.013; 117.00 vs. 135.25 mmHg, P=0.006, respectively). Body fat percentage was identified as an independent positive predictor (β=0.993; 95% confidence interval [CI], 0.070 to 1.916; P=0.036) and body water percentage was an independent negative predictor of tilted SBP (β=-1.370; 95% CI, -2.634 to 0.106; P=0.035). Conclusion High sympathetic activity, as evaluated by cardiovascular regulation, correlates with a high share of adipose tissue in young healthy persons.
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Affiliation(s)
- Tomislav Smoljo
- Department of Neurology, School of Medicine, University of Zagreb, Zagreb, Croatia
| | - Ivan Stanić
- Department of Neurology, School of Medicine, University of Zagreb, Zagreb, Croatia
| | - Sara Sila
- Children's Hospital Zagreb, Zagreb, Croatia
| | - Uroš Kovačić
- Institute of Pathophysiology, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | - Luka Crnošija
- Department of Neurology, Referral Center for Autonomic Nervous System Disorders, University Hospital Center Zagreb, Zagreb, Croatia
| | - Anamari Junaković
- Department of Neurology, Referral Center for Autonomic Nervous System Disorders, University Hospital Center Zagreb, Zagreb, Croatia
| | - Ivan Adamec
- Department of Neurology, Referral Center for Autonomic Nervous System Disorders, University Hospital Center Zagreb, Zagreb, Croatia
| | - Iva Hojsak
- Department of Neurology, School of Medicine, University of Zagreb, Zagreb, Croatia.,Children's Hospital Zagreb, Zagreb, Croatia.,Department of Pediatrics, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia
| | - Magdalena Krbot Skorić
- Department of Neurology, Referral Center for Autonomic Nervous System Disorders, University Hospital Center Zagreb, Zagreb, Croatia.,Faculty of Electrical Engineering and Computing, University of Zagreb, Zagreb, Croatia
| | - Mario Habek
- Department of Neurology, School of Medicine, University of Zagreb, Zagreb, Croatia.,Department of Neurology, Referral Center for Autonomic Nervous System Disorders, University Hospital Center Zagreb, Zagreb, Croatia
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González-Velázquez VE, Pedraza-Rodríguez EM, Carrazana-Escalona R, Moreno-Padilla M, Muñoz-Bustos GA, Sánchez-Hechavarría ME. Cardiac vagal imbalance to the isometric sustained weight test in adolescents with emotional eating behavior. Physiol Behav 2020; 223:112994. [PMID: 32502529 DOI: 10.1016/j.physbeh.2020.112994] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2020] [Revised: 05/24/2020] [Accepted: 05/29/2020] [Indexed: 11/26/2022]
Abstract
PURPOSE To assess the relationship between emotional eating behavior and heart rate variability in Spanish adolescents during an isometric exercise test. METHODS Participants included 52 adolescents aged between 13 and 18 years old. Heart rate was continuously recorded at rest (2 minutes) and during the sustained weight test (2 minutes). Linear and nonlinear methods of heart rate variability were assessed and related to the emotional eating behavior divided in two clusters. RESULTS Statistically significant differences were observed in linear and non-linear parameters of heart rate variability comparing rest and sustained weight test. An increase in the value of emotional eating in overweight adolescents was founded. During the sustained weight test, there were differences between the two emotional eating clusters regarding the variables peak high frequency power, normalized low frequency power, normalized high frequency power, low frequency/high frequency ratio, and sample entropy. A positive correlation between the emotional eating behavior and the peak high frequency power was observed, though the prediction capacity of the high frequency waves is low it is observed that there is a good fit to the regression line. CONCLUSION Results of this study shows that there was a relationship between vagal tone and emotional eating behavior in adolescents during an isometric exercise, with excessive parasympathetic predominance and sympathetic withdrawal during a physical effort.
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Affiliation(s)
- Victor Ernesto González-Velázquez
- Departamento de Ciencias Básicas Biomédicas. Facultad de Medicina. Universidad de Ciencias Médicas de Villa Clara. Villa Clara, Cuba
| | - Elys María Pedraza-Rodríguez
- Departamento de Ciencias Básicas Biomédicas. Facultad de Medicina. Universidad de Ciencias Médicas de Villa Clara. Villa Clara, Cuba
| | - Ramón Carrazana-Escalona
- Departamento de Ciencias Básicas Biomédicas. Facultad de Medicina 1. Universidad de Ciencias Médicas de Santiago de Cuba. Santiago de Cuba, Cuba
| | | | | | - Miguel Enrique Sánchez-Hechavarría
- Departamento de Ciencias Basicas y Morfologicas. Facultad de Medicina. Universidad Católica de la Santísima Concepción. Concepción, Chile..
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Clough GF, Chipperfield AJ, Thanaj M, Scorletti E, Calder PC, Byrne CD. Dysregulated Neurovascular Control Underlies Declining Microvascular Functionality in People With Non-alcoholic Fatty Liver Disease (NAFLD) at Risk of Liver Fibrosis. Front Physiol 2020; 11:551. [PMID: 32581841 PMCID: PMC7283580 DOI: 10.3389/fphys.2020.00551] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2020] [Accepted: 04/30/2020] [Indexed: 11/30/2022] Open
Abstract
Background/Aims Increasing evidence shows that non-alcoholic fatty liver disease (NAFLD) is associated with dysregulation of microvascular perfusion independently of established cardio-metabolic risk factors. We investigated whether hepatic manifestations of NAFLD such as liver fibrosis and liver fat are associated with microvascular hemodynamics through dysregulation of neurovascular control. Methods Microvascular dilator (post-occlusive reactive hyperemia) and sympathetically mediated constrictor (deep inspiratory breath-hold) responses were measured at the forearm and finger, respectively, using laser Doppler fluximetry. Non-linear complexity-based analysis was used to assess the information content and variability of the resting blood flux (BF) signals, attributable to oscillatory flow-motion activity, and over multiple sampling frequencies. Results Measurements were made in 189 adults (113 men) with NAFLD, with (n = 65) and without (n = 124) type 2 diabetes mellitus (T2DM), age = 50.9 ± 11.7 years (mean ± SD). Microvascular dilator and constrictor capacity were both negatively associated with age (r = −0.178, p = 0.014, and r = −0.201, p = 0.007, respectively) and enhanced liver fibrosis (ELF) score (r = −0.155, p = 0.038 and r = −0.418, p < 0.0001, respectively). There was no association with measures of liver fat, obesity or T2DM. Lempel-Ziv complexity (LZC) and sample entropy (SE) of the BF signal measured at the two skin sites were associated negatively with age (p < 0.01 and p < 0.001) and positively with ELF score (p < 0.05 and p < 0.0001). In individuals with an ELF score ≥7.8 the influence of both neurogenic and respiratory flow-motion activity on LZC was up-rated (p < 0.0001). Conclusion Altered microvascular network functionality occurs in adults with NAFLD suggesting a mechanistic role for dysregulated neurovascular control in individuals at risk of severe liver fibrosis.
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Affiliation(s)
- Geraldine F Clough
- Human Development and Health, Faculty of Medicine, University of Southampton, Southampton, United Kingdom
| | - Andrew J Chipperfield
- Faculty of Engineering and Physical Sciences, University of Southampton, Southampton, United Kingdom
| | - Marjola Thanaj
- Faculty of Engineering and Physical Sciences, University of Southampton, Southampton, United Kingdom
| | - Eleonora Scorletti
- Human Development and Health, Faculty of Medicine, University of Southampton, Southampton, United Kingdom.,National Institute for Health Research Southampton Biomedical Research Centre, University of Southampton, University Hospital Southampton National Health Service Foundation Trust, Southampton, United Kingdom.,Department of Gastroenterology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States
| | - Philip C Calder
- Human Development and Health, Faculty of Medicine, University of Southampton, Southampton, United Kingdom.,National Institute for Health Research Southampton Biomedical Research Centre, University of Southampton, University Hospital Southampton National Health Service Foundation Trust, Southampton, United Kingdom
| | - Christopher D Byrne
- Human Development and Health, Faculty of Medicine, University of Southampton, Southampton, United Kingdom.,National Institute for Health Research Southampton Biomedical Research Centre, University of Southampton, University Hospital Southampton National Health Service Foundation Trust, Southampton, United Kingdom
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Oliveira C, Silveira EA, Rosa L, Santos A, Rodrigues AP, Mendonça C, Silva L, Gentil P, Rebelo AC. Risk Factors Associated with Cardiac Autonomic Modulation in Obese Individuals. J Obes 2020; 2020:7185249. [PMID: 32318288 PMCID: PMC7152942 DOI: 10.1155/2020/7185249] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2020] [Accepted: 03/07/2020] [Indexed: 12/18/2022] Open
Abstract
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. Objective. To analyze the association between cardiovascular autonomic modulation and biochemical and anthropometric markers, food intake, and physical activity level in severely obese individuals. Methodology. 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/m2) were collected. Results. 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 (p = 0.049). In the physical activity analysis, there was a negative association between moderate to vigorous physical activity and the sympathetic component (p = 0.043), and for sedentary time (ST), there was a negative association with HF (p = 0.049) and LF/HF (p = 0.036) and a positive association with LF (p = 0.014). For multiple linear regression, waist circumference (WC) and HOMA-IR values were negatively associated with HF (β = -0.685, p = 0.010; β = -14.989, p = 0.010; respectively). HOMA-IR (β = 0.141, p = 0.003) and the percentage of lipids ingested (β = -0.030, p = 0.043) were negatively associated with LF/HF. Conclusion. 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.
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Affiliation(s)
- Camila Oliveira
- Medicine Faculty, Health Science Post-Graduation Program, Universidade Federal de Goiás, Goiânia, Goiás, Brazil
| | - Erika Aparecida Silveira
- Medicine Faculty, Coordinator of the Severe Obesity Study Group, Federal University of Goiás, Goiânia, Brazil
| | - Lorena Rosa
- Medicine Faculty, Health Science Post-Graduation Program, Universidade Federal de Goiás, Goiânia, Goiás, Brazil
| | - Annelisa Santos
- Medicine Faculty, Health Science Post-Graduation Program, Universidade Federal de Goiás, Goiânia, Goiás, Brazil
| | - Ana Paula Rodrigues
- Medicine Faculty, Health Science Post-Graduation Program, Universidade Federal de Goiás, Goiânia, Goiás, Brazil
| | - Carolina Mendonça
- Medicine Faculty, Health Science Post-Graduation Program, Universidade Federal de Goiás, Goiânia, Goiás, Brazil
| | - Lucas Silva
- Medicine Faculty, Health Science Post-Graduation Program, Universidade Federal de Goiás, Goiânia, Goiás, Brazil
| | - Paulo Gentil
- College of Physical Education and Dance, Federal University of Goiás, Goiânia, Brazil
| | - Ana Cristina Rebelo
- Department of Morphology, Biological Sciences Institute, Federal University of Goiás, Goiânia, Goiás, Brazil
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Alfotawi R, Alhowikan A, Alfadhel A, Premnath S, Tawhari J, Alhamid A, Bahammam S. A Novel assessment tool monitoring the level of patient anxiety during third molar surgery procedure. Heliyon 2020; 6:e02576. [PMID: 31909231 PMCID: PMC6938923 DOI: 10.1016/j.heliyon.2019.e02576] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2019] [Revised: 04/19/2019] [Accepted: 10/02/2019] [Indexed: 11/04/2022] Open
Abstract
The authors hypothesized that an audio-visual presentation providing information regarding the removal of an impacted mandibular third molar would reduce patient anxiety. Aim& objectives A clinical trial was performed to assess the level of patient anxiety during third molar surgery by using a new induction program and comparing the results amongst two groups that were the verbally informed and the audio-visual informed groups. Materials and methods the clinical trial included the patients who required surgical removal of an impacted third molar and fulfilled the predetermined criteria. The patients were divided into two groups - group 1 (no. = 20) the audio visual informed group and group 2(no. = 20) the verbally informed group. For both the groups the HR was recorded beat by beat using HR sensor (polar H1 UK) connected to an ActiGraph WGT3X- 3T USA. Also the modified dental analogue scale(MDAS) was used to subjectively record the anxiety during the surgery. Results The HR reading were statistically significant for the following surgical stages; drilling, suturing and upon leaving the clinic. The audio-visual informed group had lower self-reported anxiety scores than did the verbally informed group. Conclusion These results suggested that providing an audio-visual presentation about the surgical procedures in our routine clinical practice could aid in alleviating anxiety which would thereby reduce surgical complications.
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Affiliation(s)
- Randa Alfotawi
- Oral and Maxillofacial Department, Dental Faculty, King Saud University, Riyadh, Saudi Arabia
| | - Abdulrahman Alhowikan
- Oral and Maxillofacial Department, Dental Faculty, King Saud University, Riyadh, Saudi Arabia
| | - Alia Alfadhel
- Oral and Maxillofacial Department, Dental Faculty, King Saud University, Riyadh, Saudi Arabia
| | - Sangeetha Premnath
- Oral and Maxillofacial Department, Dental Faculty, King Saud University, Riyadh, Saudi Arabia
| | - Jamilah Tawhari
- Oral and Maxillofacial Department, Dental Faculty, King Saud University, Riyadh, Saudi Arabia
| | - Anfal Alhamid
- Oral and Maxillofacial Department, Dental Faculty, King Saud University, Riyadh, Saudi Arabia
| | - Shaima Bahammam
- Oral and Maxillofacial Department, Dental Faculty, King Saud University, Riyadh, Saudi Arabia
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Agarwal M, Rahul, Verma N, Vishwakarma P, Kanchan A, Kumar P. Heart rate recovery in normal and obese males with and without parental history of cardiovascular disease. J Family Med Prim Care 2020; 9:2379-2383. [PMID: 32754505 PMCID: PMC7380739 DOI: 10.4103/jfmpc.jfmpc_132_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2020] [Revised: 03/13/2020] [Accepted: 03/23/2020] [Indexed: 11/12/2022] Open
Abstract
Background: Parental history of cardiovascular disease (CVD) and obesity is associated with delayed parasympathetic nervous system reactivation after exercise. Heart rate recovery (HRRe) after a minute of exercise is inversely related to cardiovascular events. Aim: To determine the effect of body mass index (BMI) and parental CVD history on HRRe in apparently healthy young Indian males. Method: The present cross-sectional experimental study involved 100 males, aged18–25 years. Subjects were divided into two equal groups based on the parental CVD history—(i) Parental CVD history present, and (ii) Parental CVD history absent. Each of these groups were further divided into two equal sub groups based on BMI—(a) BMI <23kg/m2, and (b) BMI ≥25 kg/m2. Participants exercised on the treadmill at variable speeds and grades to achieve their target HR (THR). THR was calculated by adding 60–90% HR-reserve (HRR) in their basal HR (BHR). HRR was calculated by subtracting maximal HR (MHR) from BHR. MHR was estimated by the formula: 208–0.7 × age. The HRRe was calculated by subtracting the immediate postexercise HR with the HR after a minute of rest postexercise. ANOVA with post-hoc Tukey was applied and a P value ≤0.05 was considered as statistically significant. Results: HRRe value was significantly lesser in subjects having a positive parental history of CVD than the subjects with no parental history of CVD, irrespective of BMI. Also, HRRe was inversely related to BMI. Conclusion: Not only obesity but also a family history of CVD impacts the recovery of HR after vigorous-intensity exercise.
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Saad M, Ray LB, Bujaki B, Parvaresh A, Palamarchuk I, De Koninck J, Douglass A, Lee EK, Soucy LJ, Fogel S, Morin CM, Bastien C, Merali Z, Robillard R. Using heart rate profiles during sleep as a biomarker of depression. BMC Psychiatry 2019; 19:168. [PMID: 31174510 PMCID: PMC6554996 DOI: 10.1186/s12888-019-2152-1] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2018] [Accepted: 05/20/2019] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Abnormalities in heart rate during sleep linked to impaired neuro-cardiac modulation may provide new information about physiological sleep signatures of depression. This study assessed the validity of an algorithm using patterns of heart rate changes during sleep to discriminate between individuals with depression and healthy controls. METHODS A heart rate profiling algorithm was modeled using machine-learning based on 1203 polysomnograms from individuals with depression referred to a sleep clinic for the assessment of sleep abnormalities, including insomnia, excessive daytime fatigue, and sleep-related breathing disturbances (n = 664) and mentally healthy controls (n = 529). The final algorithm was tested on a distinct sample (n = 174) to categorize each individual as depressed or not depressed. The resulting categorizations were compared to medical record diagnoses. RESULTS The algorithm had an overall classification accuracy of 79.9% [sensitivity: 82.8, 95% CI (0.73-0.89), specificity: 77.0, 95% CI (0.67-0.85)]. The algorithm remained highly sensitive across subgroups stratified by age, sex, depression severity, comorbid psychiatric illness, cardiovascular disease, and smoking status. CONCLUSIONS Sleep-derived heart rate patterns could act as an objective biomarker of depression, at least when it co-occurs with sleep disturbances, and may serve as a complimentary objective diagnostic tool. These findings highlight the extent to which some autonomic functions are impaired in individuals with depression, which warrants further investigation about potential underlying mechanisms.
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Affiliation(s)
- Mysa Saad
- Sleep Research Unit, The Royal’s Institute of Mental Health Research, 1145 Carling Avenue, Ottawa, ON K1Z 7K4 Canada ,0000 0001 2182 2255grid.28046.38Department of Cellular and Molecular Medicine, University of Ottawa, 451 Smyth Road, Ottawa, ON K1H 8M5 Canada
| | - Laura B. Ray
- Sleep Research Unit, The Royal’s Institute of Mental Health Research, 1145 Carling Avenue, Ottawa, ON K1Z 7K4 Canada
| | - Brad Bujaki
- Sleep Research Unit, The Royal’s Institute of Mental Health Research, 1145 Carling Avenue, Ottawa, ON K1Z 7K4 Canada ,0000 0001 1503 7525grid.414622.7Sleep Clinic, Royal Ottawa Mental Health Centre, 1145 Carling Avenue, Ottawa, ON K1Z 7K4 Canada
| | - Amir Parvaresh
- Sleep Research Unit, The Royal’s Institute of Mental Health Research, 1145 Carling Avenue, Ottawa, ON K1Z 7K4 Canada
| | - Iryna Palamarchuk
- Sleep Research Unit, The Royal’s Institute of Mental Health Research, 1145 Carling Avenue, Ottawa, ON K1Z 7K4 Canada
| | - Joseph De Koninck
- Sleep Research Unit, The Royal’s Institute of Mental Health Research, 1145 Carling Avenue, Ottawa, ON K1Z 7K4 Canada ,0000 0001 2182 2255grid.28046.38School of Psychology, University of Ottawa, 136 Jean-Jacques Lussier, Ottawa, ON K1N 6N5 Canada
| | - Alan Douglass
- Sleep Research Unit, The Royal’s Institute of Mental Health Research, 1145 Carling Avenue, Ottawa, ON K1Z 7K4 Canada ,0000 0001 1503 7525grid.414622.7Sleep Clinic, Royal Ottawa Mental Health Centre, 1145 Carling Avenue, Ottawa, ON K1Z 7K4 Canada ,0000 0001 2182 2255grid.28046.38Department of Psychiatry, University of Ottawa, 1145 Carling Avenue, Ottawa, ON K1Z 7K4 Canada
| | - Elliott K. Lee
- Sleep Research Unit, The Royal’s Institute of Mental Health Research, 1145 Carling Avenue, Ottawa, ON K1Z 7K4 Canada ,0000 0001 1503 7525grid.414622.7Sleep Clinic, Royal Ottawa Mental Health Centre, 1145 Carling Avenue, Ottawa, ON K1Z 7K4 Canada ,0000 0001 2182 2255grid.28046.38Department of Psychiatry, University of Ottawa, 1145 Carling Avenue, Ottawa, ON K1Z 7K4 Canada
| | - Louis J. Soucy
- 0000 0001 1503 7525grid.414622.7Sleep Clinic, Royal Ottawa Mental Health Centre, 1145 Carling Avenue, Ottawa, ON K1Z 7K4 Canada ,0000 0001 2182 2255grid.28046.38Department of Psychiatry, University of Ottawa, 1145 Carling Avenue, Ottawa, ON K1Z 7K4 Canada
| | - Stuart Fogel
- Sleep Research Unit, The Royal’s Institute of Mental Health Research, 1145 Carling Avenue, Ottawa, ON K1Z 7K4 Canada ,0000 0001 2182 2255grid.28046.38School of Psychology, University of Ottawa, 136 Jean-Jacques Lussier, Ottawa, ON K1N 6N5 Canada
| | - Charles M. Morin
- 0000 0001 0621 4067grid.420732.0Centre d’étude des troubles du sommeil, Centre de recherche de l’institut universitaire en santé mentale de Québec, 2525 boulevard de la Canardière, Québec, QC G1J 2G3 Canada
| | - Célyne Bastien
- 0000 0004 1936 8390grid.23856.3aSchool of Psychology, Université Laval, 2325 rue des Bibliothèques, Québec, QC G1V 0A6 Canada ,CERVO Brain Research Centre, 2601 Chemin de la Canardière, Québec, QC G1J 2G3 Canada
| | - Zul Merali
- Sleep Research Unit, The Royal’s Institute of Mental Health Research, 1145 Carling Avenue, Ottawa, ON K1Z 7K4 Canada ,0000 0001 2182 2255grid.28046.38Department of Cellular and Molecular Medicine, University of Ottawa, 451 Smyth Road, Ottawa, ON K1H 8M5 Canada
| | - Rébecca Robillard
- Sleep Research Unit, The Royal's Institute of Mental Health Research, 1145 Carling Avenue, Ottawa, ON, K1Z 7K4, Canada. .,School of Psychology, University of Ottawa, 136 Jean-Jacques Lussier, Ottawa, ON, K1N 6N5, Canada.
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Araújo JA, Queiroz MG, Dias ARL, Sousa LCJL, Arsa G, Cambri LT. Isolated Obesity Is Not Enough to Impair Cardiac Autonomic Modulation in Metabolically Healthy Men. RESEARCH QUARTERLY FOR EXERCISE AND SPORT 2019; 90:14-23. [PMID: 30620882 DOI: 10.1080/02701367.2018.1549357] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/23/2018] [Accepted: 10/15/2018] [Indexed: 06/09/2023]
Abstract
PURPOSE To evaluate whether excess body mass influences the heart rate variability (HRV) indexes at rest, and to correlate adiposity indicators and the aerobic fitness with cardiac autonomic variables in metabolically healthy young adults. METHOD In all, 41 untrained males (Mage = 21.80, SD = 2.14 years), 14 normal weight (MBMI = 22.28, SD = 1.86 kg∙m-2), 11 overweight (MBMI = 26.95, SD = 1.43 kg∙m-2), and 16 obese (MBMI = 33.58, SD = 3.06 kg∙m-2) metabolically healthy (normal values of blood pressure, fasting blood glucose, triglycerides, and total cholesterol), underwent evaluations of the HRV at rest and of the peak oxygen consumption (VO2 peak) during maximal exercise on a cycle ergometer. RESULTS Blood pressure, heart rate, HRV indexes, casual blood glucose, oxidative stress, and antioxidant activity did not differ among the groups. The VO2 peak (mL∙kg-1∙min-1) was lower in the obese group compared with the normal weight and overweight groups. The body mass (r = -.40 to -.45) and abdominal circumference (r = -.39 to -.52) were slightly to moderately correlated with SD1, SD2, RMSSD, SDNN, pNN50, LF, and HF indexes and total power. The VO2 peak (mL∙kg-1∙min-1) was slightly to moderately correlated (r = .48 to .51) with SD2, SDNN, and LF indexes in the individuals with excess body mass. CONCLUSION Cardiac autonomic modulation at rest was preserved in metabolically healthy obese young men. However, the indicators of adiposity, as well as the aerobic fitness were correlated with cardiac autonomic modulation in the individuals with excess body mass.
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Cierpka-Kmieć K, Hering D. Tachycardia: The hidden cardiovascular risk factor in uncomplicated arterial hypertension. Cardiol J 2019; 27:857-867. [PMID: 30799548 DOI: 10.5603/cj.a2019.0021] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2019] [Accepted: 02/04/2019] [Indexed: 12/30/2022] Open
Abstract
Early detection and management of elevated blood pressure is crucial in reducing the burden of cardiovascular disease (CVD). The importance of an absolute risk assessment and patient risk stratification has been highlighted in the European hypertension guidelines since 2003. Amongst numerous risk factors influencing patient prognosis, elevated heart rate (HR) has been indicated as important predictor of future risk of hypertension, coronary heart disease, sudden cardiac death, heart failure, CVD, stroke, total cancer and mortality. Given that resting HR can be easily determined in clinical practice and modified by lifestyle changes as well as beta-blocker therapy, it seems reasonable that lowering resting HR should be a potential target to reduce disease burden and premature mortality. However, there is a lack of outcome studies of HR lowering in tachycardia-related hypertension. This review outlines the underlying mechanisms of early course hypertension pathophysiology with the critical role of the sympathetic nervous system activation, the prognostic significance of fast HR and the mechanistic rationale for the use of non-pharmacological approaches and/or highly long-acting cardioselective beta-blockers with some consideration given to betaxolol properties.
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Affiliation(s)
| | - Dagmara Hering
- Medical University of Gdansk, Poland, Debinki 7, 80-952 Gdansk, Poland.
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Cayres SU, Vanderlei LCM, Machado-Rodrigues AM, Werneck AO, Barbosa MF, Fernandes RA. Adiposity and Physical Activity Do Not Mediate the Longitudinal Association Between Sleep Quality and Arterial Thickness Among Adolescents. J Clin Sleep Med 2019; 15:215-221. [PMID: 30736879 DOI: 10.5664/jcsm.7620] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2018] [Accepted: 10/03/2018] [Indexed: 11/13/2022]
Abstract
STUDY OBJECTIVES Sleep is a behavior with the potential to affect cardiovascular health. Given the fact that adiposity and physical activity seem to be related to cardiovascular risk factors during growth, it is still unclear whether sleep quality could affect arterial thickness among adolescents. Thus, the objective of the current study was to analyze the effect of sleep quality on arterial thickness and identify the possible mediation role of physical activity and trunk fat in adolescents. METHODS This was a longitudinal study (12-month follow-up) composed of 71 adolescents with ages ranging from 11 to 14 years at baseline (absence of any known chronic diseases, and no regular medicine use). All variables were assessed twice (baseline and 12-month follow-up): (1) sleep quality was reported using the Mini Sleep Questionnaire (MSQ); (2) physical activity was estimated using pedometers; (3) trunk fat was assessed using a densitometry scanner; and (4) carotid intima-media thickness (CIMT) and femoral intima-media thickness (FIMT) were assessed using ultrasonography. RESULTS Adolescents who presented poor sleep quality demonstrated significantly increased FIMT (r = .299, 95% confidence interval .071 to .498) and for every point increase in the MSQ score from baseline to follow-up there was a 1.12% (95% confidence interval 0.26 to 1.98) increase in FIMT over time. Moreover, trunk fat and physical activity did not mediate the association between sleep quality and arterial thickness, but FIMT had a positive and independent relationship only with trunk fat. CONCLUSIONS Sleep quality was positively associated with FIMT among adolescents, whereas physical activity and adiposity did not mediate this process.
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Affiliation(s)
- Suziane Ungar Cayres
- Postgraduate Program in Movement Sciences, Sao Paulo State University, UNESP, Rio Claro, Brazil
| | | | | | - André Oliveir Werneck
- Postgraduate Program in Movement Sciences, Sao Paulo State University, UNESP, Rio Claro, Brazil
| | | | - Romulo Araúj Fernandes
- Laboratory of Investigation in Exercise - LIVE, Department of Physical Education, UNESP, Presidente Prudente, Brazil
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Abstract
BACKGROUND Graded exercises tests are performed in adult populations; nonetheless, the use of this type of assessment is greatly understudied in overweight and obese adolescents. OBJECTIVE To investigate heart rate autonomic responses to submaximal aerobic exercise in obese and overweight adolescents. METHODS We recruited 40 adolescents divided into two groups: (1) overweight group comprising 10 boys and 10 girls between Z-score +1 and +2 and (2) obese group comprising 10 boys and 10 girls above Z-score >+2. Heart rate variability was analysed before (T1) and after exercise (T2-T4) on treadmill at a slope of 0%, with 70% of the maximal estimated heart rate (220 - age) for 20 minutes. RESULTS Heart rate in the overweight group was: 93.2±10.52 bpm versus 120.8±13.49 bpm versus 94.6±11.65 bpm versus 93.0±9.23 bpm, and in the obese group was: 92.0±15.41 bpm versus 117.6±16.31 bpm versus 92.1±12.9 bpm versus 91.8±14.33 bpm. High frequency in the overweight group was: 640±633.1 ms2 versus 84±174.66 ms2 versus 603.5±655.31 ms2 versus 762.6±807.21 ms2, and in the obese group was: 628.4±779.81 ms2 versus 65.4±119.34 ms2 versus 506.2±482.70 ms2 versus 677.9±939.05 ms2; and root mean square of successive differences in the overweight group was: 37.9±18.81 ms versus 10.9±8.41 ms versus 32.8±24.07 ms versus 36.7±21.86 ms, and in the obese group was: 38.7±23.17 ms versus 11.5±8.62 ms versus 32.3±16.74 ms versus 37.3±24.21 ms. These values significantly changed during exercise compared with resting values in overweight and obese groups. Moreover, we also reported no significant difference of resting parasympathetic control of heart rate between obese and overweight adolescents. CONCLUSION There was no significant difference of autonomic responses elicited by submaximal aerobic exercise between overweight and obese adolescents.
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Dereppe H, Verbeke M, Debruxelles C, Boucq E, Ponzoni L, Cuvelier G. Energy expenditure of household activities and cardiorespiratory fitness in women with obesity. Clin Obes 2018; 8:391-397. [PMID: 30231189 DOI: 10.1111/cob.12276] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2018] [Revised: 06/27/2018] [Accepted: 07/10/2018] [Indexed: 01/22/2023]
Affiliation(s)
- H Dereppe
- Service de Cardiologie, CHWAPI - Centre d'Orthonutrition, Tournai, Belgium
| | - M Verbeke
- Laboratoire de l'effort et du mouvement, Haute Ecole Provinciale Hainaut-Condorcet, Tournai, Belgium
| | - C Debruxelles
- Laboratoire de l'effort et du mouvement, Haute Ecole Provinciale Hainaut-Condorcet, Tournai, Belgium
| | - E Boucq
- Laboratoire de l'effort et du mouvement, Haute Ecole Provinciale Hainaut-Condorcet, Tournai, Belgium
| | - L Ponzoni
- Laboratoire de l'effort et du mouvement, Haute Ecole Provinciale Hainaut-Condorcet, Tournai, Belgium
| | - G Cuvelier
- Laboratoire de l'effort et du mouvement, Haute Ecole Provinciale Hainaut-Condorcet, Tournai, Belgium
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Carvalho LP, Di Thommazo-Luporini L, Mendes RG, Cabiddu R, Ricci PA, Basso-Vanelli RP, Oliveira-Junior MC, Vieira RP, Bonjorno-Junior JC, Oliveira CR, Luporini RL, Borghi-Silva A. Metabolic syndrome impact on cardiac autonomic modulation and exercise capacity in obese adults. Auton Neurosci 2018; 213:43-50. [PMID: 30005739 DOI: 10.1016/j.autneu.2018.05.008] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2018] [Revised: 04/18/2018] [Accepted: 05/17/2018] [Indexed: 10/16/2022]
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50
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Baucom BRW, Baucom KJW, Hogan JN, Crenshaw AO, Bourne SV, Crowell SE, Georgiou P, Goodwin MS. Cardiovascular Reactivity During Marital Conflict in Laboratory and Naturalistic Settings: Differential Associations with Relationship and Individual Functioning Across Contexts. FAMILY PROCESS 2018; 57:662-678. [PMID: 29577270 DOI: 10.1111/famp.12353] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Cardiovascular reactivity during spousal conflict is considered to be one of the main pathways for relationship distress to impact physical, mental, and relationship health. However, the magnitude of association between cardiovascular reactivity during laboratory marital conflict and relationship functioning is small and inconsistent given the scope of its importance in theoretical models of intimate relationships. This study tests the possibility that cardiovascular data collected in laboratory settings downwardly bias the magnitude of these associations when compared to measures obtained in naturalistic settings. Ambulatory cardiovascular reactivity data were collected from 20 couples during two relationship conflicts in a research laboratory, two planned relationship conflicts at couples' homes, and two spontaneous relationship conflicts during couples' daily lives. Associations between self-report measures of relationship functioning, individual functioning, and cardiovascular reactivity across settings are tested using multilevel models. Cardiovascular reactivity was significantly larger during planned and spontaneous relationship conflicts in naturalistic settings than during planned relationship conflicts in the laboratory. Similarly, associations with relationship and individual functioning variables were statistically significantly larger for cardiovascular data collected in naturalistic settings than the same data collected in the laboratory. Our findings suggest that cardiovascular reactivity during spousal conflict in naturalistic settings is statistically significantly different from that elicited in laboratory settings both in magnitude and in the pattern of associations with a wide range of inter- and intrapersonal variables. These differences in findings across laboratory and naturalistic physiological responses highlight the value of testing physiological phenomena across interaction contexts in romantic relationships.
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Affiliation(s)
- Brian R W Baucom
- Department of Psychology, University of Utah, Salt Lake City, UT
| | | | - Jasara N Hogan
- Department of Psychology, University of Utah, Salt Lake City, UT
| | | | - Stacia V Bourne
- Department of Psychology, University of Utah, Salt Lake City, UT
| | - Sheila E Crowell
- Department of Psychology, University of Utah, Salt Lake City, UT
| | - Panayiotis Georgiou
- Department of Electrical Engineering, University of Southern California, Los Angeles, CA
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