1
|
Oliveira C, Silveira EA, Rosa L, Santos A, Rodrigues AP, Mendonça C, Silva L, Gentil P, Rebelo AC. Risk Factors Associated with Cardiac Autonomic Modulation in Obese Individuals. J Obes 2020; 2020:7185249. [PMID: 32318288 PMCID: PMC7152942 DOI: 10.1155/2020/7185249] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2020] [Accepted: 03/07/2020] [Indexed: 12/18/2022] Open
Abstract
Obesity leads to an imbalance in the autonomic nervous system, especially in increased sympathetic modulation and decreased vagal tone, and some anthropometric, metabolic, and lifestyle variables may increase the risk of developing cardiovascular disease. Objective. To analyze the association between cardiovascular autonomic modulation and biochemical and anthropometric markers, food intake, and physical activity level in severely obese individuals. Methodology. The present study is a cutout of a randomized clinical trial "Effect of nutritional intervention and olive oil in severe obesity" (DieTBra Trial), where the baseline data were analyzed. Anthropometric data, biochemical exams, heart rate variability (HRV), accelerometry, and 24 h recall (R24H) of obese patients (body mass index BMI ≥35 kg/m2) were collected. Results. 64 obese patients were analyzed, with a mean age of 39.10 ± 7.74 years (27 to 58 years). By HRV analysis, in the frequency domain, the obese had a higher predominance of sympathetic autonomic modulation (low frequency (LF) 56.44 ± 20.31 nu) and lower parasympathetic modulation (high frequency (HF) 42.52 ± 19.18 nu). A negative association was observed between the variables Homeostasis Evaluation Model (HOMA-IR) and HF (p = 0.049). In the physical activity analysis, there was a negative association between moderate to vigorous physical activity and the sympathetic component (p = 0.043), and for sedentary time (ST), there was a negative association with HF (p = 0.049) and LF/HF (p = 0.036) and a positive association with LF (p = 0.014). For multiple linear regression, waist circumference (WC) and HOMA-IR values were negatively associated with HF (β = -0.685, p = 0.010; β = -14.989, p = 0.010; respectively). HOMA-IR (β = 0.141, p = 0.003) and the percentage of lipids ingested (β = -0.030, p = 0.043) were negatively associated with LF/HF. Conclusion. Among the cardiovascular risk variables studied, insulin resistance and central adiposity showed the greatest influence on cardiac autonomic modulation of obese, increasing the risk for cardiovascular disease.
Collapse
Affiliation(s)
- Camila Oliveira
- Medicine Faculty, Health Science Post-Graduation Program, Universidade Federal de Goiás, Goiânia, Goiás, Brazil
| | - Erika Aparecida Silveira
- Medicine Faculty, Coordinator of the Severe Obesity Study Group, Federal University of Goiás, Goiânia, Brazil
| | - Lorena Rosa
- Medicine Faculty, Health Science Post-Graduation Program, Universidade Federal de Goiás, Goiânia, Goiás, Brazil
| | - Annelisa Santos
- Medicine Faculty, Health Science Post-Graduation Program, Universidade Federal de Goiás, Goiânia, Goiás, Brazil
| | - Ana Paula Rodrigues
- Medicine Faculty, Health Science Post-Graduation Program, Universidade Federal de Goiás, Goiânia, Goiás, Brazil
| | - Carolina Mendonça
- Medicine Faculty, Health Science Post-Graduation Program, Universidade Federal de Goiás, Goiânia, Goiás, Brazil
| | - Lucas Silva
- Medicine Faculty, Health Science Post-Graduation Program, Universidade Federal de Goiás, Goiânia, Goiás, Brazil
| | - Paulo Gentil
- College of Physical Education and Dance, Federal University of Goiás, Goiânia, Brazil
| | - Ana Cristina Rebelo
- Department of Morphology, Biological Sciences Institute, Federal University of Goiás, Goiânia, Goiás, Brazil
| |
Collapse
|
2
|
Carvalho NNC, de Oliveira Junior FA, da Silva G, Baccin Martins VJ, Braga VDA, da Costa-Silva JH, Fernandes Pimenta FC, de Brito Alves JL. Impact of arterial hypertension and type 2 diabetes on cardiac autonomic modulation in obese individuals with recommendation for bariatric surgery. Diabetes Metab Syndr Obes 2019; 12:1503-1511. [PMID: 31686874 PMCID: PMC6709514 DOI: 10.2147/dmso.s204414] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2019] [Accepted: 07/13/2019] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND AND AIM Obese individuals with recommendation for bariatric surgery (BS) exhibit increased cardiovascular risk. The association of obesity with comorbidities, such as arterial hypertension (HTN) and type 2 diabetes mellitus (T2DM) can worsen cardiovascular dysfunction. This study aimed to investigate the effect of HTN on cardiac autonomic function and whether diabetes exacerbates HTN-related impairment of autonomic function in obese subjects. METHODS Samples (n=63) were allocated to three groups: Obese without HTN and T2DM (n=29), Obese with HTN (OHTN, n=17) and OHTN with T2DM (OHTN+T2DM, n=17), in which anthropometric measures, body composition, blood biochemical parameters, blood pressure (BP) and heart rate variability (HRV) were evaluated. RESULTS The age was higher in OHTN+T2DM and OHTN than in obese groups (p<0.05). OHTN+T2DM individuals had increased neck circumference and compromised glycemic profile when compared to obese and OHTN groups (p<0.05). Mean values for standard deviation of RR (SDRR), square root of the mean squared differences of successive RR interval (RMSSD) and number of pairs of successive normal-to-normal beat intervals that differed by 50 ms (pRR50) were significantly lower in OHTN+T2DM and OHTN groups when compared to patients with obesity alone (p<0.05). The low frequency (LF), low frequency/high frequency (LF/HF) ratio were higher in the OHTN+T2DM and OHTN than subjects with obesity alone (p<0.05). Nonlinear parameters SD2 and SD1 were also lower in the OHTN+T2DM when compared to the obese group (p<0.05). However, the SD2/SD1 ratio was higher in the OHTN+T2DM and OHTN groups than the obese group. CONCLUSION T2DM and/or HTN impair the cardiac autonomic function in obese patients. However, the presence of T2DM did not exacerbate the hypertension-related impairment of autonomic function.
Collapse
Affiliation(s)
- Nara Nóbrega Crispim Carvalho
- Department of Nutrition, Health Sciences Center, Federal University of Paraiba, João Pessoa, Brazil
- Department of Endocrinology, Lauro Wanderley University Hospital, Federal University of Paraiba, João Pessoa, Brazil
| | | | - Gitana da Silva
- Lauro Wanderley Hospital, Federal University of Paraiba, João Pessoa, Brazil
| | - Vinícius José Baccin Martins
- Department of Physiology and Pathology, Health Sciences Center, Federal University of Paraiba, João Pessoa, Brazil
| | - Valdir de Andrade Braga
- Department of Biotechnology, Center of Biotechnology, Federal University of Paraíba, João Pessoa, Brazil
| | - João Henrique da Costa-Silva
- Department of Physical Education and Sport Sciences, Federal University of Pernambuco, Vitória De Santo Antão, PE, Brazil
| | | | - José Luiz de Brito Alves
- Department of Nutrition, Health Sciences Center, Federal University of Paraiba, João Pessoa, Brazil
- Correspondence: José Luiz de Brito Alves; Nara Nóbrega Crispim CarvalhoDepartment of Nutrition, Federal University of Paraiba, Campus I – Jd. Cidade Universitária, João Pessoa, PBCEP: 58051-900, BrazilTel/fax +55 8 199 845 5485 Email ;
| |
Collapse
|
3
|
Liao CD, Tsauo JY, Hsiao DJ, Liou TH, Huang SW, Lin LF. Association of physical capacity with heart rate variability based on a short-duration measurement of resting pulse rate in older adults with obesity. PLoS One 2017; 12:e0189150. [PMID: 29267296 PMCID: PMC5739389 DOI: 10.1371/journal.pone.0189150] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2017] [Accepted: 11/20/2017] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Obesity can limit physical capacity and lower physical activity levels in elderly people. Low physical activity levels may be mediated by autonomic dysfunction with decreased heart rate variability (HRV). However, the relationship between autonomic dysfunction and low physical capability remains unclear. This cross-sectional study investigated the association of low physical capability with HRV in older adults with obesity. MATERIALS AND METHODS We recruited 231 old man and 210 old women with a mean (range) age of 65.5 (51-78) and 62.9 (52-76) years, respectively. Physical capability was measured using mobility tasks, including functional reach, single-leg stance (SLS), gait speed (GS), timed up and go, and timed chair rise (TCR), and the scores on these tasks were merged and transformed into a global physical capability score (GPCS). HRV was measured using a 7-min resting pulse-based technique, and the time- and frequency-domain indices of HRV were obtained including standard deviation of normal-to-normal intervals (SDNN), root mean square of successive differences at rest (rMSSD), and high-frequency (HF) power. All HRV indices were natural log (ln) transformed for analysis. Participants were divided into high, moderate, and low physical-capability groups according to their physical performance. Multivariate analysis of covariance was performed to test differences in HRV indices among physical-capability groups with participants' characteristics serving as covariates. A stepwise regression model was established to identify the determinants of HRV indices. We used hierarchical regression analysis to identify the association of the GPCS with HRV indices. RESULTS In both men and women, the low physical-capability group exhibited significantly increased heart rate (P <0.05) and decreased HRV in terms of a decreased ln[SDNN] (P <0.001), ln[rMSSD] (P <0.05) and ln[HF] (P <0.05), compared with the high physical-capability group. GS positively predicted ln[SDNN], whereas SLS, GS, and TCR were determinants of ln[HF], regardless of gender. The GPCS in older men and women independently accounted for 29.9% (P <0.001) and 23.7% (P <0.001), respectively, in variance in ln[SDNN]. CONCLUSIONS A low physical-capability level is an independent determinant of decreased HRV in older adults with obesity.
Collapse
Affiliation(s)
- Chun-De Liao
- School and Graduate Institute of Physical Therapy, College of Medicine, National Taiwan University, Taipei, Taiwan
- Department of Physical Medicine and Rehabilitation, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan
| | - Jau-Yih Tsauo
- School and Graduate Institute of Physical Therapy, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Dun-Jen Hsiao
- College of Public Health and Nutrition, Taipei Medical University, Taipei, Taiwan
| | - Tsan-Hon Liou
- Department of Physical Medicine and Rehabilitation, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan
- Graduate Institute of Injury Prevention and control, Taipei Medical University, Taipei, Taiwan
- Department of Physical Medicine and Rehabilitation, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Shih-Wei Huang
- Department of Physical Medicine and Rehabilitation, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan
| | - Li-Fong Lin
- Department of Physical Medicine and Rehabilitation, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan
- School of Gerontology Health Management, College of Nursing, Taipei Medical University, Taipei, Taiwan
| |
Collapse
|
4
|
Ecklund-Flores L, Myers MM, Monk C, Perez A, Odendaal HJ, Fifer WP. Maternal depression during pregnancy is associated with increased birth weight in term infants. Dev Psychobiol 2017; 59:314-323. [PMID: 28323349 DOI: 10.1002/dev.21496] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2016] [Accepted: 11/28/2016] [Indexed: 12/19/2022]
Abstract
Previous research of maternal depression during pregnancy suggests an association with low birth weight in newborns. Review of these studies reveals predominant comorbidity with premature birth. This current study examines antenatal depression and birth weight in term, medically low-risk pregnancies. Maternal physiological and demographic measures were collected as well. In total, 227 pregnant women were recruited to participate in four experimental protocols at Columbia University Medical Center. Results indicate that depressed pregnant women who carry to term had significantly higher heart rates, lower heart rate variability, and gave birth to heavier babies than those of pregnant women who were not depressed. Low income participants had significantly higher levels of depression, as well as significantly higher heart rates and lower heart rate variability, than those in higher income groups. In full-term infants, maternal prenatal depression appears to promote higher birth weight, with elevated maternal heart rate as a likely mediating mechanism.
Collapse
Affiliation(s)
- Lisa Ecklund-Flores
- Department of Psychology, Mercy College, Dobbs Ferry, New York
- Division of Developmental Neuroscience, New York State Psychiatric Institute, New York, New York
| | - Michael M Myers
- Division of Developmental Neuroscience, New York State Psychiatric Institute, New York, New York
- Department of Psychiatry, Columbia University Medical Center, New York, New York
- Department of Pediatrics, Columbia University Medical Center, New York, New York
- Department of Obstetrics and Gynecology, Stellenbosh University, Cape Town, South Africa
| | - Catherine Monk
- Division of Developmental Neuroscience, New York State Psychiatric Institute, New York, New York
- Department of Psychiatry, Columbia University Medical Center, New York, New York
- Department of Obstetrics, Columbia University Medical Center, New York, New York
- Division of Behavioral Medicine, New York State Psychiatric Institute, New York, New York
| | - Albany Perez
- Department of Psychology, Mercy College, Dobbs Ferry, New York
- Division of Developmental Neuroscience, New York State Psychiatric Institute, New York, New York
| | - Hein J Odendaal
- Department of Obstetrics and Gynecology, Stellenbosh University, Cape Town, South Africa
| | - William P Fifer
- Division of Developmental Neuroscience, New York State Psychiatric Institute, New York, New York
- Department of Psychiatry, Columbia University Medical Center, New York, New York
- Department of Pediatrics, Columbia University Medical Center, New York, New York
- Department of Obstetrics and Gynecology, Stellenbosh University, Cape Town, South Africa
| |
Collapse
|