Cardiovascular and metabolic risk markers are related to parasympathetic indices in pre-pubertal adolescents

Impact of sports participation on cardiovascular health markers of children and adolescents: Systematic review and meta-analysis

BACKGROUND

Cardiovascular diseases have a high prevalence in adults and their development begins in the first decades of life. On the other hand, sports participation in childhood and adolescence provides benefits which can delay the onset of these diseases.

AIM

To synthesize the available literature on the impact of sports participation on cardiovascular outcomes in children and adolescents.

METHODS

This systematic review was conducted on studies of children and adolescents (aged 8-18 years) who regularly practiced a sport and had reported cardiovascular outcomes (blood pressure and intima-media thickness) recorded. The Medline/PubMed, SciELO, Reference Citation Analysis (https://www.referencecitationanalysis.com/) and Bireme databases were searched.

RESULTS

In total, 3314 publications for blood pressure and 122 publications for intima-media thickness were identified in the databases. After exclusions (e.g., duplicate articles, animal studies and those that did not meet the inclusion criteria), four publications for blood pressure (449 adolescents) and two publications for intima-media thickness were included (402 adolescents). For blood pressure, all publications were longitudinal in design (follow-up ranging from 12 wk to 12 mo) and involved adolescents aged from 8 years to 18 years of age. For intima-media thickness, both publications were longitudinal in design and involved adolescents aged from 11 years to 18 years of age.

CONCLUSION

Sports participation seems to promote benefits to cardiovascular structure and function in adolescents. However, studies with adolescents are scarce and further research is needed to understand this phenomenon.

Association between Metabolic Syndrome Components and Cardiac Autonomic Modulation among Children and Adolescents: A Systematic Review and Meta-Analysis

Simple Summary

The clustering of metabolic syndrome (MetS) risk factors is becoming more prevalent in young people (up to the age of 19 years) leading to the development of type 2 diabetes (T2D) and cardiovascular diseases in early adulthood. The impact of MetS risk factors on cardiac autonomic modulation (CAM) or vice versa have been noted to track from childhood to pre-adolescence and adolescence. Understating associations in this age group may help improve the clinical outcomes of the MetS, even when MetS symptoms are not visible. Potential damage from each individual MetS component and the ability to predict early cardiac damage or upcoming cardiovascular events is very important. Therefore, the present systematic review and meta-analysis investigated the associations between CAM and MetS risk factors individually to verify which MetS risk components were significantly correlated with which heart rate variability (HRV) indices before or at the onset of the MetS among young people. The purpose of this review was to outline the importance of potentially screening HRV indices in young people even with only one MetS risk factor, as a pre-indicator for early cardiovascular risk stratification. Cross-sectional studies that examined the relationship of MetS risk factors with HRV indices were searched using four databases including PubMed, the Cochrane clinical trials library, Medline and the Web of Science. Correlation coefficients with 95% confidence intervals (95% CI), and random effects meta-analyses of the association between MetS risk factors with HRV indices were performed. Our results propose that lipid profiles including high density lipoprotein (HDL) and triglycerides (TGs), waist circumference (WC) and blood pressure (BP) are associated with CAM in young people up to the age of 19 years. The use of HRV indices to predict future MetS risk, and relationships with individual risk factors including HDL, BP, WC and TGs, were established. Furthermore, arterial pressure, respiration, stress and physical activity must be taken into consideration for future studies along with CAM related to young people (up to the age of 19 years), and it is recommended to explore further the associations reported here, as CAM is not the only determinant of neurovisceral regulation.

Abstract

Background: the clustering of metabolic syndrome (MetS) risk factors is becoming more prevalent in children, leading to the development of type 2 diabetes (T2D) and cardiovascular diseases in early adulthood. The impact of MetS risk factors on cardiac autonomic modulation (CAM) or vice versa has been noted to track from childhood to pre-adolescence and adolescence. Understating associations in this age group may help to improve the clinical outcomes of the MetS, even when MetS symptoms are not visible. Potential damage from each individual MetS component and the ability to predict early cardiac damage or upcoming cardiovascular events is very important. Therefore, the present systematic review and meta-analysis investigated the associations between CAM and MetS risk factors individually to verify which of the MetS risk components were significantly correlated with heart rate variability (HRV) indices before or at the onset of the MetS among young people. The purpose of this review was to outline the importance of potentially screening HRV indices in young people even with only one MetS risk factor, as a pre-indicator for early cardiovascular risk stratification. Methods: cross-sectional studies that examined the relationship of MetS risk factors with HRV indices were searched using four databases including PubMed, the Cochrane clinical trials library, Medline and the Web of Science. Correlation coefficients with 95% confidence intervals (95% CI), and random effects meta-analyses of the association between MetS risk factors with HRV indices were performed. Results: out of 14 cross-sectional studies and one case-control study, 8 studies (10 data sets) provided association data for the meta-analysis. Our results indicated significant positive correlations for systolic blood pressure (SBP) (correlation coefficient 0.13 (95%CI: 0.06; 0.19), I² = 47.26%) and diastolic blood pressure (DBP) (correlation coefficient 0.09 (95%CI: −0.01; 0.18), I² = 0%) with a Low Frequency/High Frequency ratio (LF/HF). Significant negative correlations for waist circumference (WC) (correlation coefficient −0.12 (95%CI: −0.19; −0.04), I² = 51.50%), Triglycerides (TGs) (correlation coefficient −0.09 (95%CI: −0.15; −0.02), I² = 0%) and ≥2 MetS risk factors (correlation coefficient −0.10 (95%CI: −0.16; −0.03), I² = 0%); with high frequency (HF) were revealed. Significant positive correlations for high density lipoprotein (HDL) (correlation coefficient 0.08 (95%CI: 0.05; 0.11), I² = 0%) and significant negative correlations of ≥2 MetS risk (correlation coefficient −0.04 (95%CI: −0.12; 0.03), I² = 0.0%) with low frequency (LF) were revealed. Significant negative correlations for TGs (correlation coefficient −0.09 (95%CI: −0.23; 0.05), I² = 2.01%) with a mean square root of the sum of differences between mean time between two successive intervals (rMSSD) and significant positive correlation of HDL (correlation coefficient 0.09 (95%CI: −0.01; 0.19), I² = 0.33%) with standard deviation of the time between two successive intervals (SDNN) were also revealed. An Egger’s test indicated that there was no obvious publication bias for any of the above relationships except for TGs and rMSSD. The significance level stipulated for the meta-analysis was p < 0.05. Conclusions: lipid profiles (HDL and TGs), WC and BP were associated with CAM in young people up to the age of 19 years. The use of HRV indices to predict future MetS risk, and relationships with individual risk factors including HDL, BP, WC and TGs, were established. Future studies related to young people (up to the age of 19 years) are recommended to explore the associations reported here further.

Cardiovascular Risk Factors and Heart Rate Variability: Impact of the Level of the Threshold-Based Artefact Correction Used to Process the Heart Rate Variability Signal

The associations between cardiovascular disease (CVD) risk factors and heart rate variability (HRV) have shown some inconsistencies. To examine the impact of the different Kubios threshold-based artefact correction levels on the associations between different CVD risk factors and a heart rate variability (HRV) score in three independent human cohorts. A total of 107 children with overweight/obesity, 132 young adults, and 73 middle-aged adults were included in the present study. Waist circumference and the HRV score were negatively associated using the medium and the strong Kubios filters in children (β = -0.22 and - 0.24, P = 0.03 and 0.02 respectively) and the very strong Kubios filter in middle-aged adults (β = -0.39, P = 0.01). HDL-C was positively associated with the HRV score across Kubios filters (β ranged from 0.21 to 0.31, all P ≤ 0.04), while triglycerides were negatively associated with the HRV score using the very strong Kubios filter in young adults (β = -0.22, P = 0.02). Glucose metabolism markers (glucose, insulin, and HOMA index) were inversely associated with the HRV score across Kubios filters in young adults (β ranged from -0.29 to -0.22; all P ≤ 0.03). Importantly, most of these associations disappeared after including HR as a covariate, especially in children and young adults. It should be mandatory to report the Kubios filter used and to include the HR (as a confounder factor) to allow the comparability of the results across different studies.

Impact of physical exercise/activity on vascular structure and inflammation in pediatric populations: A literature review

PURPOSE

To describe the effects of physical exercise/activity on the vascular architecture of children and adolescents, as well as to identify the effects of inflammation and sedentary behaviors on this relationship.

METHODS

Potentially relevant articles were identified in the databases MEDLINE and PubMed covering the period from 2000 to 2015. No language restrictions were applied.

RESULTS

Thirteen articles were found that included obese boys and girls in their samples (aged 9-19). Six interventional studies assessed inflammation and in five of these, physical exercise decreased inflammation. In 10 studies, vascular architecture was affected by physical exercise/activity.

CONCLUSIONS

The impact of physical exercise on vascular architecture and inflammation seems relevant, but has been mainly investigated in obese groups.

PRACTICAL IMPLICATIONS

Health professionals should act together in organized interventions in schools, targeting the promotion of higher physical activity levels in children and adolescents.