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El-Ayash H, Puyau M, Bacha F. Hyperglycemia: A determinant of cardiac autonomic dysfunction in youth with obesity across the spectrum of glycemic regulation. Pediatr Obes 2023; 18:e13063. [PMID: 37312269 DOI: 10.1111/ijpo.13063] [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: 03/29/2023] [Revised: 05/12/2023] [Accepted: 05/24/2023] [Indexed: 06/15/2023]
Abstract
OBJECTIVES To characterize the determinants of heart rate variability (HRV) in youth with obesity across the glycemia spectrum. METHODS A total of 94 adolescents, 15 ± 2.1 years (21 with normal weight, 23 with overweight-normal glucose tolerance, 26 with prediabetes and 24 with type 2 diabetes [T2D]) underwent an assessment of body composition (dual-energy x-ray absorptiometry), 2-h oral glucose tolerance test with the calculation of indices of glycemia and insulin sensitivity (IS), inflammatory markers (high-sensitivity C-reactive protein [hs-CRP] and tumour necrosis factor-α [TNF-α]), and HRV by peripheral arterial tonometry. RESULTS The HRV frequency-domain index (low-frequency to high-frequency ratio [LF/HF]), an estimate of the ratio between sympathetic and parasympathetic activity, increased across the glycemic spectrum, and was highest in T2D compared with the other three groups (p = 0.004). LF/HF correlated with %body fat (r = 0.22, p = 0.04); fasting (r = 0.39, p < 0.001), 2-h (r = 0.31, p = 0.004), and area under the curve glucose (r = 0.32, p = 0.003); hs-CRP (r = 0.33, p = 0.002) and TNF-α (r = 0.38, p = 0.006). In a linear regression model, fasting glucose (β = 0.39, p = 0.003) and hs-CRP (β = 0.21, p = 0.09) contributed to the variance in Ln LF/HF independent of IS, %body fat, age, sex, race-ethnicity and Tanner stage (R2 = 0.23, p = 0.013). CONCLUSIONS Youth with impaired glucose regulation have evidence of cardiac autonomic dysfunction with decreased HRV, and sympathetic overdrive (increased LF/HF). This dysfunction is mainly related to glycemia and systemic inflammation.
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Affiliation(s)
- Heba El-Ayash
- USDA/ARS Children's Nutrition Research Center, Baylor College of Medicine, Houston, Texas, USA
- Division of Pediatric Endocrinology and Diabetes, Texas Children's Hospital, Baylor College of Medicine, Houston, Texas, USA
| | - Maurice Puyau
- USDA/ARS Children's Nutrition Research Center, Baylor College of Medicine, Houston, Texas, USA
| | - Fida Bacha
- USDA/ARS Children's Nutrition Research Center, Baylor College of Medicine, Houston, Texas, USA
- Division of Pediatric Endocrinology and Diabetes, Texas Children's Hospital, Baylor College of Medicine, Houston, Texas, USA
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Vágvölgyi A, Ábrahám JE, Máthéné Köteles É, Korom A, Barnai M, Szűcs M, Orosz A, Kempler P, Menyhárt A, Nemes A, Várkonyi T, Baczkó I, Kósa I, Lengyel C. A three-month physical training program improves cardiovascular autonomic function in patients with metabolic syndrome with and without diabetes - a pilot study. Front Endocrinol (Lausanne) 2023; 14:1224353. [PMID: 37664832 PMCID: PMC10469893 DOI: 10.3389/fendo.2023.1224353] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Accepted: 07/24/2023] [Indexed: 09/05/2023] Open
Abstract
Introduction Vascular complications and neuropathy may develop in the presence of metabolic syndrome. The aim of our study was to measure the cardiovascular autonomic function following physical training in patients with metabolic syndrome with and without diabetes. Subjects and methods 56 patients with metabolic syndrome (32 men/24 women, 40 non-diabetic patients (NDMetS)/16 diabetic patients (DMetS) [mean ± SD]: age: 50.35 ± 8.03 vs. 56.8 ± 9.30 years, p=0.023; baseline BMI: 32.2 ± 7.03 vs. 32.8 ± 5.94 kg/m2, p=0.739) were involved in our study. All tests and measurements were carried out before and following a 3-month physical training period. Autonomic function was assessed by means of five standard cardiovascular reflex tests. ECG repolarization parameters, including short-term QT variability and stress-ECG were also measured. Results In the whole population, Valsalva-ratio (VR) and the autonomic score (AS) improved following training (VR: 1.49 ± 0.24 vs. 1.64 ± 0.34, p=0.001; AS: 2.05 ± 1.73 vs. 1.41 ± 1.36, p=0.015) accompanied by the significant decrease of the systolic (150.3 ± 16.12 vs. 134.1 ± 16.67 mmHg, p<0.001) and diastolic (90.64 ± 12.8 vs. 82.79 ± 11.1 mmHg, p<0.001) blood pressure. An improvement in VR was detected in NDMetS patients following training (1.51 ± 0.24 vs. 1.67 ± 0.31, p= 0.002). No significant changes could be detected in autonomic tests' results in the DMetS patient group following training. The applied exercise training program did not lead to significant changes in ECG repolarization. The stress-ECG test in the whole study population yielded a significant increase in the test duration (12.9 ± 3.76 vs. 15.1 ± 2.96 min, p<0.001) and in the test load (10.5 ± 2.78 vs. 11.6 ± 2.39 MET, p<0.001). The load capability improved significantly in both subgroups: 11.1 ± 2.04 vs. 12.1 ± 1.82, (p<0.001) and 9.0 ± 3.64 vs. 10.4 ± 3.05, (p=0.033) in subpopulations of NDMetS and DMetS, respectively. The DMetS patients achieved a significantly lower MET score at baseline (p=0.039) and following training (p=0.044) in comparison to the NDMetS patients. Conclusion The three-month exercise program improved the Valsalva-ratio and the AN score in the MetS patients, that is potentially protective against cardiovascular events. The training had some beneficial effect on blood pressure and the results of the stress-ECG tests in both groups. The absence of significant change in the reflex tests in DMetS group reflects an impaired adaptation compared to the NDMestS group.
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Affiliation(s)
- Anna Vágvölgyi
- Department of Medicine, Albert Szent-Györgyi Medical School, University of Szeged, Szeged, Hungary
| | - Judit Erzsébet Ábrahám
- Department of Medical Prevention, Albert Szent-Györgyi Medical School, University of Szeged, Szeged, Hungary
| | - Éva Máthéné Köteles
- Department of Physiotherapy, Faculty of Health Sciences and Social Studies, University of Szeged, Szeged, Hungary
| | - Andrea Korom
- Department of Physiotherapy, Faculty of Health Sciences and Social Studies, University of Szeged, Szeged, Hungary
| | - Mária Barnai
- Department of Physiotherapy, Faculty of Health Sciences and Social Studies, University of Szeged, Szeged, Hungary
| | - Mónika Szűcs
- Department of Medical Physics and Informatics, Albert Szent-Györgyi Medical School, University of Szeged, Szeged, Hungary
| | - Andrea Orosz
- Department of Pharmacology and Pharmacotherapy, Albert Szent-Györgyi Medical School, University of Szeged, Szeged, Hungary
| | - Péter Kempler
- Department of Oncology and Internal Medicine, Semmelweis University, Budapest, Hungary
| | - Adrienn Menyhárt
- Department of Oncology and Internal Medicine, Semmelweis University, Budapest, Hungary
| | - Attila Nemes
- Department of Medicine, Albert Szent-Györgyi Medical School, University of Szeged, Szeged, Hungary
| | - Tamás Várkonyi
- Department of Medicine, Albert Szent-Györgyi Medical School, University of Szeged, Szeged, Hungary
| | - István Baczkó
- Department of Pharmacology and Pharmacotherapy, Albert Szent-Györgyi Medical School, University of Szeged, Szeged, Hungary
| | - István Kósa
- Department of Medicine, Albert Szent-Györgyi Medical School, University of Szeged, Szeged, Hungary
- Department of Medical Prevention, Albert Szent-Györgyi Medical School, University of Szeged, Szeged, Hungary
| | - Csaba Lengyel
- Department of Medicine, Albert Szent-Györgyi Medical School, University of Szeged, Szeged, Hungary
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Sparks S, Pinto J, Hayes G, Spitschan M, Bulte DP. The impact of Alzheimer's disease risk factors on the pupillary light response. Front Neurosci 2023; 17:1248640. [PMID: 37650103 PMCID: PMC10463762 DOI: 10.3389/fnins.2023.1248640] [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: 06/27/2023] [Accepted: 07/31/2023] [Indexed: 09/01/2023] Open
Abstract
Alzheimer's disease (AD) is the leading cause of dementia, and its prevalence is increasing and is expected to continue to increase over the next few decades. Because of this, there is an urgent requirement to determine a way to diagnose the disease, and to target interventions to delay and ideally stop the onset of symptoms, specifically those impacting cognition and daily livelihood. The pupillary light response (PLR) is controlled by the sympathetic and parasympathetic branches of the autonomic nervous system, and impairments to the pupillary light response (PLR) have been related to AD. However, most of these studies that assess the PLR occur in patients who have already been diagnosed with AD, rather than those who are at a higher risk for the disease but without a diagnosis. Determining whether the PLR is similarly impaired in subjects before an AD diagnosis is made and before cognitive symptoms of the disease begin, is an important step before using the PLR as a diagnostic tool. Specifically, identifying whether the PLR is impaired in specific at-risk groups, considering both genetic and non-genetic risk factors, is imperative. It is possible that the PLR may be impaired in association with some risk factors but not others, potentially indicating different pathways to neurodegeneration that could be distinguished using PLR. In this work, we review the most common genetic and lifestyle-based risk factors for AD and identify established relationships between these risk factors and the PLR. The evidence here shows that many AD risk factors, including traumatic brain injury, ocular and intracranial hypertension, alcohol consumption, depression, and diabetes, are directly related to changes in the PLR. Other risk factors currently lack sufficient literature to make any conclusions relating directly to the PLR but have shown links to impairments in the parasympathetic nervous system; further research should be conducted in these risk factors and their relation to the PLR.
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Affiliation(s)
- Sierra Sparks
- Department of Engineering Science, Institute of Biomedical Engineering, University of Oxford, Oxford, United Kingdom
| | - Joana Pinto
- Department of Engineering Science, Institute of Biomedical Engineering, University of Oxford, Oxford, United Kingdom
| | - Genevieve Hayes
- Department of Engineering Science, Institute of Biomedical Engineering, University of Oxford, Oxford, United Kingdom
| | - Manuel Spitschan
- TUM Department of Sport and Health Sciences (TUM SG), Chronobiology and Health, Technical University of Munich, Munich, Germany
- TUM Institute for Advanced Study (TUM-IAS), Technical University of Munich, Garching, Germany
- Max Planck Institute for Biological Cybernetics, Translational Sensory and Circadian Neuroscience, Tübingen, Germany
| | - Daniel P. Bulte
- Department of Engineering Science, Institute of Biomedical Engineering, University of Oxford, Oxford, United Kingdom
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Butler MG, Victor AK, Reiter LT. Autonomic nervous system dysfunction in Prader-Willi syndrome. Clin Auton Res 2023; 33:281-286. [PMID: 36515769 DOI: 10.1007/s10286-022-00909-7] [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: 09/26/2022] [Accepted: 11/14/2022] [Indexed: 12/15/2022]
Abstract
INTRODUCTION Prader-Willi syndrome is a complex neurodevelopmental genetic disorder due to lack of paternal expression of critical imprinted genes in the 15q11.2-q13.1 chromosomal region, generally from a paternal deletion. Predominant features include infantile hypotonia, a poor suck with failure to thrive, craniofacial features, and developmental and behavioral problems including self-injury and childhood onset of obesity. In addition to severe obesity, patients with PWS present with other symptoms of autonomic nervous system dysfunction. METHODS We examined the features seen in Prader-Willi syndrome and searched the literature for evidence of autonomic nervous system involvement in this rare obesity-related disorder and illustrative findings possibly due to autonomic nervous system dysfunction. Additionally, we reviewed the literature in relation to childhood obesity syndromes and compared those syndromes to the syndromic obesity found in Prader-Willi syndrome. RESULTS We report autonomic nervous system-related symptoms associated with childhood obesity impacting features seen in Prader-Willi syndrome and possibly other obesity-related genetic syndromes. We compiled evidence of both an autonomic route for the obesity seen in PWS and other autonomic nervous system-related dysfunctions. These include decreased salvation, sleep disordered breathing, increased pain and thermal threshold instability, delayed gastric emptying, altered blood pressure readings, and pupillary constriction responses as evidence of autonomic nervous system involvement. CONCLUSIONS We summarized and illustrated findings of autonomic nervous system dysfunction in Prader-Willi syndrome and other obesity-related syndromes and genetic factors that may play a causative role in development.
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Affiliation(s)
- Merlin G Butler
- Departments of Psychiatry & Behavioral Sciences and Pediatrics, University of Kansas Medical Center, Kansas City, KS, 66160, USA.
| | - A Kaitlyn Victor
- Department of Neurology, The University of Tennessee Health Science Center, Memphis, TN, 38163, USA
- IPBS Program, The University of Tennessee Health Science Center, Memphis, TN, 38163, USA
| | - Lawrence T Reiter
- Department of Neurology, The University of Tennessee Health Science Center, Memphis, TN, 38163, USA
- Department of Pediatrics and Anatomy & Neurobiology, The University of Tennessee Health Science Center, Memphis, TN, 38163, USA
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Khaytin I, Victor AK, Barclay SF, Benson LA, Slattery SM, Rand CM, Kurek KC, Weese-Mayer DE. Rapid-onset obesity with hypothalamic dysfunction, hypoventilation, and autonomic dysregulation (ROHHAD): a collaborative review of the current understanding. Clin Auton Res 2023; 33:251-268. [PMID: 37162653 DOI: 10.1007/s10286-023-00936-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Accepted: 03/01/2023] [Indexed: 05/11/2023]
Abstract
PURPOSE To provide an overview of the discovery, presentation, and management of Rapid-onset Obesity with Hypothalamic dysfunction, Hypoventilation, and Autonomic Dysregulation (ROHHAD). To discuss a search for causative etiology spanning multiple disciplines and continents. METHODS The literature (1965-2022) on the diagnosis, management, pathophysiology, and potential etiology of ROHHAD was methodically reviewed. The experience of several academic centers with expertise in ROHHAD is presented, along with a detailed discussion of scientific discovery in the search for a cause. RESULTS ROHHAD is an ultra-rare syndrome with fewer than 200 known cases. Although variations occur, the acronym ROHHAD is intended to alert physicians to the usual sequence or unfolding of the phenotypic presentation, including the full phenotype. Nearly 60 years after its first description, more is known about the pathophysiology of ROHHAD, but the etiology remains enigmatic. The search for a genetic mutation common to patients with ROHHAD has not, to date, demonstrated a disease-defining gene. Similarly, a search for the autoimmune basis of ROHHAD has not resulted in a definitive answer. This review summarizes current knowledge and potential future directions. CONCLUSION ROHHAD is a poorly understood, complex, and potentially devastating disorder. The search for its cause intertwines with the search for causes of obesity and autonomic dysregulation. The care for the patient with ROHHAD necessitates collaborative international efforts to advance our knowledge and, thereby, treatment, to decrease the disease burden and eventually to stop, and/or reverse the unfolding of the phenotype.
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Affiliation(s)
- Ilya Khaytin
- Center for Autonomic Medicine in Pediatrics (CAMP), Division of Autonomic Medicine, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA.
- Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
- Stanley Manne Children's Research Center, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA.
| | - A Kaitlyn Victor
- College of Graduate Health Sciences, The University of Tennessee Health Science Center, Memphis, TN, USA
| | - Sarah F Barclay
- Alberta Children's Hospital Research Institute, University of Calgary, Calgary, AB, Canada
| | - Leslie A Benson
- Department of Neurology, Boston Children's Hospital, Boston, MA, USA
| | - Susan M Slattery
- Center for Autonomic Medicine in Pediatrics (CAMP), Division of Autonomic Medicine, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA
- Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
- Stanley Manne Children's Research Center, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA
| | - Casey M Rand
- Center for Autonomic Medicine in Pediatrics (CAMP), Division of Autonomic Medicine, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA
- Stanley Manne Children's Research Center, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA
| | - Kyle C Kurek
- Alberta Children's Hospital Research Institute, University of Calgary, Calgary, AB, Canada
| | - Debra E Weese-Mayer
- Center for Autonomic Medicine in Pediatrics (CAMP), Division of Autonomic Medicine, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA
- Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
- Stanley Manne Children's Research Center, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA
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Gonçalves Teixeira B, Paciência I, Cavaleiro Rufo J, Mendes F, Farraia M, Padrão P, Moreira P, Moreira A. The Influence of Obesity in the Autonomic Nervous System Activity in School-Aged Children in Northern Portugal: A Cross-Sectional Study. ACTA MEDICA PORT 2023; 36:317-325. [PMID: 37130573 DOI: 10.20344/amp.17144] [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: 09/10/2021] [Accepted: 09/19/2022] [Indexed: 05/04/2023]
Abstract
INTRODUCTION Obesity is one of the most prevalent chronic diseases in childhood, being an important public health issue. Excessive weight has been associated with autonomic dysfunction but the evidence in children is scarce. Therefore, the aim of this study was to assess the effect of overweight and obesity on the autonomic nervous system activity, in children. MATERIAL AND METHODS Data from a cross-sectional study of 1602 children, aged 7 to 12 years, was used and 858 children were included in the analysis. Body mass index was calculated and classified according to criteria of the World Health Organization (WHO), Centers for Disease Control and Prevention (CDC) and the International Obesity Task Force (IOTF). Body composition was characterized by bioelectrical impedance. Linear regression models were used to determine the association between body mass index, body composition and the autonomic nervous system activity, assessed by pupillometry. RESULTS Average dilation velocity was higher among children with obesity, according to the CDC and percentage of body fat criteria (β = 0.053, 95% CI = 0.005 to 0.101 and β = 0.063, 95% CI = 0.016 to 0.109, respectively). The same trend was observed for WHO and IOTF criteria (β = 0.045, 95% CI = -0.001 to 0.091, and β = 0.055, 95% CI = -0.001 to 0.111, respectively). CDC and WHO body mass index z-scores were also positively associated with the values of average dilation velocity (rs = 0.030, p = 0.048; and rs = 0.027, p = 0.042, respectively). CONCLUSION Our findings suggest an association between body mass and changes in the autonomic activity, Moreover, this study provides proof of concept for interventions targeting the prevention/treatment of obesity in children that may offer some benefit in re-establishing the balance of the autonomic nervous system, and subsequently preventing the consequences associated with the autonomic nervous system dysfunction.
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Affiliation(s)
| | - Inês Paciência
- Serviço de Imunologia Básica e Clínica. Departamento de Patologia. Faculdade de Medicina da Universidade do Porto. Centro Hospitalar Universitário de São João. Porto; EPIUnit. Instituto de Saúde Pública. Universidade do Porto. Porto; Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR). Porto. Portugal
| | - João Cavaleiro Rufo
- Serviço de Imunologia Básica e Clínica. Departamento de Patologia. Faculdade de Medicina da Universidade do Porto. Centro Hospitalar Universitário de São João. Porto; EPIUnit. Instituto de Saúde Pública. Universidade do Porto. Porto; Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR). Porto. Portugal
| | - Francisca Mendes
- Serviço de Imunologia Básica e Clínica. Departamento de Patologia. Faculdade de Medicina da Universidade do Porto. Centro Hospitalar Universitário de São João. Porto; EPIUnit. Instituto de Saúde Pública. Universidade do Porto. Porto; Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR). Porto. Portugal
| | - Mariana Farraia
- Serviço de Imunologia Básica e Clínica. Departamento de Patologia. Faculdade de Medicina da Universidade do Porto. Centro Hospitalar Universitário de São João. Porto; EPIUnit. Instituto de Saúde Pública. Universidade do Porto. Porto; Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR). Porto. Portugal
| | - Patrícia Padrão
- Faculdade de Ciências da Nutrição e Alimentação. Universidade do Porto. Porto; EPIUnit. Instituto de Saúde Pública. Universidade do Porto. Porto; Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR). Porto. Portugal
| | - Pedro Moreira
- Faculdade de Ciências da Nutrição e Alimentação. Universidade do Porto. Porto; EPIUnit. Instituto de Saúde Pública. Universidade do Porto. Porto; Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR). Porto. Portugal
| | - André Moreira
- Serviço de Imunologia Básica e Clínica. Departamento de Patologia. Faculdade de Medicina da Universidade do Porto. Centro Hospitalar Universitário de São João. Porto; EPIUnit. Instituto de Saúde Pública. Universidade do Porto. Porto; Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR). Porto. Portugal
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Kappes C, Stein R, Körner A, Merkenschlager A, Kiess W. Stress, Stress Reduction and Obesity in Childhood and Adolescence. Horm Res Paediatr 2023; 96:88-96. [PMID: 34469895 DOI: 10.1159/000519284] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Accepted: 08/11/2021] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Obesity in childhood and adolescence remains a great global health challenge. Stress exposure during childhood and adolescence is associated with a higher risk for obesity, yet the linkage between stress and obesity is multidimensional, and its biological and behavioral mechanisms are still not fully understood. SUMMARY In this literature review, we identified different types of stress exposure in children and adolescents, including first studied effects of the COVID-19 pandemic as a prolonged stress exposure and their association with obesity risk. We investigated studies on the connection of altered stress biology and behavioral pathways as well as intervention programs on stress reduction in children and adolescents with obesity. KEY MESSAGES There is evidence that stress exposure in childhood and adolescence promotes biological and behavioral alterations that contribute to the multifactorial pathogenesis of obesity. COVID-19 related-stress presents the most current example of a negative influence on weight development in children and adolescents. However, longitudinal studies on the linkage between environmental, behavioral, and biological factors across development are few, and results are partly equivocal. Intervention programs to reduce stress in children through mindfulness might be a promising adjunctive tool in the prevention and treatment of childhood and adolescent obesity that could further offer proof of concept of theoretically elaborated cause-and-effect relationships.
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Affiliation(s)
- Claudia Kappes
- University Hospital for Children and Adolescents, Medical Faculty, University of Leipzig, Leipzig, Germany
| | - Robert Stein
- University Hospital for Children and Adolescents, Medical Faculty, University of Leipzig, Leipzig, Germany.,Helmholtz Institute for Metabolic, Obesity and Vascular Research (HI-MAG) of the Helmholtz Zentrum München at the University of Leipzig and University Hospital Leipzig, Leipzig, Germany
| | - Antje Körner
- University Hospital for Children and Adolescents, Medical Faculty, University of Leipzig, Leipzig, Germany
| | - Andreas Merkenschlager
- University Hospital for Children and Adolescents, Medical Faculty, University of Leipzig, Leipzig, Germany
| | - Wieland Kiess
- University Hospital for Children and Adolescents, Medical Faculty, University of Leipzig, Leipzig, Germany
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Effects of Aerobic Exercise on the Serum Leptin Level and Heart Rate Variability in the Obese Girl Children. COMPUTATIONAL INTELLIGENCE AND NEUROSCIENCE 2022; 2022:2298994. [PMID: 35720911 PMCID: PMC9205701 DOI: 10.1155/2022/2298994] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Revised: 05/20/2022] [Accepted: 05/26/2022] [Indexed: 11/17/2022]
Abstract
Objective The present study examined the effects of a 16-week aerobic exercise (AE) on the serum leptin level and heart rate variability (time domain and frequency domain) in the obese girl children and correlation coefficients of changes between the serum leptin level and heart rate variability after a 16-week AE intervention. Methods 36 participants were randomly assigned to either aerobic exercise (AE, n = 18) or obese group (n = 18). The obese girl children in the AE group conducted a 16-week (4 times per week and 60 min per time) exercise protocols, and the obese group did not perform regular physical training during 16 weeks of study. Then, the serum leptin level and HRV (time domain and frequency domain) were measured in all subjects before and after AE intervention. Results (1) After 16-week AE intervention, compared with pre-exercise, LF/HF decreased (P < 0.05), HF, SDNN, and RMSSD significantly increased (P < 0.05 and P < 0.01), and there was no significant difference in LF (P > 0.05) in the AE group. Nevertheless, there was no significant change before and after the test in the serum leptin level and HRV of the obese group (P > 0.05, respectively). (2) After 16-week AE intervention, compared with the obese group, SDNN and HF significantly increased (P < 0.05, respectively), LF/HF significantly decreased (P < 0.05) in the AE group, but there was no significant difference in RMSSD and LF between the obese group and AE group. (3) The reduction variables of the serum leptin level before and after the AE intervention are positively correlated with the reduction in the LF/HF (r = 0.478, P < 0.05) and negatively correlated with the increasing in the RMSSD (r = -0.482, P < 0.05). But there is no significant association between the reduction in the serum leptin level and the change of LF, HF, and SDNN (P > 0.05, respectively). Conclusion 16-week AE significantly reduced the serum leptin level and improved cardiac autonomic function in the obese girl children. Moreover, the reduction in the serum leptin level was associated with the increase in parasympathetic activation and improved sympathetic-vagus balance after AE intervention. More research is needed to see whether the effect of exercise on leptin levels in obese girl children can reduce the risk of cardiovascular disease in adulthood.
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HRV analysis: undependability of approximate entropy at locating optimum complexity in malnourished children. Cardiol Young 2022; 32:425-430. [PMID: 34134801 DOI: 10.1017/s1047951121002316] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
INTRODUCTION Approximate Entropy is an extensively enforced metric to evaluate chaotic responses and irregularities of RR intervals sourced from an eletrocardiogram. However, to estimate their responses, it has one major problem - the accurate determination of tolerances and embedding dimensions. So, we aimed to overt this potential hazard by calculating numerous alternatives to detect their optimality in malnourished children. MATERIALS AND METHODS We evaluated 70 subjects split equally: malnourished children and controls. To estimate autonomic modulation, the heart rate was measured lacking any physical, sensory or pharmacologic stimuli. In the time series attained, Approximate Entropy was computed for tolerance (0.1→0.5 in intervals of 0.1) and embedding dimension (1→5 in intervals of 1) and the statistical significances between the groups by their Cohen's ds and Hedges's gs were totalled. RESULTS The uppermost value of statistical significance accomplished for the effect sizes for any of the combinations was -0.2897 (Cohen's ds) and -0.2865 (Hedges's gs). This was achieved with embedding dimension = 5 and tolerance = 0.3. CONCLUSIONS Approximate Entropy was able to identify a reduction in chaotic response via malnourished children. The best values of embedding dimension and tolerance of the Approximate Entropy to identify malnourished children were, respectively, embedding dimension = 5 and embedding tolerance = 0.3. Nevertheless, Approximate Entropy is still an unreliable mathematical marker to regulate this.
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Cakan P, Yildiz S, Akyay A, Öncül Y. Intensive chemotherapy perturbs heart rate variability in children with cancer. Neurophysiol Clin 2021; 52:69-80. [PMID: 34973888 DOI: 10.1016/j.neucli.2021.11.001] [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: 06/10/2021] [Revised: 11/18/2021] [Accepted: 11/19/2021] [Indexed: 11/26/2022] Open
Abstract
OBJECTIVES In children, cancer chemotherapy may impair the functioning of the cardiac autonomic nervous system. Moreover, it is not known whether there are any differences between intensive and maintenance phases of chemotherapy. Therefore, the aim of the current study was to assess autonomic nervous system activity using heart rate variability, in children receiving intensive or maintenance cancer chemotherapy. METHODS For that purpose, children who were healthy (healthy control, n = 30), receiving intensive chemotherapy (chemotherapy, n = 30), and receiving maintenance chemotherapy (maintenance, n = 25) were included in the study. Autonomic nervous system activity was measured by means of heart rate variability. Electrocardiogram recordings were used to calculate time- and frequency-domain heart rate variability parameters. RESULTS Time-domain parameters such as standard deviation of NN intervals and frequency-domain parameters such as total power were lower during the intensive chemotherapy but not during maintenance phase (standard deviation of NN intervals: 50±5, 33±3, and 48±3 ms, and total power: 2613±504, 1379±296 and 2295±264 ms2, respectively for healthy control, chemotherapy and maintenance groups, P<0.001 for both standard deviation of NN intervals and total power). DISCUSSION The present results indicate that intensive chemotherapy perturbs the function of heart rate variability in children, with recovery during the maintenance phase. This suggests that intensive chemotherapy is likely to affect the autonomic nervous system but this effect does not appear to be permanent.
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Affiliation(s)
- Pinar Cakan
- Department of Physiology, University of Health Sciences, Hamidiye Faculty of Medicine, Istanbul, Turkey.
| | - Sedat Yildiz
- Department of Physiology Inonu University, Faculty of Medicine, Malatya, Turkey
| | - Arzu Akyay
- Department of Pediatric Hematology, Inonu University, Faculty of Medicine, Malatya, Turkey
| | - Yurday Öncül
- Department of Pediatric Hematology, Inonu University, Faculty of Medicine, Malatya, Turkey
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11
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Baum P, Toyka KV, Blüher M, Kosacka J, Nowicki M. Inflammatory Mechanisms in the Pathophysiology of Diabetic Peripheral Neuropathy (DN)-New Aspects. Int J Mol Sci 2021; 22:10835. [PMID: 34639176 PMCID: PMC8509236 DOI: 10.3390/ijms221910835] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Revised: 09/30/2021] [Accepted: 10/04/2021] [Indexed: 12/15/2022] Open
Abstract
The pathogenesis of diabetic neuropathy is complex, and various pathogenic pathways have been proposed. A better understanding of the pathophysiology is warranted for developing novel therapeutic strategies. Here, we summarize recent evidence from experiments using animal models of type 1 and type 2 diabetes showing that low-grade intraneural inflammation is a facet of diabetic neuropathy. Our experimental data suggest that these mild inflammatory processes are a likely common terminal pathway in diabetic neuropathy associated with the degeneration of intraepidermal nerve fibers. In contrast to earlier reports claiming toxic effects of high-iron content, we found the opposite, i.e., nutritional iron deficiency caused low-grade inflammation and fiber degeneration while in normal or high non-heme iron nutrition no or only extremely mild inflammatory signs were identified in nerve tissue. Obesity and dyslipidemia also appear to trigger mild inflammation of peripheral nerves, associated with neuropathy even in the absence of overt diabetes mellitus. Our finding may be the experimental analog of recent observations identifying systemic proinflammatory activity in human sensorimotor diabetic neuropathy. In a rat model of type 1 diabetes, a mild neuropathy with inflammatory components could be induced by insulin treatment causing an abrupt reduction in HbA1c. This is in line with observations in patients with severe diabetes developing a small fiber neuropathy upon treatment-induced rapid HbA1c reduction. If the inflammatory pathogenesis could be further substantiated by data from human tissues and intervention studies, anti-inflammatory compounds with different modes of action may become candidates for the treatment or prevention of diabetic neuropathy.
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Affiliation(s)
- Petra Baum
- Department of Neurology, University of Leipzig, Liebigstraße 20, D-04103 Leipzig, Germany;
| | - Klaus V. Toyka
- Department of Neurology, University of Würzburg, Josef-Schneider-Str. 11, D-97080 Würzburg, Germany;
| | - Matthias Blüher
- Department of Medicine, University of Leipzig, Liebigstraße 20, D-04103 Leipzig, Germany;
| | - Joanna Kosacka
- Department of Visceral, Transplant, Thoracic and Vascular Surgery, University of Leipzig, D-04103 Leipzig, Germany;
| | - Marcin Nowicki
- Institute of Anatomy, University of Leipzig, Liebigstraße 13, D-04103 Leipzig, Germany
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12
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Rudd KL, Alkon A, Abrams B, Bush NR. Infant weight-for-length gain associated with autonomic nervous system reactivity. Pediatr Res 2021; 90:472-478. [PMID: 33203965 PMCID: PMC8126564 DOI: 10.1038/s41390-020-01246-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Revised: 10/07/2020] [Accepted: 10/13/2020] [Indexed: 11/20/2022]
Abstract
BACKGROUND Research suggests that children's health and well-being are supported by core adaptive systems, including the autonomic nervous system (ANS). Despite evidence for the importance of adulthood ANS regulation in the development of disease, few studies have examined how early development may influence emerging ANS function. Therefore, we examined how infant adiposity gain during early infancy related to ANS regulation at 6 months. METHODS Infant weight and length were abstracted from birth records and measured during the 6-month assessment in a low-income, racially/ethnically diverse sample (N = 60). WHO-standardized weight-for-length-gain change was calculated across the first 6 months of life. ANS reactivity was measured as the combined sympathetic (i.e., pre-ejection period) and parasympathetic (i.e., respiratory sinus arrhythmia) nervous system responses during the developmentally challenging Still Face Paradigm (SFP). ANS "classic reactivity" response was characterized by paired sympathetic activation and parasympathetic withdrawal. RESULTS Lower weight-for-length gain in the first 6 months predicted classic reactivity during still face. However, greater weight-for-length gain predicted "classic reactivity" during the reunion, when infants were expected to recover, suggesting autonomic dysregulation. CONCLUSIONS These findings suggest an association between early life adiposity gain and the development of infant ANS regulation. IMPACT Adiposity gain during early infancy was associated with autonomic nervous system regulation at 6 months. This study identifies early adiposity gain (greater than average infant weight-for-length gain) as a risk for ANS dysregulation. This research focuses on a critical developmental period of ANS plasticity. If confirmed, findings can be used to inform early intervention programs targeting obesity prevention and to promote self-regulation.
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Affiliation(s)
- Kristen L. Rudd
- University of California, San Francisco; Department of Psychiatry and Behavioral Sciences; San Francisco, CA
| | - Abbey Alkon
- University of California, San Francisco, Department of Family Health Care Nursing; San Francisco, CA
| | - Barbara Abrams
- University of California, Berkeley, School of Public Health, Division of Epidemiology; Berkeley, CA
| | - Nicole R. Bush
- University of California, San Francisco; Department of Psychiatry and Behavioral Sciences; San Francisco, CA,University of California, San Francisco; Department of Pediatrics; San Francisco, CA
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13
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Jung HW, Kim HY, Kim JY, Cheon JE, Kim IO, Kim SK, Shin CH, Yang SW, Lee YA. Cardiac autonomic dysfunction is associated with hypothalamic damage in patients with childhood-onset craniopharyngioma. PLoS One 2021; 16:e0246789. [PMID: 33591998 PMCID: PMC7886170 DOI: 10.1371/journal.pone.0246789] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2020] [Accepted: 01/26/2021] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Autonomic nervous system dysfunction is implicated in the development of hypothalamic obesity. We investigated the relationship between hypothalamic involvement (HI), central obesity, and cardiac autonomic dysfunction by assessing heart rate variability (HRV) indices in patients with childhood-onset craniopharyngioma. METHODS A cross-sectional study of 48 patients (28 males, 10-30 years old) with hypothalamic damage after childhood-onset craniopharyngioma was performed. Postoperative HI was graded as mild (n = 19) or extensive (n = 29) on magnetic resonance imaging. Anthropometry, body composition and HRV indices including the standard deviation of all normal R-R intervals (SDNN) and total power (TP) as overall variability markers, root-mean square differences of successive R-R intervals (RMSSD) and high frequency (HF) as parasympathetic modulation markers, and low frequency (LF) as a sympathetic/sympathovagal modulation marker were measured. RESULTS Patients with extensive HI had increased means of body mass index, waist circumference, and fat mass than those with mild HI (P < 0.05, for all). Centrally obese patients had a lower mean HF, a parasympathetic modulation marker, than centrally non-obese patients (P < 0.05). The extensive HI group had lower means of overall variability (SDNN and TP), parasympathetic modulation (HF), and sympathetic/sympathovagal modulation (LF) than the mild HI group (P < 0.05, for all). The interaction effect of HI and central obesity on HRV indices was not significant. In models adjusted for age, sex, and family history of cardiometabolic disease, the means of the overall variability indices (P < 0.05 for both SDNN and TP) and a sympathetic/sympathovagal modulation index (P < 0.05 for LF) were lower with extensive HI, without differences according to central obesity. CONCLUSIONS The reduced HRV indices with extensive HI suggests that hypothalamic damage may contribute to cardiac autonomic dysfunction, underscoring the importance of minimizing hypothalamic damage in patients with childhood-onset craniopharyngioma.
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Affiliation(s)
- Hae Woon Jung
- Department of Pediatrics, Kyung Hee University Medical Center, Seoul, Republic of Korea
| | - Hwa Young Kim
- Department of Pediatrics, Seoul National University Children’s Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Ji Young Kim
- Department of Pediatrics, Seoul National University Children’s Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Jung-Eun Cheon
- Department of Radiology, Seoul National University Children’s Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - In-One Kim
- Department of Radiology, Seoul National University Children’s Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Seung-Ki Kim
- Department of Neurosurgery, Seoul National University Children’s Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Choong Ho Shin
- Department of Pediatrics, Seoul National University Children’s Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Sei Won Yang
- Department of Pediatrics, Seoul National University Children’s Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Young Ah Lee
- Department of Pediatrics, Seoul National University Children’s Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea
- * E-mail:
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14
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Magalhães BC, Soares Júnior NDJS, Dias Filho CAA, Andrade RM, Dias CJM, de Oliveira SDFA, Santana LSOS, Sena CDS, Monzani-Brito JDO, Ferreira AC, Mostarda CT. Effect of obesity on sleep quality, anthropometric and autonomic parameters in adolescent. SLEEP SCIENCE (SAO PAULO, BRAZIL) 2021; 13:298-303. [PMID: 33564377 PMCID: PMC7856663 DOI: 10.5935/1984-0063.20200037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Objective To compare the effects of obesity on sleep quality, the anthropometric and autonomic parameters of adolescents. Material and Methods A cross-sectional study was carried out with adolescents aged 11 to 18, analyzing parameters such as BMI, sleep quality records, waist circumference, fat percentage, blood pressure and sexual maturation, in addition to autonomic cardiac function through the analysis of heart rate variability. Results The anthropometric parameters of waist circumference, percentage fat mass, were significantly higher in the group of obese adolescents. Sympathetic modulation in LF% was significantly higher in obesity. Parasympathetic modulation in HF% was significantly lower in obese than in eutrophic. Conclusion Obese adolescents do not have poor sleep quality; there is no distinction between boys and girls regarding the analyzed variables; however, obesity alone was responsible for negatively influencing anthropometric parameters, as well as impairing the autonomic cardiac modulation.
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Affiliation(s)
- Bruna Cruz Magalhães
- Federal University of Maranhão, Department of Nutrition - São Luís - Maranhão - Brazil
| | | | - Carlos Alberto Alves Dias Filho
- Federal University of Maranhão, Laboratory of Cardiovascular Adaptations to Exercise (LACORE) - São Luís - Maranhão - Brazil
| | - Rafael Martins Andrade
- Federal University of Maranhão, Laboratory of Cardiovascular Adaptations to Exercise (LACORE) - São Luís - Maranhão - Brazil
| | - Carlos José Moraes Dias
- Federal University of Maranhão, Physical Education Department - São Luís - Maranhão - Brazil
| | | | | | - Carlan da Silva Sena
- Federal University of Maranhão, Laboratory of Cardiovascular Adaptations to Exercise (LACORE) - São Luís - Maranhão - Brazil
| | | | - Andressa Coelho Ferreira
- Federal University of Maranhão, Laboratory of Cardiovascular Adaptations to Exercise (LACORE) - São Luís - Maranhão - Brazil
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15
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Brasil I, Monteiro W, Lima T, Seabra A, Farinatti P. Effects of judo training upon body composition, autonomic function, and cardiorespiratory fitness in overweight or obese children aged 8- to 13 years. J Sports Sci 2020; 38:2508-2516. [PMID: 32646282 DOI: 10.1080/02640414.2020.1792189] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Physical training is recommended for obese paediatric populations. We investigated the effects of recreational judo training (JT) upon body composition and distribution, cardiorespiratory fitness, and heart rate variability (HRV) in overweight or obese children. A controlled trial (RBR-9d94td) was conducted with 35 children (8-13 years) assigned into groups according to their body mass index (BMI): eutrophic (EU; n = 15; z-BMI ≤ +l and ≥ -2) and overweight or obese (OB; n = 20; z-BMI > +1 and ≤ +3). The 12-week JT included 60-min sessions performed 2 times/week at 65-75% maximal heart rate (HR). BMI, waist circumference, blood pressure, HRV, peak oxygen uptake (VO2peak), gas exchange threshold (GET), and body fractioning were assessed. Significant reductions in OB (P < 0.05) occurred for whole body and trunk fat (~3%), trunk/limb fat-ratio (~4%), resting HR (~3%), and sympathovagal balance (log LF:HF, ~85%). Increases (P < 0.05) occurred in lean mass (~8%), parasympathetic modulation (log HF, ~4%), VO2peak (~5-10%), and VO2 (~15%), speed (~10%) and slope (~13%) at GET. Markers of cardiorespiratory fitness (relative VO2, slope and speed at GET) in OB approached EU after JT. In conclusion, a relatively short JT intervention to improved body composition, autonomic modulation, and physical fitness in obese children.
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Affiliation(s)
- Iedda Brasil
- Laboratory of Physical Activity and Health Promotion, University of Rio de Janeiro State , Rio de Janeiro, Brazil.,Graduate Program in Exercise Science and Sports, University of Rio de Janeiro State , Rio de Janeiro, Brazil
| | - Walace Monteiro
- Laboratory of Physical Activity and Health Promotion, University of Rio de Janeiro State , Rio de Janeiro, Brazil.,Graduate Program in Exercise Science and Sports, University of Rio de Janeiro State , Rio de Janeiro, Brazil.,Graduate Program in Physical Activity Sciences, Salgado de Oliveira University , Niterói, Brazil
| | - Tainah Lima
- Laboratory of Physical Activity and Health Promotion, University of Rio de Janeiro State , Rio de Janeiro, Brazil
| | - André Seabra
- Research Centre in Physical Activity, Health and Leisure, Faculty of Sport, University of Porto , Porto, Portugal
| | - Paulo Farinatti
- Laboratory of Physical Activity and Health Promotion, University of Rio de Janeiro State , Rio de Janeiro, Brazil.,Graduate Program in Exercise Science and Sports, University of Rio de Janeiro State , Rio de Janeiro, Brazil.,Graduate Program in Physical Activity Sciences, Salgado de Oliveira University , Niterói, Brazil
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16
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Parsanathan R, Jain SK. Novel Invasive and Noninvasive Cardiac-Specific Biomarkers in Obesity and Cardiovascular Diseases. Metab Syndr Relat Disord 2020; 18:10-30. [PMID: 31618136 PMCID: PMC7041332 DOI: 10.1089/met.2019.0073] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Cardiovascular disease (CVD) is the leading cause of fatality and disability worldwide regardless of gender. Obesity has reached epidemic proportions in population across different regions. According to epidemiological studies, CVD risk markers in childhood obesity are one of the significant risk factors for adulthood CVD, but have received disproportionally little attention. This review has examined the evidence for the presence of traditional cardiac biomarkers (nonspecific; lactate dehydrogenase, alanine aminotransferase, aspartate aminotransferase, creatine kinase, myoglobulin, glycogen phosphorylase isoenzyme BB, myosin light chains, ST2, and ischemia-modified albumin) and novel emerging cardiac-specific biomarkers (cardiac troponins, natriuretic peptides, heart-type fatty acid-binding protein, and miRNAs). Besides, noninvasive anatomical and electrophysiological markers (carotid intima-media thickness, coronary artery calcification, and heart rate variability) in CVDs and obesity are also discussed. Modifiable and nonmodifiable risk factors associated with metabolic syndrome in the progression of CVD, such as obesity, diabetes, hypertension, dyslipidemia, oxidative stress, inflammation, and adipocytokines are also outlined. These underlying prognostic risk factors predict the onset of future microvascular and macrovascular complications. The understanding of invasive and noninvasive cardiac-specific biomarkers and the risk factors may yield valuable insights into the pathophysiology and prevention of CVD in a high-risk obese population at an early stage.
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Affiliation(s)
- Rajesh Parsanathan
- Department of Pediatrics and Center for Cardiovascular Diseases and Sciences, Louisiana State University Health Sciences Center-Shreveport, Shreveport, Louisiana
| | - Sushil K. Jain
- Department of Pediatrics and Center for Cardiovascular Diseases and Sciences, Louisiana State University Health Sciences Center-Shreveport, Shreveport, Louisiana
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17
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Redón P, Grassi G, Redon J, Álvarez-Pitti J, Lurbe E. Identifying poor cardiorespiratory fitness in overweight and obese children and adolescents by using heart rate variability analysis under resting conditions. Blood Press 2019; 29:13-20. [PMID: 31829032 DOI: 10.1080/08037051.2019.1700777] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Background: Childhood obesity, including overweight, continues increasing worldwide affecting health expectancy, quality of life and healthcare expenditure. These subjects have higher probability of suffering or developing cardio metabolic risk factors. Recent studies have revealed cardiorespiratory fitness (CRF) as a valuable clinical parameter to identify these subjects and have even suggested cut-off values. However, evaluating CRF in overweight and obese youth can be difficult to implement, unfriendly and expensive.Objective: Develop a screening tool to identify high-risk subjects in a representative population of those attending overweight/obesity assessment programmes without prior intervention. It will be based on heart rate variability parameters, which has strong association with CRF and cardio metabolic risk factors.Methods: Sixty-three subjects, overweight and obese, between 9 and 17 years of age, and of both sexes were enrolled. None of them had secondary obesity syndromes and/or suffered from acute or chronic disease. Anthropometric parameters, electrocardiogram signal recording under resting conditions and cardiorespiratory fitness - evaluated by oxygen consumption and time elapsed of cardiopulmonary exercise test - were measured.Results: Significant differences in the sympathetic nervous system activity - assessed by heart rate variability analysis - are observed when grouping by overweight and obesity degree as well as by CRF (poor/normal). Body mass index, puberty and sympathetic nervous system activity are the significant variables of a logistic regression model develop to identify poor CRF individuals. Its accuracy reaches 92%.Conclusions: A screening tool based on heart rate variability and anthropometric parameters was developed to identify subjects with higher probability of suffering or developing cardio metabolic risk factors.
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Affiliation(s)
- Pau Redón
- Pediatric Department, Consorcio Hospital General, University of Valencia, Valencia, Spain.,CIBER Fisiopatología Obesidad y Nutrición (CB06/03), Instituto de Salud Carlos III, Madrid, Spain
| | - Guido Grassi
- Clinica Medica, Department of Medicine and Surgery, Universitá Milano-Bicocca and IRCCS Multimedica, Milano, Italy
| | - Josep Redon
- CIBER Fisiopatología Obesidad y Nutrición (CB06/03), Instituto de Salud Carlos III, Madrid, Spain.,INCLIVA Research Institute, Valencia, Spain.,Hypertension Clinic, Department of Internal Medicine, Hospital Clínico de Valencia University of Valencia, Valencia, Spain
| | - Julio Álvarez-Pitti
- Pediatric Department, Consorcio Hospital General, University of Valencia, Valencia, Spain.,CIBER Fisiopatología Obesidad y Nutrición (CB06/03), Instituto de Salud Carlos III, Madrid, Spain
| | - Empar Lurbe
- Pediatric Department, Consorcio Hospital General, University of Valencia, Valencia, Spain.,CIBER Fisiopatología Obesidad y Nutrición (CB06/03), Instituto de Salud Carlos III, Madrid, Spain
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18
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Williams SM, Eleftheriadou A, Alam U, Cuthbertson DJ, Wilding JPH. Cardiac Autonomic Neuropathy in Obesity, the Metabolic Syndrome and Prediabetes: A Narrative Review. Diabetes Ther 2019; 10:1995-2021. [PMID: 31552598 PMCID: PMC6848658 DOI: 10.1007/s13300-019-00693-0] [Citation(s) in RCA: 54] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2019] [Indexed: 12/19/2022] Open
Abstract
Cardiac autonomic neuropathy (CAN) is a major complication of type 1 and type 2 diabetes mellitus (T1DM and T2DM). The increased morbidity, cardiovascular and all-cause mortality associated with CAN is established from numerous epidemiological studies. However, CAN is increasingly recognised in people with prediabetes (pre-DM) and the metabolic syndrome (MetS) with a reported prevalence up to 11% and 24% respectively. CAN is associated with components of MetS including hypertension and obesity, predating hyperglycaemia. The aetiology of CAN is multifactorial and there is a reciprocal relationship with insulin resistance and MetS. Obstructive sleep apnoea (OSA) is also associated with CAN possibly through MetS and an independent mechanism. An estimated global prevalence of the impaired glucose tolerance (IGT) form of pre-DM of 587 million people by 2045 means CAN will become a major clinical problem. CAN is independently associated with silent myocardial ischaemia, major cardiovascular events, myocardial dysfunction and cardiovascular mortality. Screening for CAN in pre-DM using risk scores with analysis of heart rate variability (HRV) or Sudoscan is important to allow earlier treatment at a reversible stage. The link between obesity and CAN highlights the therapeutic potential of lifestyle interventions including diet and physical activity to reverse MetS and prevent CAN. Weight loss achieved using these dietary and exercise lifestyle interventions improves the sympathetic and parasympathetic HRV indices of cardiac autonomic function. Further research is needed to identify high-risk populations of people with pre-DM or obesity that might benefit from targeted pharmacotherapy including metformin, sodium/glucose cotransporter 2 (SGLT2) inhibitors and glucagon-like peptide 1 (GLP-1) analogues. Bariatric surgery also improves HRV through weight loss which might also prevent CAN in severe obesity. This article reviews the literature on CAN in obesity, pre-DM and MetS, to help determine a rationale for screening, early intervention treatment and formulate future research questions in this highly prevalent condition.
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Affiliation(s)
| | | | - Uazman Alam
- Diabetes and Neuropathy Research, Department of Eye and Vision Sciences and Pain Research Institute, Institute of Ageing and Chronic Disease, University of Liverpool and Aintree University Hospital NHS Foundation Trust, Liverpool, UK
- Royal Liverpool and Broadgreen University NHS Hospital Trust, Liverpool, UK
- Division of Endocrinology, Diabetes and Gastroenterology, University of Manchester, Manchester, UK
| | - Daniel J Cuthbertson
- Obesity and Endocrinology Research, Institute of Ageing and Chronic Disease, Faculty of Health and Life Sciences, University of Liverpool, Liverpool, UK
| | - John P H Wilding
- Obesity and Endocrinology Research, Institute of Ageing and Chronic Disease, Faculty of Health and Life Sciences, University of Liverpool, Liverpool, UK
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19
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Ladeiras-Lopes R, Bucciarelli-Ducci C. Dysfunctional Postprandial Flow Changes, Adverse Cardiac Remodeling, and Hypertension: Follow Your Heart but Trust Your Gut? Circ Cardiovasc Imaging 2019; 12:e009981. [PMID: 31707791 DOI: 10.1161/circimaging.119.009981] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Ricardo Ladeiras-Lopes
- Cardiology Department, Gaia Hospital Centre, Vila Nova de Gaia, Portugal (R.L.-L.).,Cardiovascular Research Centre, Faculty of Medicine, University of Porto, Portugal (R.L.-L.).,Bristol Heart Institute, Bristol National Institute of Health Research (NIHR) Biomedical Research Centre, University Hospitals Bristol NHS Trust and University of Bristol, Bristol, United Kingdom (R.L.-L., C.B.-D.)
| | - Chiara Bucciarelli-Ducci
- Bristol Heart Institute, Bristol National Institute of Health Research (NIHR) Biomedical Research Centre, University Hospitals Bristol NHS Trust and University of Bristol, Bristol, United Kingdom (R.L.-L., C.B.-D.)
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20
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Complexity of Cardiac Autonomic Modulation in Diabetes Mellitus: A New Technique to Perceive Autonomic Dysfunction. ROMANIAN JOURNAL OF DIABETES NUTRITION AND METABOLIC DISEASES 2019. [DOI: 10.2478/rjdnmd-2019-0029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Abstract
Backgound and aims. In this study we analyzed heart rate variability (HRV) via chaotic global techniques so as to discriminate diabetics from control subjects. Matherial and method. Chaotic global analysis of the RR-intervals from the electrocardiogram and preprocessing adjustments were undertaken. The effect of varying two parameters to adjust the Multi-Taper Method (MTM) power spectrum were evaluated. Then, cubic spline interpolations from 1Hz to 13Hz were applied whilst the spectral parameters were fixed. Precisely 1000 RR-intervals of data were recorded. Results. CFP1 and CFP3 are the only significant combinations of chaotic globals when the default standard conditions are enforced. MTM spectral adjustments and cubic spline interpolation are trivial at effecting the outcome between the two datasets. The most influencial constraint on the outcome is data length. Conclusion. Chaotic global analysis was offered as a reliable, low-cost and robust technique to detect autonomic dysfunction in subjects with diabetes mellitus.
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21
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Doom JR, Lumeng JC, Sturza J, Kaciroti N, Vazquez DM, Miller AL. Longitudinal associations between overweight/obesity and stress biology in low-income children. Int J Obes (Lond) 2019; 44:646-655. [PMID: 31477784 PMCID: PMC7050333 DOI: 10.1038/s41366-019-0447-4] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2019] [Revised: 07/01/2019] [Accepted: 07/22/2019] [Indexed: 01/22/2023]
Abstract
Background/Objectives Associations between overweight and altered stress biology have been reported cross-sectionally during childhood, but it is unclear whether overweight precedes altered stress biology or if altered stress biology predicts greater likelihood of overweight over time. The current longitudinal study investigates associations between overweight/obesity, salivary alpha amylase and cortisol morning intercept, diurnal slope, and reactivity to social stress in a cohort of low-income children during preschool and middle childhood. Subjects/Methods Children were recruited through Head Start and were observed and followed into middle childhood (N = 257; M = 8.0 years). Height and weight were measured at both time points. Saliva samples were collected across the day and in response to a social challenge at both ages for alpha amylase and cortisol determination. Results Cross-lagged panel analyses indicated that overweight/obesity at preschool predicted lower morning alpha amylase (β = −0.18, 95% CI: −0.34, −0.03; p = .023), lower morning cortisol (β = −0.22, 95% CI: −0.38, −0.06; p = .006), lower sAA diurnal slope (β = −0.18, 95% CI: −0.34, −0.03; p = .021), and lower cortisol stress reactivity (β = −0.19, 95% CI: −0.35, −0.02; p = .031) in middle childhood. Lower alpha amylase reactivity at preschool was the only biological factor that predicted higher likelihood of overweight/obesity at middle childhood (β = −0.20, 95% CI: −0.38, −0.01; p = .035). Conclusions These findings suggest that overweight/obesity may be driving changes in stress biology across early to middle childhood, particularly in down-regulation of morning levels of stress hormones, diurnal sAA slope, and cortisol reactivity to stress, rather than stress biology driving overweight/obesity.
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Affiliation(s)
- Jenalee R Doom
- Department of Psychology, University of Denver, Denver, CO, USA. .,Department of Pediatrics, University of Michigan Medical School, Ann Arbor, MI, USA. .,Center for Human Growth & Development, University of Michigan, Ann Arbor, MI, USA.
| | - Julie C Lumeng
- Department of Pediatrics, University of Michigan Medical School, Ann Arbor, MI, USA.,Center for Human Growth & Development, University of Michigan, Ann Arbor, MI, USA.,Department of Nutritional Sciences, University of Michigan School of Public Health, Ann Arbor, MI, USA
| | - Julie Sturza
- Department of Pediatrics, University of Michigan Medical School, Ann Arbor, MI, USA.,Center for Human Growth & Development, University of Michigan, Ann Arbor, MI, USA
| | - Niko Kaciroti
- Center for Human Growth & Development, University of Michigan, Ann Arbor, MI, USA.,Department of Biostatistics, University of Michigan School of Public Health, Ann Arbor, MI, USA
| | - Delia M Vazquez
- Department of Pediatrics, University of Michigan Medical School, Ann Arbor, MI, USA.,Center for Human Growth & Development, University of Michigan, Ann Arbor, MI, USA
| | - Alison L Miller
- Center for Human Growth & Development, University of Michigan, Ann Arbor, MI, USA.,Department of Health Behavior and Health Education, University of Michigan School of Public Health, Ann Arbor, MI, USA
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22
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Rastović M, Srdić-Galić B, Barak O, Stokić E, Polovina S. AGING, HEART RATE VARIABILITY AND METABOLIC IMPACT OF OBESITY. Acta Clin Croat 2019; 58:430-438. [PMID: 31969754 PMCID: PMC6971797 DOI: 10.20471/acc.2019.58.03.05] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
The relationship between aging and changes in heart rate variability (HRV) could depend on the metabolic profile of obese people, i.e. metabolically healthy obese (MHO) and metabolically unhealthy obese (MUO). We aimed to determine the age at which obesity related autonomic dysfunction becomes significant and whether it decreases differently according to metabolic profile. We analyzed HRV in 99 adults using Wildman's criteria for metabolic profile and 5-minute HRV for autonomic nervous system. In MHO, high frequency (HF) decreased in the 4th decade of life. In MUO, standard deviation of R-R intervals (SDNN), root mean square of successive differences of all R-R intervals (RMSSD), number of adjacent intervals differing by more than 50 ms expressed as percentage of all intervals in the collecting period (pNN50), HF, low frequency (LF), LF/HF (LF divided by HF) and total power (TP) decreased in the 4th decade of life (partial shared variance 28%-36%). In conclusion, an age dependent decrease of HRV occurs in MUO between the third and fifth decade of life. In MHO, HF significantly decreases around the age of 40 years. Cardiometabolic profile influences metabolic aging, altering the autonomic nervous system.
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Affiliation(s)
| | - Biljana Srdić-Galić
- 1Subotica General Hospital, Department of Internal Medicine, Division of Endocrinology, Subotica, Serbia; 2University of Novi Sad, Faculty of Medicine, Department of Anatomy, Novi Sad, Serbia; 3University of Novi Sad, Faculty of Medicine, Department of Physiology, Novi Sad, Serbia; 4University of Novi Sad, Faculty of Medicine, Institute of Internal Disease, Department of Endocrinology, Diabetes and Metabolic Disorders, Novi Sad, Serbia; 5Clinical Center of Serbia, Department of Endocrinology, Diabetes and Metabolic Diseases, Belgrade, Serbia; 6University of Novi Sad, Faculty of Pharmacy, Department of Internal Medicine, Novi Sad, Serbia
| | - Otto Barak
- 1Subotica General Hospital, Department of Internal Medicine, Division of Endocrinology, Subotica, Serbia; 2University of Novi Sad, Faculty of Medicine, Department of Anatomy, Novi Sad, Serbia; 3University of Novi Sad, Faculty of Medicine, Department of Physiology, Novi Sad, Serbia; 4University of Novi Sad, Faculty of Medicine, Institute of Internal Disease, Department of Endocrinology, Diabetes and Metabolic Disorders, Novi Sad, Serbia; 5Clinical Center of Serbia, Department of Endocrinology, Diabetes and Metabolic Diseases, Belgrade, Serbia; 6University of Novi Sad, Faculty of Pharmacy, Department of Internal Medicine, Novi Sad, Serbia
| | - Edita Stokić
- 1Subotica General Hospital, Department of Internal Medicine, Division of Endocrinology, Subotica, Serbia; 2University of Novi Sad, Faculty of Medicine, Department of Anatomy, Novi Sad, Serbia; 3University of Novi Sad, Faculty of Medicine, Department of Physiology, Novi Sad, Serbia; 4University of Novi Sad, Faculty of Medicine, Institute of Internal Disease, Department of Endocrinology, Diabetes and Metabolic Disorders, Novi Sad, Serbia; 5Clinical Center of Serbia, Department of Endocrinology, Diabetes and Metabolic Diseases, Belgrade, Serbia; 6University of Novi Sad, Faculty of Pharmacy, Department of Internal Medicine, Novi Sad, Serbia
| | - Snežana Polovina
- 1Subotica General Hospital, Department of Internal Medicine, Division of Endocrinology, Subotica, Serbia; 2University of Novi Sad, Faculty of Medicine, Department of Anatomy, Novi Sad, Serbia; 3University of Novi Sad, Faculty of Medicine, Department of Physiology, Novi Sad, Serbia; 4University of Novi Sad, Faculty of Medicine, Institute of Internal Disease, Department of Endocrinology, Diabetes and Metabolic Disorders, Novi Sad, Serbia; 5Clinical Center of Serbia, Department of Endocrinology, Diabetes and Metabolic Diseases, Belgrade, Serbia; 6University of Novi Sad, Faculty of Pharmacy, Department of Internal Medicine, Novi Sad, Serbia
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23
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Non-linear regulation of cardiac autonomic modulation in obese youths: interpolation of ultra-short time series. Cardiol Young 2019; 29:1196-1201. [PMID: 31451125 DOI: 10.1017/s1047951119001951] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
BACKGROUND In this study, we applied ultra-short time series of interbeat intervals (RR-intervals) to evaluate heart rate variability through default chaotic global techniques with the purpose of discriminating obese youths from non-obese youth patients. METHOD Chaotic global analysis of the RR-intervals from the electrocardiogram and pre-processing adjustments was undertaken. The effect of cubic spline interpolations was assessed, while the spectral parameters remained fixed. Exactly, 125 RR-intervals of data were recorded. RESULTS CFP1, CFP3, and CFP6 were the only significant combinations of chaotic globals when the standard conditions were enforced and at the level p<0.01 (or <1%). These significances were acheived via Kruskal-Wallis and Cohen's ds effects sizes tests of significance after Anderson-Darling and Lilliefors statistical tests indicated non-normal distributions in the majority of cases. Adjustments of the cubic spline interpolation from 1 to 13 Hz were revealed to be inconsequential when measured by Kruskal-Wallis and Cohen's ds, regarding the outcome between the two datasets. CONCLUSION Chaotic global analysis was offered as a robust technique to distinguish autonomic dysfunction in obese youths. It can discriminate the two different groups using ultra-short data lengths, and no cubic spline interpolations need be applied.
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24
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Plaza-Florido A, Migueles JH, Mora-Gonzalez J, Molina-Garcia P, Rodriguez-Ayllon M, Cadenas-Sanchez C, Esteban-Cornejo I, Navarrete S, Maria Lozano R, Michels N, Sacha J, Ortega FB. The Role of Heart Rate on the Associations Between Body Composition and Heart Rate Variability in Children With Overweight/Obesity: The ActiveBrains Project. Front Physiol 2019; 10:895. [PMID: 31379602 PMCID: PMC6646801 DOI: 10.3389/fphys.2019.00895] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2019] [Accepted: 06/27/2019] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND Heart rate variability (HRV) is negatively associated with body mass index and adiposity in several populations. However, less information is available about this association in children with overweight and obesity, especially severe/morbid obesity, taking into consideration the dependence of HRV on heart rate (HR). OBJECTIVES (1) to examine associations between body composition measures and HRV, (2) to study differences in HRV between children with overweight and severe/morbid obesity; and (3) to test whether relationships and differences tested in objectives 1 and 2, respectively are explained by the dependency of HRV on HR. METHODS A total of 107 children with overweight/obesity (58% boys, 10.03 ± 1.13 years) participated in this study. Body composition measures were evaluated by Dual-energy X-ray absorptiometry (DXA). HRV parameters were measured with Polar RS800CX®. RESULTS Body composition measures were negatively associated with HRV indicators of parasympathetic activity (β values ranging from -0.207 to -0.307, all p < 0.05). Children with severe/morbid obesity presented lower HRV values with respect to children with overweight/mild obesity in HRV parameters indicators of parasympathetic activity (p = 0.035). All associations disappeared after further adjustment for HR (all p > 0.05). CONCLUSION All associations between adiposity/obesity and HRV could be explained by HR, suggesting a key confounding role of HR in HRV studies in children with weight disturbances.
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Affiliation(s)
- Abel Plaza-Florido
- PROFITH “PROmoting FITness and Health Through Physical Activity” Research Group, Sport and Health University Research Institute (iMUDS), Department of Physical and Sports Education, Faculty of Sport Sciences, University of Granada, Granada, Spain
| | - Jairo H. Migueles
- PROFITH “PROmoting FITness and Health Through Physical Activity” Research Group, Sport and Health University Research Institute (iMUDS), Department of Physical and Sports Education, Faculty of Sport Sciences, University of Granada, Granada, Spain
| | - Jose Mora-Gonzalez
- PROFITH “PROmoting FITness and Health Through Physical Activity” Research Group, Sport and Health University Research Institute (iMUDS), Department of Physical and Sports Education, Faculty of Sport Sciences, University of Granada, Granada, Spain
| | - Pablo Molina-Garcia
- PROFITH “PROmoting FITness and Health Through Physical Activity” Research Group, Sport and Health University Research Institute (iMUDS), Department of Physical and Sports Education, Faculty of Sport Sciences, University of Granada, Granada, Spain
- Department of Rehabilitation Sciences, KU Leuven, Leuven, Belgium
| | - Maria Rodriguez-Ayllon
- PROFITH “PROmoting FITness and Health Through Physical Activity” Research Group, Sport and Health University Research Institute (iMUDS), Department of Physical and Sports Education, Faculty of Sport Sciences, University of Granada, Granada, Spain
| | - Cristina Cadenas-Sanchez
- PROFITH “PROmoting FITness and Health Through Physical Activity” Research Group, Sport and Health University Research Institute (iMUDS), Department of Physical and Sports Education, Faculty of Sport Sciences, University of Granada, Granada, Spain
| | - Irene Esteban-Cornejo
- PROFITH “PROmoting FITness and Health Through Physical Activity” Research Group, Sport and Health University Research Institute (iMUDS), Department of Physical and Sports Education, Faculty of Sport Sciences, University of Granada, Granada, Spain
- Center for Cognitive and Brain Health, Department of Psychology, Northeastern University, Boston, MA, United States
| | - Socorro Navarrete
- Andalusian Centre of Sport Medicine (CAMD), Junta de Andalucía, Granada, Spain
| | - Rosa Maria Lozano
- Andalusian Centre of Sport Medicine (CAMD), Junta de Andalucía, Granada, Spain
| | - Nathalie Michels
- Department of Public Health, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Jerzy Sacha
- Faculty of Physical Education and Physiotherapy, Opole University of Technology, Opole, Poland
- Department of Cardiology, University Hospital, University of Opole, Opole, Poland
| | - Francisco B. Ortega
- PROFITH “PROmoting FITness and Health Through Physical Activity” Research Group, Sport and Health University Research Institute (iMUDS), Department of Physical and Sports Education, Faculty of Sport Sciences, University of Granada, Granada, Spain
- Department of Biosciences and Nutrition, Karolinska Institutet, Huddinge, Sweden
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25
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Night-time cardiac autonomic modulation as a function of sleep-wake stages is modified in otherwise healthy overweight adolescents. Sleep Med 2019; 64:30-36. [PMID: 31655323 DOI: 10.1016/j.sleep.2019.06.008] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2018] [Revised: 05/31/2019] [Accepted: 06/01/2019] [Indexed: 11/20/2022]
Abstract
OBJECTIVE Even though sympathetic dominance during the daytime period is well known, currently, scarce data exist on autonomic nervous system (ANS) regulation during sleep in pediatric obesity. We aimed to evaluate sleep cardiac ANS regulation in normal-weight (NW) and overweight and obese (OW) adolescents. PATIENTS/METHODS In this study, 60 healthy adolescents (15.7 ± 0.7 years) belonging to a birth cohort since infancy were classified based on body mass index percentiles criteria as: OW (N = 27) or NW (N = 33). Sleep was evaluated by polysomnography (PSG) during two consecutive in-lab overnight sessions. Non-rapid eye movement (non-REM) sleep stages (stages 1, 2, and slow-wave sleep [SWS]), rapid eye movement (REM) sleep, and wakefulness (Wake) were scored. R-waves were detected automatically in the electrocardiographic (ECG) signal. An all-night heart rate variability analysis was conducted in the ECG signal, with several time- and frequency-domain measures calculated for each sleep-wake stage. Sleep time was divided into thirds (T1, T2, T3). The analysis was performed using a mixed-effects linear regression model. RESULTS Sleep organization was comparable except for reduced REM sleep percentage in the OW group (p < 0.04). Shorter R-R intervals were found for all sleep stages in the OW group; time-domain measured standard deviation of all R-R intervals (RRSD) was lower during stage 2, SWS and REM sleep (all p < 0.05). The square root of the mean of the sum of the squares of differences between adjacent R-R intervals (RMSSD) was also lower only during wake after sleep onset (WASO) in T1 and T3 (p < 0.05). The OW group had increased very low- and low-frequency (LF) power during WASO (in T1 and T2), and LF power during stage 2 and REM sleep (in T2). During WASO in the OW group, high-frequency (HF) power was lower (in T1 and T2), and LF/HF ratio was higher (in T2, p < 0.007). CONCLUSIONS Several sleep-stage-dependent changes in cardiac autonomic regulation characterized the OW group. As sleep-related ANS balance was disturbed in the absence of concomitant metabolic alterations in this sample of otherwise healthy OW adolescents, their relevance for pediatric obesity should be further explored throughout development.
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26
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Plaza-Florido A, Migueles JH, Mora-Gonzalez J, Molina-Garcia P, Rodriguez-Ayllon M, Cadenas-Sanchez C, Esteban-Cornejo I, Solis-Urra P, de Teresa C, Gutiérrez Á, Michels N, Sacha J, Ortega FB. Heart Rate Is a Better Predictor of Cardiorespiratory Fitness Than Heart Rate Variability in Overweight/Obese Children: The ActiveBrains Project. Front Physiol 2019; 10:510. [PMID: 31133870 PMCID: PMC6514130 DOI: 10.3389/fphys.2019.00510] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2018] [Accepted: 04/11/2019] [Indexed: 01/01/2023] Open
Abstract
Cardiac autonomic function can be quantified through mean heart rate (HR) or heart rate variability (HRV). Numerous studies have supported the utility of different HRV parameters as indicators of cardiorespiratory fitness (CRF). However, HR has recently shown to be a stronger predictor of CRF than HRV in healthy young adults, yet these findings need to be replicated, in other age groups such as children. Therefore, this study aimed: (1) to study the associations between indicators of cardiac autonomic function (HR, standard and corrected HRV parameters) and CRF in overweight/obese children; and (2) to test which of the two indicators (i.e., HR or HRV) is a stronger predictor of CRF. This study used cross-sectional baseline data of 107 overweight/obese children (10.03 ± 1.13 years, 58% boys) from the ActiveBrains project. Cardiac autonomic indicators were measured with Polar RS800CX®. CRF was assessed using a gas analyzer while performing a maximal incremental treadmill test. Correlations and stepwise linear regressions were performed. Mean HR and standard HRV parameters (i.e., pNN50, RMSSD, and SDNN) were associated with CRF (r coefficients ranging from -0.333 to 0.268; all p ≤ 0.05). The association of HR with CRF persisted after adjusting for sex, peak height velocity (PHV), adiposity moderate-to-vigorous physical activity, energy intake and circadian-related variable intradaily variability of activity patterns whilst for HRV parameters (i.e., pNN50, RMSSD, and SDNN) disappeared. Stepwise linear regression models entering HR and all HRV parameters showed that mean HR was the strongest predictor of CRF (β = -0.333, R 2 = 0.111, p < 0.001). Standard and corrected HRV parameters did not provide additional value to the coefficient of determination (all p > 0.05). Our findings suggest that HR is the strongest indicator of CRF. It seems that quantification of HRV parameters in time and frequency domain do not add relevant clinical information about the cardiovascular health status (as measured by CRF) in overweight/obese children beyond the information already provided by the simple measure of HR.
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Affiliation(s)
- Abel Plaza-Florido
- PROFITH “PROmoting FITness and Health Through Physical Activity” Research Group, Department of Physical and Sports Education, Faculty of Sport Sciences, University of Granada, Granada, Spain
| | - Jairo H. Migueles
- PROFITH “PROmoting FITness and Health Through Physical Activity” Research Group, Department of Physical and Sports Education, Faculty of Sport Sciences, University of Granada, Granada, Spain
| | - Jose Mora-Gonzalez
- PROFITH “PROmoting FITness and Health Through Physical Activity” Research Group, Department of Physical and Sports Education, Faculty of Sport Sciences, University of Granada, Granada, Spain
| | - Pablo Molina-Garcia
- PROFITH “PROmoting FITness and Health Through Physical Activity” Research Group, Department of Physical and Sports Education, Faculty of Sport Sciences, University of Granada, Granada, Spain
- Department of Rehabilitation Sciences, KU Leuven – University of Leuven, Leuven, Belgium
| | - Maria Rodriguez-Ayllon
- PROFITH “PROmoting FITness and Health Through Physical Activity” Research Group, Department of Physical and Sports Education, Faculty of Sport Sciences, University of Granada, Granada, Spain
| | - Cristina Cadenas-Sanchez
- PROFITH “PROmoting FITness and Health Through Physical Activity” Research Group, Department of Physical and Sports Education, Faculty of Sport Sciences, University of Granada, Granada, Spain
| | - Irene Esteban-Cornejo
- PROFITH “PROmoting FITness and Health Through Physical Activity” Research Group, Department of Physical and Sports Education, Faculty of Sport Sciences, University of Granada, Granada, Spain
- Center for Cognitive and Brain Health, Department of Psychology, Northeastern University, Boston, MA, United States
| | - Patricio Solis-Urra
- PROFITH “PROmoting FITness and Health Through Physical Activity” Research Group, Department of Physical and Sports Education, Faculty of Sport Sciences, University of Granada, Granada, Spain
- IRyS Group, School of Physical Education, Pontificia Universidad Católica de Valparaíso, Valparaíso, Chile
| | - Carlos de Teresa
- Andalusian Centre of Sport Medicine (CAMD), Junta de Andalucía, Granada, Spain
| | - Ángel Gutiérrez
- Department of Medical Physiology, School of Medicine, University of Granada, Granada, Spain
| | - Nathalie Michels
- Department of Public Health, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Jerzy Sacha
- Faculty of Physical Education and Physiotherapy, Opole University of Technology, Opole, Poland
- Department of Cardiology, University Hospital in Opole, University of Opole, Opole, Poland
| | - Francisco B. Ortega
- PROFITH “PROmoting FITness and Health Through Physical Activity” Research Group, Department of Physical and Sports Education, Faculty of Sport Sciences, University of Granada, Granada, Spain
- Department of Biosciences and Nutrition, Karolinska Institutet, Huddinge, Sweden
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Kosacka J, Woidt K, Toyka KV, Paeschke S, Klöting N, Bechmann I, Blüher M, Thiery J, Ossmann S, Baum P, Nowicki M. The role of dietary non-heme iron load and peripheral nerve inflammation in the development of peripheral neuropathy (PN) in obese non-diabetic leptin-deficient ob/ob mice. Neurol Res 2019; 41:341-353. [DOI: 10.1080/01616412.2018.1564191] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Affiliation(s)
- Joanna Kosacka
- Department of Neurology, University of Leipzig, Leipzig, Germany
| | - Katrin Woidt
- Institute of Anatomy, University of Leipzig, Leipzig, Germany
| | - Klaus V. Toyka
- Department of Neurology, University of Würzburg, Würzburg, Germany
| | - Sabine Paeschke
- Institute of Anatomy, University of Leipzig, Leipzig, Germany
| | - Nora Klöting
- Department of Medicine, University of Leipzig, Leipzig, Germany
- Integrated Research and Treatment Center (IFB) Adiposity Disease, Leipzig, Germany
| | - Ingo Bechmann
- Institute of Anatomy, University of Leipzig, Leipzig, Germany
| | - Matthias Blüher
- Department of Medicine, University of Leipzig, Leipzig, Germany
| | - Joachim Thiery
- Institute of Laboratory Medicine, Clinical Chemistry and Molecular Diagnostics (ILM), University of Leipzig, Leipzig, German
| | | | - Petra Baum
- Department of Neurology, University of Leipzig, Leipzig, Germany
| | - Marcin Nowicki
- Institute of Anatomy, University of Leipzig, Leipzig, Germany
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28
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Gajardo AIJ, Madariaga S, Maldonado PE. Autonomic nervous system assessment by pupillary response as a potential biomarker for cardiovascular risk: A pilot study. J Clin Neurosci 2018; 59:41-46. [PMID: 30448298 DOI: 10.1016/j.jocn.2018.11.015] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2018] [Accepted: 11/05/2018] [Indexed: 11/19/2022]
Abstract
BACKGROUND Cardiovascular risk (CVR) biomarkers are of increasing interest because of their potential utility in management of cardiovascular diseases. The activity of the autonomic nervous system (ANS) is known to be highly correlated with CVR and therefore, is a putative biomarker. Common ANS measurement tools have several technological limitations and high-variance signals. The pupillary responses (PR) is controlled by both components of the ANS, and recent advances in pupillometry are making this measurement, easy and reliable. Thus, PR assessment could become a useful clinical tool to measure the ANS modulation and its relation to CVR. Here, we aimed to evaluate differences in PR between low CVR and moderate/high CVR individuals. METHODS We performed a cross-sectional study. We recruited voluntaries with low CVR (group 1, n = 12) and patients with moderate/high CVR (group 2, n = 7). An eye tracker was used to measure PR to different visual stimulus that included colors (white, black, gray) and images with known emotional valence (pleasant, unpleasant and neutrals), which were intercalated by pink "noise" images. Differences in PR between both CVR groups were assessed by Mann Whitney U test of different epochs of the PR. RESULTS PR was significantly different between both CVR groups (p-value < 0,05) when the observed images were unpleasant, neutral, and pink noise, for different epochs of the PR. CONCLUSIONS This is the first study that demonstrates that PR is different according to CVR. Thus, PR could be considered as a novel biomarker of CVR to be tested in prospective studies.
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Affiliation(s)
- Abraham I J Gajardo
- Department of Internal Medicine, Clinical Hospital of Universidad de Chile, Chile; Laboratory of Oxidative Stress and Renal Pathophysiology, Institute of Biomedical Science, Faculty of Medicine, Universidad de Chile, Chile
| | - Samuel Madariaga
- Department of Neuroscience and Biomedical Neuroscience Institute, Faculty of Medicine, Universidad de Chile, Chile
| | - Pedro E Maldonado
- Department of Neuroscience and Biomedical Neuroscience Institute, Faculty of Medicine, Universidad de Chile, Chile.
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29
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Subramanian SK, Sharma VK, Rajendran R. Assessment of heart rate variability for different somatotype category among adolescents. J Basic Clin Physiol Pharmacol 2018; 30:jbcpp-2018-0104. [PMID: 30422802 DOI: 10.1515/jbcpp-2018-0104] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2018] [Accepted: 10/01/2018] [Indexed: 11/15/2022]
Abstract
Background Somatotype is a quantified expression of the morphological conformation of a person in terms of three-numeral rating each representing one component; fat (endomorphy), muscle mass (mesomorphy) and bone length (ectomorphy) in the same order. Certain somatotypes are more prone to develop the particular disease. Obesity and overweight are already epidemic among Indian adolescents and are increasing at an alarming rate, and obesity is linked to cardiovascular (CV) risk in this age group. Identifying the heart rate variability (HRV) is an established non-invasive test to identify the CV risk. The objective of this study is to record the HRV data for each somatotype category and to compare the HRV data among these somatotype categories in adolescents. Methods The volunteer adolescents in the age group of 12-17 years were classified into a different somatotyping categories based on the Heath Carter somatotyping method. The short-term HRV was recorded in all the subjects using wireless BioHarness 3.0. Results Based on the time domain and frequency domain parameters, the parasympathetic activity showed decreasing order as follows: central>ectomorphy>mesomorphy>endomorphy, whereas sympathetic activity showed increasing order as follows: central<ectomorphy<mesomorphy<endomorphy in both boys and girls. Girls have higher parasympathetic activity and lesser sympathetic activity than boys in ectomorphy and mesomorphy. In the central somatotype and endomorphy categories, genders were comparable. Conclusion Our study suggests that endomorphy and mesomorphy have poorer autonomic tone when compared to other somatotype categories.
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Affiliation(s)
| | - Vivek Kumar Sharma
- Professor and Head, Government Institute of Medical Sciences, Department of Physiology, Greater Noida, Uttar Pradesh 201310, India
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30
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Heart Rate Variability Analysis: Higuchi and Katz’s Fractal Dimensions in Subjects with Type 1 Diabetes Mellitus. ROMANIAN JOURNAL OF DIABETES NUTRITION AND METABOLIC DISEASES 2018. [DOI: 10.2478/rjdnmd-2018-0034] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Abstract
Background and aims: Statistical markers are valuable when assessing physiological status over periods of time and in certain disease states. We assess if type 1 diabetes mellitus promote modification in the autonomic nervous system using the main two types of algorithms to estimate a Fractal Dimension: Higuchi and Katz.
Material and methods: 46 adults were divided into two equal groups. The autonomic evaluation consisted of recording heart rate variability (HRV) for 30 minutes in supine position in absence of any other stimuli. Fractal dimensions ought then able to determine which series of interbeat intervals are derived from diabetics’ or not. We then equated results to observe which assessment gave the greatest significance by One-way analysis of variance (ANOVA1), Kruskal-Wallis technique and Cohen’s d effect sizes.
Results: Katz’s fractal dimension is the most robust algorithm when assisted by a cubic spline interpolation (6 Hz) to increase the number of samples in the dataset. This was categorical after two tests for normality; then, ANOVA1, Kruskal-Wallis and Cohen’s d effect sizes (p≈0.01 and Cohen’s d=0.814143 –medium effect size).
Conclusion: Diabetes significantly reduced the chaotic response as measured by Katz’s fractal dimension. Katz’s fractal dimension is a viable statistical marker for subjects with type 1 diabetes mellitus.
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31
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Messerli-Bürgy N, Arhab A, Stülb K, Kakebeeke TH, Zysset AE, Leeger-Aschmann CS, Schmutz EA, Ehlert U, Kriemler S, Jenni OG, Munsch S, Puder JJ. Physiological stress measures in preschool children and their relationship with body composition and behavioral problems. Dev Psychobiol 2018; 60:1009-1022. [DOI: 10.1002/dev.21782] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2017] [Revised: 07/26/2018] [Accepted: 08/06/2018] [Indexed: 11/08/2022]
Affiliation(s)
- Nadine Messerli-Bürgy
- Department of Clinical Psychology and Psychotherapy; University of Fribourg; Fribourg Switzerland
- Department of Psychology; University of Fribourg; Fribourg Switzerland
- Endocrinology, Diabetes & Metabolism Service; Centre Hospitalier Universitaire Vaudois (CHUV); Lausanne Switzerland
| | - Amar Arhab
- Endocrinology, Diabetes & Metabolism Service; Centre Hospitalier Universitaire Vaudois (CHUV); Lausanne Switzerland
| | - Kerstin Stülb
- Department of Clinical Psychology and Psychotherapy; University of Fribourg; Fribourg Switzerland
| | - Tanja H. Kakebeeke
- Child Development Center; University Children's Hospital Zurich; Zurich Switzerland
- Children's Research Center; University Children's Hospital Zurich; Zurich Switzerland
| | - Annina E. Zysset
- Child Development Center; University Children's Hospital Zurich; Zurich Switzerland
| | | | - Einat A. Schmutz
- Epidemiology, Biostatistics and Prevention Institute; University of Zurich; Zurich Switzerland
| | - Ulrike Ehlert
- Department of Psychology - Clinical Psychology and Psychotherapy; University of Zurich; Zurich Switzerland
| | - Susi Kriemler
- Epidemiology, Biostatistics and Prevention Institute; University of Zurich; Zurich Switzerland
| | - Oskar G. Jenni
- Child Development Center; University Children's Hospital Zurich; Zurich Switzerland
- Children's Research Center; University Children's Hospital Zurich; Zurich Switzerland
| | - Simone Munsch
- Department of Clinical Psychology and Psychotherapy; University of Fribourg; Fribourg Switzerland
| | - Jardena J. Puder
- Endocrinology, Diabetes & Metabolism Service; Centre Hospitalier Universitaire Vaudois (CHUV); Lausanne Switzerland
- Division of Pediatric Endocrinology, Diabetology and Obesity; Centre Hospitalier Universitaire Vaudois (CHUV); Lausanne Switzerland
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Haraldsdottir K, Watson AM, Goss KN, Beshish AG, Pegelow DF, Palta M, Tetri LH, Barton GP, Brix MD, Centanni RM, Eldridge MW. Impaired autonomic function in adolescents born preterm. Physiol Rep 2018; 6:e13620. [PMID: 29595875 PMCID: PMC5875539 DOI: 10.14814/phy2.13620] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2018] [Accepted: 01/25/2018] [Indexed: 01/01/2023] Open
Abstract
Preterm birth temporarily disrupts autonomic nervous system (ANS) development, and the long-term impacts of disrupted fetal development are unclear in children. Abnormal cardiac ANS function is associated with worse health outcomes, and has been identified as a risk factor for cardiovascular disease. We used heart rate variability (HRV) in the time domain (standard deviation of RR intervals, SDRR; and root means squared of successive differences, RMSSD) and frequency domain (high frequency, HF; and low frequency, LF) at rest, as well as heart rate recovery (HRR) following maximal exercise, to assess autonomic function in adolescent children born preterm. Adolescents born preterm (less than 36 weeks gestation at birth) in 2003 and 2004 and healthy age-matched full-term controls participated. Wilcoxon Rank Sum tests were used to compare variables between control and preterm groups. Twenty-one adolescents born preterm and 20 term-born controls enrolled in the study. Preterm-born subjects had lower time-domain HRV, including SDRR (69.1 ± 33.8 vs. 110.1 ± 33.0 msec, respectively, P = 0.008) and RMSSD (58.8 ± 38.2 vs. 101.5 ± 36.2 msec, respectively, P = 0.012), with higher LF variability in preterm subjects. HRR after maximal exercise was slower in preterm-born subjects at 1 min (30 ± 12 vs. 39 ± 9 bpm, respectively, P = 0.013) and 2 min (52 ± 10 vs. 60 ± 10 bpm, respectively, P = 0.016). This study is the first report of autonomic dysfunction in adolescents born premature. Given prior association of impaired HRV with adult cardiovascular disease, additional investigations into the mechanisms of autonomic dysfunction in this population are warranted.
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Affiliation(s)
- Kristin Haraldsdottir
- Department of PediatricsUniversity of WisconsinMadisonWisconsin
- Department of KinesiologyUniversity of WisconsinMadisonWisconsin
| | - Andrew M. Watson
- Department of Orthopedics & RehabilitationUniversity of WisconsinMadisonWisconsin
| | - Kara N. Goss
- Department of PediatricsUniversity of WisconsinMadisonWisconsin
- Department of MedicineUniversity of WisconsinMadisonWisconsin
| | - Arij G. Beshish
- Department of PediatricsUniversity of WisconsinMadisonWisconsin
| | | | - Mari Palta
- Department of Biostatistics and Medical InformaticsUniversity of WisconsinMadisonWisconsin
| | - Laura H. Tetri
- Department of PediatricsUniversity of WisconsinMadisonWisconsin
| | | | - Melissa D. Brix
- Department of PediatricsUniversity of WisconsinMadisonWisconsin
| | | | - Marlowe W. Eldridge
- Department of PediatricsUniversity of WisconsinMadisonWisconsin
- Department of KinesiologyUniversity of WisconsinMadisonWisconsin
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Mori S, Shiraishi A, Epplen K, Butcher D, Murase D, Yasuda Y, Murase T. Characterization of skin function associated with obesity and specific correlation to local/systemic parameters in American women. Lipids Health Dis 2017; 16:214. [PMID: 29132429 PMCID: PMC5683228 DOI: 10.1186/s12944-017-0608-1] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2017] [Accepted: 11/05/2017] [Indexed: 01/26/2023] Open
Abstract
Background Obesity is considered problematic not only as a major cause of diabetes, hypertension, and dyslipidemia, but also as a risk of intractable dermatosis; however influence of obesity on skin function has not been clarified. To clarify the mechanism of obesity-associated skin disorders, we aimed to characterize the skin function of subjects with obesity, and identify possible influencing factors. Methods Complex analyses including instrumental measurement, biochemical and lipidomics were performed for facial skin and physical evaluation in 93 Caucasian women with obesity (OB) and non-obesity (NOB). Results In OB, imbalance in metabolism of carbohydrate and lipid, autonomic nerve activity, and secreted factors were confirmed. In the skin properties in OB, surface roughness was higher by 70%, the water content was lower by 12%, and changes in the lipid profile of stratum corneum ceramide were observed; in particular, a 7% reduction of [NP]-type ceramide, compared with NOB. Moreover, significant redness accompanied by a 34% increase in skin blood flow was observed in OB. Correlation analysis elucidated that the water content was strongly correlated with local skin indices, such as the ceramide composition, redness, blood flow, and TNFα in the stratum corneum, whereas roughness was correlated with the systemic indices, such as serum insulin, leptin, and IL-6. Conclusions Characteristics of obesity-associated skin were (A) reduction of the barrier and moisturizing function accompanied by intercellular lipid imbalance, (B) increased redness accompanied by hemodynamic changes, and (C) surface roughness. It was suggested that each symptom is due to different causes in local and/or systemic physiological impairment related to the autonomic nerve-vascular system, inflammation and insulin resistance. Electronic supplementary material The online version of this article (10.1186/s12944-017-0608-1) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Shinobu Mori
- Biological Science Laboratories, Kao Corporation, 2606 Akabane, Ichikai-machi, Haga-gun, Tochigi, 321-3497, Japan.
| | - Akiko Shiraishi
- Biological Science Laboratories, Kao Corporation, 2606 Akabane, Ichikai-machi, Haga-gun, Tochigi, 321-3497, Japan
| | - Karen Epplen
- Spring Grove Laboratories, 375 Thomas More Parkway, Suite 112, Crestview Hills, KY, 41017, USA
| | - Desiree Butcher
- Spring Grove Laboratories, 375 Thomas More Parkway, Suite 112, Crestview Hills, KY, 41017, USA
| | - Daiki Murase
- Biological Science Laboratories, Kao Corporation, 2606 Akabane, Ichikai-machi, Haga-gun, Tochigi, 321-3497, Japan
| | - Yuka Yasuda
- Analysis Science Laboratories, Kao Corporation, 2606 Akabane, Ichikai-machi, Haga-gun, Tochigi, 321-3497, Japan
| | - Takatoshi Murase
- Biological Science Laboratories, Kao Corporation, 2606 Akabane, Ichikai-machi, Haga-gun, Tochigi, 321-3497, Japan
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Bjelakovic L, Vukovic V, Jovic M, Bankovic S, Kostic T, Radovanovic D, Pantelic S, Zivkovic M, Stojanovic S, Bjelakovic B. Heart rate recovery time in metabolically healthy and metabolically unhealthy obese children. PHYSICIAN SPORTSMED 2017; 45:438-442. [PMID: 28885093 DOI: 10.1080/00913847.2017.1376571] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
BACKGROUND Autonomic dysfunction is an emerging non-traditional cardiovascular risk factor that correlates with obesity, components of metabolic syndrome, as well as cardiorespiratory fitness. As a simple and validated index of autonomic balance, heart rate recovery (HRR) has been reported as a useful biomarker for predicting cardiovascular morbidity and mortality. OBJECTIVES The aim of this study was to compare HRR in metabolically healthy vs. metabolically unhealthy obese children. METHODS A total of 56 obese children of whom 31 had metabolic syndrome were examined. All the participants underwent the multistage submaximal cycle ergometer test and HRR was determined one minute after the test. RESULTS The HRR was significantly lower (18.9 ± 3.7) in a group of metabolically unhealthy obese children compared to metabolically healthy obese children (24 ± 4.1) p < 0.001. Logistic regression analysis showed that reduction in HRR was also influenced by higher BMI. CONCLUSION Our findings implicate the presence of the autonomic dysfunction as reflected by impaired heart rate recovery (HRR) in obese children with metabolic syndrome.
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Affiliation(s)
- Ljiljana Bjelakovic
- a Department of medical science, Faculty of Sport and Physical Education , University of Nis , Nis , Serbia
| | - Vladimir Vukovic
- b Department of Molecular Medicine , Universita Cattolica del Sacro Cuore , Rome , Italy
| | - Marko Jovic
- c Medical faculty , University of Nis , Nis , Serbia
| | | | - Tomislav Kostic
- c Medical faculty , University of Nis , Nis , Serbia.,d Clinic of Cardiology , Clinical Center Nis , Nis , Serbia
| | - Dragan Radovanovic
- a Department of medical science, Faculty of Sport and Physical Education , University of Nis , Nis , Serbia
| | - Sasa Pantelic
- e Faculty of Sport and Physical Education , University of Nis , Nis , Serbia
| | - Mladen Zivkovic
- e Faculty of Sport and Physical Education , University of Nis , Nis , Serbia
| | - Sanja Stojanovic
- f Niska Banja, Medical Faculty University of Nis , Institute of cardiology , Nis , Serbia
| | - Bojko Bjelakovic
- c Medical faculty , University of Nis , Nis , Serbia.,g Clinic of Pediatrics , Clinical Center , Nis , Serbia
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Lourenço Dias AR, de Souza KA, de Jesus Lima de Sousa LC, dos Santos KM, Kolesny Tricot G, de Araújo JA, Teresa Cambri L, Arsa G. Higher blood pressure and lower cardiac vagal activity in obese young individuals in supine and seated position. J Clin Transl Res 2017; 3:328-337. [PMID: 30895274 PMCID: PMC6426250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Obesity triggers alterations in hemodynamic and autonomic control. There are few studies that investigate the effects of overweight and obesity in early adulthood on hemodynamic and autonomic variables. AIM The aim of this study was to determine whether overweight and obesity in young individuals cause alterations in hemodynamic parameters and heart rate variability (HRV) in supine and seated position, and to correlate these variables with anthropometric features. METHODS Measurements were performed in 40 young untrained male study participants. The subjects were eutrophic (22.8 ± 0.3 kg/m2, N = 19), overweight (27.0 ± 0.5 kg/m2, N = 10), and obese (33.5 ± 0.8 kg/m2, N = 11). After 5 min in supine and seated position, the R-R intervals and blood pressure (BP) were recorded. RESULTS The systolic blood pressure were higher in overweight (supine, 122.9 ± 2.3 mmHg) and obese (supine, 123.9 ± 2.2; seated, 121.7 ± 2.3 mmHg) individuals compared to eutrophic individuals (supine, 111.8 ± 1.64; seated, 111.3 ± 1.8 mmHg) (p ⩽ 0.05). Obese subjects exhibited lower HRV (SD1, RMSSD, pNN50) compared to eutrophic individuals when seated. In obese subjects, the heart rate (HR) increased and HRV decreased (p ≤ 0.05) when seated versus supine position. The body mass, body mass index (BMI), and waist and abdominal circumferences correlated positively with BP (r = 0.40-0.64, p ≤ 0.05), while the BMI, waist circumference, BP, and HR were negatively correlated (r = -0.32 -0.62, p ≤ 0.05) with HRV (pNN50 and HF) in both body positions. BMI, waist circumference, BP and HR correlated negat- ively with additional HRV indices (SD1, SD2, RMSSD, TP, and LF) when seated. CONCLUSIONS Obese and overweight individuals presented higher SBP, and obese individuals had lower HRV and cardiac vagal activity, associated with anthropometric variables. RELEVANCE FOR PATIENTS The monitoring of HRV in obese subjects in seated position allows improved prognosis of metabolic consequences to cardiac autonomic control.
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Affiliation(s)
| | - Katrice Almeida de Souza
- 1Graduate Program on Physical Education, Federal University of Mato Grosso, Cuiaba, Mato Grosso, Brazil
| | | | | | - Gabriel Kolesny Tricot
- 1Graduate Program on Physical Education, Federal University of Mato Grosso, Cuiaba, Mato Grosso, Brazil
| | - Jaqueline Alves de Araújo
- 1Graduate Program on Physical Education, Federal University of Mato Grosso, Cuiaba, Mato Grosso, Brazil
| | - Lucieli Teresa Cambri
- 1Graduate Program on Physical Education, Federal University of Mato Grosso, Cuiaba, Mato Grosso, Brazil
| | - Gisela Arsa
- 1Graduate Program on Physical Education, Federal University of Mato Grosso, Cuiaba, Mato Grosso, Brazil
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Sympathetic neural activity, metabolic parameters and cardiorespiratory fitness in obese youths. J Hypertens 2017; 35:571-577. [PMID: 27930438 DOI: 10.1097/hjh.0000000000001200] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
OBJECTIVE The main objective of this cross-sectional study is to assess the cardiac autonomic neural activity in the presence of abnormally increased body weight in youths and its relationship to metabolic risk factors and cardiorespiratory fitness (CRF). METHODS Sixty-four overweight and obese patients, aged 9-17 years, of both sexes, stratified according to the international BMI cut-off, were enrolled. Continuous ECG was recorded during 15 min in resting conditions, and the heart rate variability (HRV) was measured in the time domain, frequency domain and for nonlinear dynamics. In addition, cardiometabolic risk factors and CRF in effort conditions were assessed. RESULTS Among the overweight and obese youths, no significant differences were observed regarding metabolic parameters and heart rate, although CRF was the lowest in the severely obese youths. Likewise, no significant differences were observed in HRV, independent of how it was assessed. A positive and significant relationship, independent of the degree of obesity, pubertal stage and breathing rate under resting conditions, has been observed among sympathovagal balance, insulin and the homeostatic model assessment index. Furthermore, CRF assessed by volume oxygen peak was associated with insulin levels (r = -0.273; P < 0.05), the SD of the NN interval series (r = 0.268, P < 0.05) and the long-term variation using the Poincaré plot (PS1: r = 0.275, P < 0.05; PS2: r = 0.273, P < 0.05). CONCLUSION The key findings of the present study were the presence of a link among fasting insulin, HRV and CRF independent of the degree of obesity, indicating the heterogeneity of obese children and adolescents.
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Palmeira AC, Farah BQ, Soares AHG, Cavalcante BR, Christofaro DGD, Barros MVGD, Ritti-Dias RM. ASSOCIAÇÃO ENTRE A ATIVIDADE FÍSICA DE LAZER E DE DESLOCAMENTO COM A VARIABILIDADE DA FREQUÊNCIA CARDÍACA EM ADOLESCENTES DO SEXO MASCULINO. REVISTA PAULISTA DE PEDIATRIA 2017; 35:302-308. [PMID: 28977292 PMCID: PMC5606175 DOI: 10.1590/1984-0462/;2017;35;3;00007] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/29/2016] [Accepted: 11/18/2016] [Indexed: 11/21/2022]
Abstract
Objective: To investigate the association between heart rate variability (HRV) parameters with leisure time and commuting physical activities in adolescent boys. Methods: The sample included 1152 male adolescents aged 14 to 19 years. The variation of consecutive heart beats (RR intervals) was assessed and HRV parameters in time (SDNN, RMSSD, pNN50) and frequency domains (LF/HF) were calculated. Leisure time and commuting physical activities were obtained using a questionnaire. A binary logistic regression was performed between HRV parameters and physical activity. Results: Leisure time physical activity was associated with SDNN, RMSSD, pNN50, while LF/HF was not associated. These associations were stronger when adolescents were also physically active for more than six months. Commuting physical activity was not associated with any HRV parameter. Boys who practiced commuting physical activity and were also physically active for more than six months presented a lower chance of having low SDNN and RMSSD. Conclusions: Leisure time physical activity was associated with better HRV and these associations were enhanced when adolescents were physically active for more than six months. Commuting physical activity was not associated with HRV parameters; however, it became associated with better HRV when adolescents were physically active in commuting for more than six months.
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Van De Wielle R, Michels N. Longitudinal Associations of Leptin and Adiponectin with Heart Rate Variability in Children. Front Physiol 2017; 8:498. [PMID: 28747890 PMCID: PMC5506193 DOI: 10.3389/fphys.2017.00498] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2017] [Accepted: 06/28/2017] [Indexed: 12/13/2022] Open
Abstract
For early prevention of cardiovascular disease, early detection and risk factor insights are necessary. The autonomic balance reflects cardiovascular risk and can be measured by heart rate variability (HRV). Therefore, our purpose is to examine associations between HRV and the energy-related biomarkers leptin and adiponectin in children. Participants of this study were Belgian children recruited for the longitudinal ChiBS study (year 2010-2012). HRV was measured and fasting blood samples were taken in 249 children at baseline (4.4-11.0 y) and 223 children at follow-up (6.7-12.2 y). Cross-sectional and longitudinal linear regression analyses were separated by sex and adjusted for age, socio-economic status, body fat%, negative emotions, puberty, and mean heart rate. Leptin was a negative cross-sectional and longitudinal predictor of parasympathetic activity in boys; while leptin in girls was cross-sectionally associated with higher LF and LF/HF suggesting sympathetic predominance. Adiponectin was a negative cross-sectional and longitudinal predictor of parasympathetic activity in boys; but when adjusting for mean heart rate, this effect disappeared and adiponectin was a positive cross-sectional and longitudinal predictor of parasympathetic activity in girls. These results stress the importance of considering sex differences and adjustment for heart rate in testing HRV predictors. Leptin seemed disadvantageous for the autonomic balance, while adiponectin seemed advantageous for the autonomic balance in girls only. More research is needed to see whether leptin and adiponectin are interesting in cardiovascular screening/prevention or in determining the cardiovascular gain during weight loss follow-up.
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Affiliation(s)
- Roos Van De Wielle
- Department of Public Health, Faculty of Medicine and Health Sciences, Ghent UniversityGhent, Belgium
| | - Nathalie Michels
- Department of Public Health, Faculty of Medicine and Health Sciences, Ghent UniversityGhent, Belgium
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Jezdimirovic T, Stajer V, Semeredi S, Calleja-Gonzalez J, Ostojic SM. Does body fat percentage predict post-exercise heart rate response in non-obese children and adolescents? J Pediatr Endocrinol Metab 2017; 30:629-633. [PMID: 28525355 DOI: 10.1515/jpem-2016-0468] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2016] [Accepted: 04/06/2017] [Indexed: 11/15/2022]
Abstract
BACKGROUND A correlation between adiposity and post-exercise autonomic regulation has been established in overweight and obese children. However, little information exists about this link in non-obese youth. The main purpose of this cross-sectional study was to describe the relationship between body fat percentage (BFP) and heart rate recovery after exercise [post-exercise heart rate (PEHR)], a marker of autonomic regulation, in normal-weight children and adolescents. METHODS We evaluated the body composition of 183 children and adolescents (age 15.0±2.3 years; 132 boys and 51 girls) who performed a maximal graded exercise test on a treadmill, with the heart rate monitored during and immediately after exercise. RESULTS A strong positive trend was observed in the association between BFP and PEHR (r=0.14; p=0.06). Hierarchical multiple regression revealed that our model explained 18.3% of the variance in PEHR (p=0.00), yet BFP accounted for only 0.9% of the variability in PEHR (p=0.16). The evaluation of the contribution of each independent variable revealed that only two variables made a unique statistically significant contribution to our model (p<0.01), with age contributing 38.7% to our model (p=0.00) while gender accounted for an additional 25.5% (p=0.01). Neither BFP (14.4%; p=0.16) nor cardiorespiratory endurance (5.0%, p=0.60) made a significant unique contribution to the model. CONCLUSIONS Body fatness seems to poorly predict PEHR in our sample of non-obese children and adolescents, while non-modifiable variables (age and gender) were demonstrated as strong predictors of heart rate recovery. The low amount of body fat reported in non-obese young participants was perhaps too small to cause disturbances in autonomic nervous system regulation.
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Fricke L, Petroff D, Desch S, Lurz P, Reinhardt S, Sonnabend M, Classen J, Baum P. Does dysfunction of the autonomic nervous system affect success of renal denervation in reducing blood pressure? SAGE Open Med 2017; 5:2050312117702031. [PMID: 28507735 PMCID: PMC5415324 DOI: 10.1177/2050312117702031] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2016] [Accepted: 03/06/2017] [Indexed: 11/18/2022] Open
Abstract
Objectives: Renal denervation is an interventional approach aiming to reduce high blood pressure. Its efficacy is subject of controversial debate. We analyzed autonomic function in patients undergoing renal denervation to identify responders. Methods: A total of 21 patients with treatment-resistant hypertension scheduled for renal denervation were included. Heart rate variability, pupillary function and sympathetic skin response were examined prior to intervention. Before and 1 or 3 months after intervention, 24-h ambulatory blood pressure readings were taken. Results: Patients were stratified according to sympathetic nervous system function. Sympathetic activity was reduced in 12 participants (group 1) and normal or enhanced in nine patients (group 2). The mean of daytime systolic blood pressure decreased in groups 1 and 2 from 168 to 157 mmHg (95% confidence interval for difference, 1–21 mmHg, p = 0.035) and from 166 to 145 mmHg (8–34 mmHg, p = 0.005), respectively. In a linear model, blood pressure reduction was 11.3 mmHg (0.3–22 mmHg) greater in group 2 than in group 1 (p = 0.045). Conclusion: Patients with preexisting reduced activity of the sympathetic nervous system benefited less from renal denervation.
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Affiliation(s)
- Lisa Fricke
- Department of Neurology, University Hospital Leipzig, Leipzig, Germany
| | - David Petroff
- Clinical Trial Centre, Leipzig University, Leipzig, Germany
| | - Steffen Desch
- Medical Clinic II-Department of Cardiology, Angiology and Intensive Care Medicine, University Lübeck Heart Centre, University of Lübeck, Lübeck, Germany
| | - Philipp Lurz
- Department of Internal Medicine/Cardiology, Heart Centre, Leipzig University, Leipzig, Germany
| | - Sebastian Reinhardt
- Department of Cardiology and Angiology, University Hospital Leipzig, Leipzig, Germany
| | - Melanie Sonnabend
- Department of Internal Medicine/Cardiology, Heart Centre, Leipzig University, Leipzig, Germany
| | - Joseph Classen
- Department of Neurology, University Hospital Leipzig, Leipzig, Germany
| | - Petra Baum
- Department of Neurology, University Hospital Leipzig, Leipzig, Germany
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Majeed F, Yar T, Alsunni A, Alhawaj AF, AlRahim A, Alzaki M. Synergistic effect of energy drinks and overweight/obesity on cardiac autonomic testing using the Valsalva maneuver in university students. Ann Saudi Med 2017; 37:181-188. [PMID: 28578355 PMCID: PMC6150576 DOI: 10.5144/0256-4947.2017.181] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Obesity and caffeine consumption may lead to autonomic disturbances that can result in a wide range of cardiovascular disorders. OBJECTIVES To determine autonomic disturbances produced by the synergistic effects of overweight or obesity (OW/OB) and energy drinks. DESIGN Cross-sectional, analytical. SETTING Physiology department at a university in Saudi Arabia. SUBJECTS AND METHODS University students, 18-22 years of age, of normal weight (NW) and OW/OB were recruited by convenience sampling. Autonomic testing by the Valsalva ratio (VR) along with systolic and diastolic blood pressure, pulse pressure, and mean arterial blood pressure were measured at baseline (0 minute) and 60 minutes after energy drink consumption. MAIN OUTCOME MEASURE(S) Autonomic disturbance, hemodynamic changes. RESULTS In 50 (27 males and 23 females) subjects, 21 NW and 29 OW/OB, a significant decrease in VR was observed in OW/OB subjects and in NW and OW/OB females at 60 minutes after energy drink consumption. Values of systolic and diastolic blood pressure, pulse pressure and mean arterial blood pressure were also significantly higher in OW/OB and in females as compared to NW and males. BMI was negatively correlated with VR and diastolic blood pressure at 60 minutes. CONCLUSION Obesity and energy drinks alter autonomic functions. In some individuals, OW/OB may augment these effects. LIMITATIONS Due to time and resource restraints, only the acute effects of energy drinks were examined.
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Affiliation(s)
- Farrukh Majeed
- Dr. Farrukh Majeed, Department of Physiology,, College of Medicine,, University of Dammam,, Al-Rakha, Dammam 31451, Saudi Arabia, +966 13 333 5132, , ORCID: http://orcid.org/0000-0002-2987-601X
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Miller AL, Kaciroti N, Sturza J, Retzloff L, Rosenblum K, Vazquez DM, Lumeng JC. Associations between stress biology indicators and overweight across toddlerhood. Psychoneuroendocrinology 2017; 79:98-106. [PMID: 28273588 PMCID: PMC5367941 DOI: 10.1016/j.psyneuen.2017.02.013] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2016] [Revised: 02/11/2017] [Accepted: 02/12/2017] [Indexed: 12/21/2022]
Abstract
Biological stress responses are proposed as a pathway through which stress exposure can "get under the skin" and lead to health problems, specifically obesity. Yet, it is not clear when such associations may emerge or whether they are bidirectional. Cortisol and salivary alpha amylase (sAA) were considered indicators of the biological stress response. We tested the longitudinal association between cortisol and sAA and weight in 215 low-income children at ages 21, 27, and 33 months (52% male; 46% non-Hispanic white). sAA and cortisol intercept and slope (representing morning level and rate of change across the day) were calculated for each age point using random effect models. Children were weighed and length measured and categorized as overweight versus normal weight (overweight defined as weight-for-length z-score ≥85th percentile for age and sex). Cross-lagged models stratified by sex and controlling for birthweight z-score tested the concurrent and cross-lagged associations between each of 4 indices of stress biology individually (cortisol and sAA intercept and slope) and overweight. Overweight status was correlated across time. Cortisol and sAA were correlated across occasions of measurement, though somewhat less strongly in boys. There were no concurrent associations between stress indicators and overweight. sAA at 27 months predicted greater risk of overweight at 33 months in girls, such that both lower sAA intercept and more rapidly increasing sAA at 27 months predicted greater risk of overweight at 33 months (β=-0.64, p<0.05 and β=1.09, p<0.05, respectively). For boys only, overweight at 21 months predicted lower sAA intercept at 27 months (β=-0.35, p<0.05). Findings suggest that longitudinal associations of stress biology and weight status may be present only on a limited basis very early in the lifespan.
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Affiliation(s)
- Alison L Miller
- Center for Human Growth and Development, University of Michigan, United States; Department of Health Behavior and Health Education, University of Michigan School of Public Health,United States.
| | - Niko Kaciroti
- Center for Human Growth and Development, University of Michigan, United States; Department of Biostatistics, University of Michigan School of Public Health, United States
| | - Julie Sturza
- Center for Human Growth and Development, University of Michigan, United States
| | - Lauren Retzloff
- Center for Human Growth and Development, University of Michigan, United States
| | - Katherine Rosenblum
- Center for Human Growth and Development, University of Michigan, United States; Department of Psychiatry, University of Michigan Medical School, United States
| | - Delia M Vazquez
- Center for Human Growth and Development, University of Michigan, United States; Department of Biostatistics, University of Michigan School of Public Health, United States; Department of Pediatrics, University of Michigan Medical School, United States
| | - Julie C Lumeng
- Center for Human Growth and Development, University of Michigan, United States; Department of Pediatrics, University of Michigan Medical School, United States; Department of Nutritional Sciences, University of Michigan School of Public Health, United States
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Hursh BE, Fazeli MS, Wang S, Marchant EA, Woo P, Elango R, Lavoie PM, Chanoine JP, Collet JP. Cardiac Autonomic Function at Baseline and under Stress and Its Relationship to Circulatory Markers of Inflammation in Obese Compared to Nonobese Children: A Pilot Study. Horm Res Paediatr 2017; 85:339-46. [PMID: 27105080 DOI: 10.1159/000445685] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2016] [Accepted: 03/18/2016] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND/AIMS The autonomic nervous system (ANS) provides neurogenic control of inflammatory reactions. ANS changes in obesity may result in inflammation. This study sought to gain insight into cardiac autonomic dysfunction and inflammation in childhood obesity, and to gather pilot data on the potential relationship between altered ANS and inflammation. METHODS Fifteen obese children and adolescents without metabolic complications and 15 nonobese controls underwent heart rate variability and impedance cardiography testing during rest, mental stress, and physical stress. Inflammatory cytokines and immune reactivity were measured. RESULTS There was no statistically significant difference between groups in cardiac ANS testing at rest or in response to stress. Median high-sensitivity C-reactive protein (hsCRP) was higher in the obese group [obese 2.6 mg/l (IQR 1.6-11.9); nonobese 0.3 mg/l (IQR 0.2-0.7); p < 0.001]. Interleukin-6 and tumour necrosis factor-α were similar between groups. Immune reactivity testing (in vitro Toll-like receptor stimulation) revealed a strong, but comparable, inflammatory response in both groups. CONCLUSIONS Obese children and adolescents without metabolic complications did not have cardiac ANS dysfunction. While hsCRP was elevated, systemic cytokines were not raised. Compared to prior studies, which often focused on children with obesity and its complications, it is encouraging that obese children without metabolic complications may not yet have autonomic dysfunction.
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Affiliation(s)
- Brenden E Hursh
- Endocrinology and Diabetes Unit, BC Children's Hospital, The University of British Columbia, Vancouver, B.C., Canada
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Li G, Sheng X, Xu Y, Jiang H, Zheng C, Guo J, Sun S, Yi Z, Qin S, Liu S, Gao Y, Zhang C, Xu H, Wu B, Zou L, Liang S, Zhu G. Co-expression changes of lncRNAs and mRNAs in the cervical sympathetic ganglia in diabetic cardiac autonomic neuropathic rats. J Neurosci Res 2016; 95:1690-1699. [DOI: 10.1002/jnr.24000] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2016] [Revised: 11/04/2016] [Accepted: 11/22/2016] [Indexed: 12/20/2022]
Affiliation(s)
- Guilin Li
- Department of Physiology; Basic Medical College of Nanchang University; Nanchang 330006 PR China
| | - Xuan Sheng
- Department of Physiology; Basic Medical College of Nanchang University; Nanchang 330006 PR China
| | - Yurong Xu
- Department of Physiology; Basic Medical College of Nanchang University; Nanchang 330006 PR China
| | - Huaide Jiang
- Department of Physiology; Basic Medical College of Nanchang University; Nanchang 330006 PR China
| | - Chaoran Zheng
- Department of Physiology; Basic Medical College of Nanchang University; Nanchang 330006 PR China
| | - Jingjing Guo
- Department of Physiology; Basic Medical College of Nanchang University; Nanchang 330006 PR China
| | - Shanshan Sun
- Undergraduate Student of Second Clinical Medical College; Medical College of Nanchang University; Nanchang 330008 PR China
| | - Zhihua Yi
- Department of Physiology; Basic Medical College of Nanchang University; Nanchang 330006 PR China
| | - Shulan Qin
- Endocrine Department of Third Affiliated Hospital; Medical College of Nanchang University; Nanchang 330008 PR China
| | - Shuangmei Liu
- Department of Physiology; Basic Medical College of Nanchang University; Nanchang 330006 PR China
| | - Yun Gao
- Department of Physiology; Basic Medical College of Nanchang University; Nanchang 330006 PR China
| | - Chunping Zhang
- Department of Medical Genetics and Biology; Basic Medical College of Nanchang University; Nanchang 330006 PR China
| | - Hong Xu
- Department of Physiology; Basic Medical College of Nanchang University; Nanchang 330006 PR China
| | - Bing Wu
- Department of Physiology; Basic Medical College of Nanchang University; Nanchang 330006 PR China
| | - Lifang Zou
- Department of Physiology; Basic Medical College of Nanchang University; Nanchang 330006 PR China
| | - Shangdong Liang
- Department of Physiology; Basic Medical College of Nanchang University; Nanchang 330006 PR China
| | - Gaochun Zhu
- Department of Anatomy; Basic Medical College of Nanchang University; Nanchang 330006 PR China
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Van Eyck A, Van Hoorenbeeck K, De Winter BY, Van Gaal L, De Backer W, Verhulst SL. Sleep disordered breathing and autonomic function in overweight and obese children and adolescents. ERJ Open Res 2016; 2:00038-2016. [PMID: 27999786 PMCID: PMC5168620 DOI: 10.1183/23120541.00038-2016] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2016] [Accepted: 10/15/2016] [Indexed: 12/18/2022] Open
Abstract
Obstructive sleep apnoea (OSA), common in children with obesity, is associated with cardiovascular morbidity. Autonomic dysfunction has been suggested to be a key player in the development of these complications. We investigated the relationship between obesity, OSA and sympathetic activity in children. 191 children with obesity were included and distributed into two groups: 131 controls and 60 with OSA. Beat-to-beat RR interval data were extracted from polysomnography for heart rate variability analysis. Urinary free cortisol levels were determined. Urinary free cortisol did not differ between groups and was not associated with OSA, independent of the level of obesity. Differences in heart rate variability measures were found: mean RR interval decreased with OSA, while low/high-frequency band ratio and mean heart rate increased with OSA. Heart rate variability measures correlated with OSA, independent of obesity parameters and age: oxygen desaturation index correlated with mean heart rate (r=0.19, p=0.009) and mean RR interval (r= −0.18, p=0.02), while high-frequency bands and low/high-frequency band ratio correlated with arterial oxygen saturation measured by pulse oximetry (SpO2) (r= −0.20, p=0.008 and r= −0.16, p=0.04) and SpO2 nadir (r=0.23, p=0.003 and r= −0.19, p=0.02). These results suggest that sympathetic heart activity is increased in children with obesity and OSA. Measures of hypoxia were related to increased sympathetic tone, suggesting that intermittent hypoxia is involved in autonomic dysfunction. Sympathetic heart activity is increased in children with obstructive sleep apnoea and obesityhttp://ow.ly/iSVc305AZRv
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Affiliation(s)
- Annelies Van Eyck
- Laboratory of Experimental Medicine and Pediatrics, University of Antwerp, Antwerp, Belgium; Dept of Paediatrics, Antwerp University Hospital, Edegem, Belgium
| | - Kim Van Hoorenbeeck
- Laboratory of Experimental Medicine and Pediatrics, University of Antwerp, Antwerp, Belgium; Dept of Paediatrics, Antwerp University Hospital, Edegem, Belgium
| | - Benedicte Y De Winter
- Laboratory of Experimental Medicine and Pediatrics, University of Antwerp, Antwerp, Belgium
| | - Luc Van Gaal
- Laboratory of Experimental Medicine and Pediatrics, University of Antwerp, Antwerp, Belgium; Dept of Endocrinology, Diabetology and Metabolism, Antwerp University Hospital, Edegem, Belgium
| | - Wilfried De Backer
- Laboratory of Experimental Medicine and Pediatrics, University of Antwerp, Antwerp, Belgium; Dept of Pulmonology, Antwerp University Hospital, Edegem, Belgium
| | - Stijn L Verhulst
- Laboratory of Experimental Medicine and Pediatrics, University of Antwerp, Antwerp, Belgium; Dept of Paediatrics, Antwerp University Hospital, Edegem, Belgium
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Wang Y, Zekveld AA, Naylor G, Ohlenforst B, Jansma EP, Lorens A, Lunner T, Kramer SE. Parasympathetic Nervous System Dysfunction, as Identified by Pupil Light Reflex, and Its Possible Connection to Hearing Impairment. PLoS One 2016; 11:e0153566. [PMID: 27089436 PMCID: PMC4835104 DOI: 10.1371/journal.pone.0153566] [Citation(s) in RCA: 51] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2015] [Accepted: 03/31/2016] [Indexed: 12/31/2022] Open
Abstract
CONTEXT Although the pupil light reflex has been widely used as a clinical diagnostic tool for autonomic nervous system dysfunction, there is no systematic review available to summarize the evidence that the pupil light reflex is a sensitive method to detect parasympathetic dysfunction. Meanwhile, the relationship between parasympathetic functioning and hearing impairment is relatively unknown. OBJECTIVES To 1) review the evidence for the pupil light reflex being a sensitive method to evaluate parasympathetic dysfunction, 2) review the evidence relating hearing impairment and parasympathetic activity and 3) seek evidence of possible connections between hearing impairment and the pupil light reflex. METHODS Literature searches were performed in five electronic databases. All selected articles were categorized into three sections: pupil light reflex and parasympathetic dysfunction, hearing impairment and parasympathetic activity, pupil light reflex and hearing impairment. RESULTS Thirty-eight articles were included in this review. Among them, 36 articles addressed the pupil light reflex and parasympathetic dysfunction. We summarized the information in these data according to different types of parasympathetic-related diseases. Most of the studies showed a difference on at least one pupil light reflex parameter between patients and healthy controls. Two articles discussed the relationship between hearing impairment and parasympathetic activity. Both studies reported a reduced parasympathetic activity in the hearing impaired groups. The searches identified no results for pupil light reflex and hearing impairment. DISCUSSION AND CONCLUSIONS As the first systematic review of the evidence, our findings suggest that the pupil light reflex is a sensitive tool to assess the presence of parasympathetic dysfunction. Maximum constriction velocity and relative constriction amplitude appear to be the most sensitive parameters. There are only two studies investigating the relationship between parasympathetic activity and hearing impairment, hence further research is needed. The pupil light reflex could be a candidate measurement tool to achieve this goal.
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Affiliation(s)
- Yang Wang
- Section Ear & Hearing, Dept. of Otolaryngology-Head and Neck Surgery and EMGO Institute for Health and Care Research, VU University medical center, Amsterdam, The Netherlands
- Eriksholm Research Centre, Oticon A/S, Snekkersten, Denmark
| | - Adriana A. Zekveld
- Section Ear & Hearing, Dept. of Otolaryngology-Head and Neck Surgery and EMGO Institute for Health and Care Research, VU University medical center, Amsterdam, The Netherlands
- Department of Behavioural Sciences and Learning, Linköping University, Linköping, Sweden
- Linnaeus Centre HEAD, The Swedish Institute for Disability Research, Linköping and Örebro Universities, Linköping, Sweden
| | - Graham Naylor
- MRC/CSO Institute of Hearing Research, Scottish Section, Glasgow, United Kingdom
| | - Barbara Ohlenforst
- Section Ear & Hearing, Dept. of Otolaryngology-Head and Neck Surgery and EMGO Institute for Health and Care Research, VU University medical center, Amsterdam, The Netherlands
- Eriksholm Research Centre, Oticon A/S, Snekkersten, Denmark
| | - Elise P. Jansma
- Medical Library, VU University Amsterdam, Amsterdam, the Netherlands
| | - Artur Lorens
- Institute of Physiology and Pathology of Hearing, Warsaw, Poland
| | - Thomas Lunner
- Eriksholm Research Centre, Oticon A/S, Snekkersten, Denmark
- Linnaeus Centre HEAD, The Swedish Institute for Disability Research, Linköping and Örebro Universities, Linköping, Sweden
- Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden
| | - Sophia E. Kramer
- Section Ear & Hearing, Dept. of Otolaryngology-Head and Neck Surgery and EMGO Institute for Health and Care Research, VU University medical center, Amsterdam, The Netherlands
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Paschoal MA, Brunelli AC, Tamaki GM, Magela SS. Cardiac Autonomic Adjustments During Baroreflex Test in Obese and Non-Obese Preadolescents. Arq Bras Cardiol 2016; 106:297-303. [PMID: 27007224 PMCID: PMC4845702 DOI: 10.5935/abc.20160040] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2015] [Accepted: 11/30/2015] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND Recent studies have shown changes in cardiac autonomic control of obese preadolescents. OBJECTIVE To assess the heart rate responses and cardiac autonomic modulation of obese preadolescents during constant expiratory effort. METHODS This study assessed 10 obese and 10 non-obese preadolescents aged 9 to 12 years. The body mass index of the obese group was between the 95th and 97th percentiles of the CDC National Center for Health Statistics growth charts, while that of the non-obese group, between the 5th and 85th percentiles. Initially, they underwent anthropometric and clinical assessment, and their maximum expiratory pressures were obtained. Then, the preadolescents underwent a constant expiratory effort of 70% of their maximum expiratory pressure for 20 seconds, with heart rate measurement 5 minutes before, during and 5 minutes after it. Heart rate variability (HRV) and heart rate values were analyzed by use of a software. RESULTS The HRV did not differ when compared before and after the constant expiratory effort intra- and intergroup. The heart rate values differed (p < 0.05) during the effort, being the total variation in non-obese preadolescents of 18.5 ± 1.5 bpm, and in obese, of 12.2 ± 1.3 bpm. CONCLUSION The cardiac autonomic modulation did not differ between the groups when comparing before and after the constant expiratory effort. However, the obese group showed lower cardiovascular response to baroreceptor stimuli during the effort, suggesting lower autonomic baroreflex sensitivity.
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Mochizuki H, Taniguchi A, Nakazato Y, Ishii N, Ebihara Y, Sugiyama T, Shiomi K, Nakazato M. Increased body mass index associated with autonomic dysfunction in Parkinson's disease. Parkinsonism Relat Disord 2016; 24:129-31. [DOI: 10.1016/j.parkreldis.2016.01.007] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2015] [Revised: 12/10/2015] [Accepted: 01/07/2016] [Indexed: 10/22/2022]
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Altay Y, Altay MM, Demirok G, Balta O, Bolu H. Measurements of Pupillary Diameter and Wavefront Aberrations in Pregnant Women. SCIENTIFICA 2016; 2016:4129524. [PMID: 26998383 PMCID: PMC4779841 DOI: 10.1155/2016/4129524] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/05/2015] [Revised: 01/30/2016] [Accepted: 02/01/2016] [Indexed: 05/23/2023]
Abstract
Purpose. To show whether pregnancy affects the measurements of pupillary diameter and wavefront (WF) aberrations. Methods. This was a case-control study including 34 healthy pregnant women in the third trimester and age-matched 34 nonpregnant women. Only women who had no ocular abnormalities and no refractive error were included. We measured photopic and mesopic pupil diameter and WF aberrations at the third trimester and at the second postpartum month. Measurements of the right eyes were used in this study. The differences between groups were analysed by paired t-test and t-test. Results. Pregnant women's mean photopic pupil size in the third trimester was significantly higher than in postpartum period and in control group (3.74 ± 0.77, 3.45 ± 0.53, and 3.49 ± 0.15 mm, p < 0.05, resp.). Mesopic pupil size in the third trimester was also higher than in postpartum period and in control group (6.77 ± 0.52, 6.42 ± 0.55, and 6.38 ± 0.21 mm, p < 0.05, resp.). RMS-3 and RMS-5 values were higher in pregnancy but these differences were not statistically significant. Conclusion. Pregnancy increased photopic and mesopic pupil size significantly but did not increase wavefront aberrations notably. Increased pupil size may be due to increased sympathetic activity during pregnancy. And this activity can be noninvasively determined by measuring pupil size.
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Affiliation(s)
- Yesim Altay
- Department of Ophthalmology, Ankara Training and Research Hospital, 06340 Ankara, Turkey
| | - Mehmet Metin Altay
- Etlik Zubeyde Hanim Women's Health Training and Research Hospital, 06010 Ankara, Turkey
| | - Gulizar Demirok
- Department of Ophthalmology, Ufuk University Faculty of Medicine, 06520 Ankara, Turkey
| | - Ozgur Balta
- Department of Ophthalmology, Ankara Training and Research Hospital, 06340 Ankara, Turkey
| | - Hulya Bolu
- Department of Ophthalmology, Batıgoz Eye Hospital, Izmir, Turkey
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Obesity and Prader-Willi Syndrome Affect Heart Rate Recovery from Dynamic Resistance Exercise in Youth. Diseases 2016; 4:diseases4010004. [PMID: 28933384 PMCID: PMC5456310 DOI: 10.3390/diseases4010004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2015] [Revised: 12/23/2015] [Accepted: 01/13/2016] [Indexed: 01/11/2023] Open
Abstract
Following exercise, heart rate decline is initially driven by parasympathetic reactivation and later by sympathetic withdrawal. Obesity delays endurance exercise heart rate recovery (HRR) in both children and adults. Young people with Prader-Willi Syndrome (PWS), a congenital cause for obesity, have shown a slower 60-s endurance exercise HRR compared to lean and obese children, suggesting compromised regulation. This study further evaluated effects of obesity and PWS on resistance exercise HRR at 30 and 60 s in children. PWS (8–18 years) and lean and obese controls (8–11 years) completed a weighted step-up protocol (six sets x 10 reps per leg, separated by one-minute rest), standardized using participant stature and lean body mass. HRR was evaluated by calculated HRR value (HRRV = difference between HR at test termination and 30 (HRRV30) and 60 (HRRV60) s post-exercise). PWS and obese had a smaller HRRV30 than lean (p < 0.01 for both). Additionally, PWS had a smaller HRRV60 than lean and obese (p = 0.01 for both). Obesity appears to delay early parasympathetic reactivation, which occurs within 30 s following resistance exercise. However, the continued HRR delay at 60 s in PWS may be explained by either blunted parasympathetic nervous system reactivation, delayed sympathetic withdrawal and/or poor cardiovascular fitness.
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