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Mirzohreh ST, Panahi P, Heidari F. Exploring heart rate variability in polycystic ovary syndrome: implications for cardiovascular health: a systematic review and meta-analysis. Syst Rev 2024; 13:194. [PMID: 39049099 PMCID: PMC11271026 DOI: 10.1186/s13643-024-02617-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Accepted: 07/16/2024] [Indexed: 07/27/2024] Open
Abstract
OBJECTIVES Polycystic ovary syndrome (PCOS) is a prevalent and complex endocrine disorder that affects women of reproductive age. It has significant implications for female endocrine function, reproductive health, and metabolic disturbances, including insulin resistance, impaired glucose tolerance, and dyslipidemia. Studies have shown that decreased heart rate variability (HRV), a marker of autonomic dysfunction, is associated with adverse cardiovascular events. Recent research has focused on investigating autonomic function in PCOS, and some studies have suggested altered autonomic drive in these patients. The aim of this systematic review and meta-analysis was to evaluate cardiac autonomic function by analyzing HRV in women with PCOS. METHODS This systematic review was prepared using PRISMA reporting guidelines. The databases searched were PubMed, Scopus, Web of Science, and Cochrane. Risk of Bias was assessed using ROBINS-I for non-RCTs. The GRADE approach was employed to evaluate the level of certainty in the evidence for each outcome. In order to identify the underlying cause of high heterogeneity, a subgroup analysis was conducted. Sensitivity analysis was checked. A random effect model was used and calculated a pooled standardized mean difference (SMD) with a 95% confidence interval (CI). RESULTS Seventeen articles were included in the final analysis, varied in quality, ranging from a "low" to a "high risk of bias". Combined analyses indicated a notable decrease in HRV among individuals with PCOS compared to the control group. Significant changes were observed in SDNN (SMD: -0.763, 95%CI [-1.289 to -0.237], p=0.004), PNN50 (SMD: -1.245, 95%CI [-2.07, -0.419], p=0.003), LF/HF ratio (SMD: 0.670, 95%CI [0.248, 1.091], p=0.002), HFnu (SMD: -0.873, 95%CI [-1.257, -0.489], p=0.000), LFnu (SMD: 0.840, 95%CI [0.428, 1.251], p=0.000) and TP (SMD: -1.997, 95%CI [-3.306, -0.687], p=0.003). The heterogeneity was partially explained by types of study design. Subgroup analysis revealed significant alterations of HRV in normal-weighted and overweight PCOS cases. Conversely, no significant changes in HRV were observed in obese PCOS cases. CONCLUSION The findings of this meta-analysis provide evidence suggesting diminished HRV in individuals with PCOS compared to non-PCOS control group.
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Affiliation(s)
| | - Padideh Panahi
- Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Fariba Heidari
- Department of Community and Family Medicine, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
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Martínez-González-Moro I, Albertus Cámara I, Paredes Ruiz MJ. Influences of Intense Physical Effort on the Activity of the Autonomous Nervous System and Stress, as Measured with Photoplethysmography. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:16066. [PMID: 36498140 PMCID: PMC9735638 DOI: 10.3390/ijerph192316066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/25/2022] [Revised: 11/27/2022] [Accepted: 11/28/2022] [Indexed: 06/17/2023]
Abstract
Background: The autonomic nervous system, which is composed of the sympathetic and parasympathetic nervous system, is closely related to the cardiovascular system. The temporal variation between each of the intervals between the consecutive “R” waves of an electrocardiogram is known as heart rate variability. Depending on the type of activity, both systems can be activated, and also influence the interval between “R” waves. Currently, with advancements in technology and electronic devices, photoplethysmography is used. Photoplethysmography detects changes in the intensity of reflected light that allow differentiation between systole and diastole and, therefore, determines the heart rate, its frequency and its variations. In this way, changes in the autonomic nervous system can be detected by devices such as the Max Pulse®. Objective: To determine whether the information provided by Max Pulse® on autonomic balance and stress is modified after intense physical exercise, thereby determining whether there is a relationship with body composition, and also whether there are differences with respect to gender. Materials and Methods: Fifty-three runners (38.9% female) with a mean age of 31.3 ± 8.1 years participated in the study. Two measurements (before and after intense physical effort) were performed with the Max Pulse® device. The flotoplethysmography measurement lasted 3 min, and was performed in the supine position. The exercise test was performed on a treadmill. It was initiated at a speed of 6 and 7 km/h for women and men, respectively. Subjects indicated the end of the test by making a hand gesture when unable to continue the test. Results: Autonomic nervous system activity and mental stress values decreased significantly (p < 0.05) in men and women, while autonomic nervous system balance decreased only in women. Physical stress increased (p < 0.05) in both sexes. Conclusions: Intense exercise causes changes in variables that assess autonomic nervous system balance and stress, as measured by a device based on photoplethysmography. The changes are evident in both sexes, and are not related to body composition.
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Nie J, Tong TK, Zhou Y, Shi Q, Zhang H, Kong Z. Cardiac autonomic disturbance following resistance and sprint-interval exercises in non-obese and obese young men. Appl Physiol Nutr Metab 2022; 47:949-962. [PMID: 35728265 DOI: 10.1139/apnm-2022-0166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
This study examined the alterations of heart rate variability (HRV) following iso-duration resistance (RES) and sprint-interval (SIE) exercises by comparing with that of non-exercise control (CON) in 14 non-obese (NOB) and 15 obese (OB) young men. Time and frequency domain measures as well as non-linear metrics of HRV were assessed before and immediately after exercise, and during every 20 min until 120 min post exercise. The variables during the first 4 hrs of actual sleep time at night, and the period of 12-14 hrs post exercise were also measured. All trials were scheduled at 20:00. It was found that RES and SIE attenuated the HRV in both NOB and OB (P <0.05), and the attenuated HRV restored progressively during subsequent recovery. Although the changes in HRV indices among various time points during the recovery period and its interaction across RES, SIE and CON were not different between NOB and OB, the restoration of the declined HRV indices to corresponding CON level in the two exercise trials in OB appeared to be sluggish in relative to NOB. Notwithstanding, post-exercise HRV that recorded during actual sleep at night and during 12-14 hrs apart from exercise were unvaried among the three trials in both groups (P>0.05). These findings suggest that obesity is likely to be a factor hindering the removal of exercise-induced cardiac autonomic disturbance in young men. Nonetheless, the declined HRV following both the RES and SIE protocols were well restored after a resting period of ~10 hrs regardless of obesity. The study was registered at ISRCTN as DOI:10.1186/ISRCTN88544091.
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Affiliation(s)
- Jinlei Nie
- Macao Polytechnic University, 59192, Faculty of Health Sciences and Sports, Macau, Macao;
| | - Tomas K Tong
- Hong Kong Baptist University, 26679, Hong Kong, Hong Kong;
| | - Yingqi Zhou
- Chengde Medical University, 92979, Chengde, Hebei, China;
| | - Qingde Shi
- Macao Polytechnic University, 59192, Faculty of Health Sciences and Sports, Macau, Macao;
| | - Haifeng Zhang
- Hebei Normal University, 66447, Physical Education College, Shijiazhuang, Heibei, China;
| | - Zhaowei Kong
- University of Macau, 59193, Faculty of Education, Taipa, Macao;
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Larkey L, Kim W, James D, Kishida M, Vizcaino M, Huberty J, Krishnamurthi N. Mind-Body and Psychosocial Interventions May Similarly Affect Heart Rate Variability Patterns in Cancer Recovery: Implications for a Mechanism of Symptom Improvement. Integr Cancer Ther 2021; 19:1534735420949677. [PMID: 32783546 PMCID: PMC7425257 DOI: 10.1177/1534735420949677] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Background: Advancements in early detection and treatment of cancer have led to increased survival rates and greater need to identify effective supportive care options for resolving symptoms of survivorship. Many non-pharmacological approaches to symptom management during and after cancer treatment involve emotional self-regulation as a central strategy for improving well-being. Identifying commonalities among these strategies’ mechanisms of action may facilitate understanding of what might be useful for optimizing intervention effects. Heart rate variability (HRV) parameters are indicative of improved autonomic nervous system (ANS) balance and resiliency and reduced emotional distress and are thus identified as a mechanism to discuss as a marker of potential for intervention efficacy and a target for optimization. Methods: HRV data from 2 studies, 1 examining a mind-body intervention and 1 examining a psychosocial intervention, are presented as a point of discussion about preliminary associations between the interventions, change in HRV, and emotional distress reduction. Results: HRV significantly decreased in sympathetic activity in response to a mind-body intervention (Qigong/Tai Chi), and increased vagal tone in response to a psychosocial (storytelling) intervention. In both, these changes in HRV parameters were associated with improved emotional states. Conclusion: Our preliminary data suggest that HRV may serve as an important marker of underlying changes that mediate emotional regulation; this observation deserves further investigation. If identified as a worthy target, focusing on interventions that improve HRV within the context of interventions for cancer patients may be important to key outcomes and clinical practice.
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Affiliation(s)
- Linda Larkey
- Edson College of Nursing and Health Innovation, Arizona State University, Phoenix, AZ, USA
| | - Wonsun Kim
- Edson College of Nursing and Health Innovation, Arizona State University, Phoenix, AZ, USA
| | - Dara James
- Edson College of Nursing and Health Innovation, Arizona State University, Phoenix, AZ, USA
| | - Moé Kishida
- Edson College of Nursing and Health Innovation, Arizona State University, Phoenix, AZ, USA
| | | | - Jennifer Huberty
- College of Health Solutions, Arizona State University, Phoenix, AZ, USA
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Strüven A, Holzapfel C, Stremmel C, Brunner S. Obesity, Nutrition and Heart Rate Variability. Int J Mol Sci 2021; 22:ijms22084215. [PMID: 33921697 PMCID: PMC8072942 DOI: 10.3390/ijms22084215] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Revised: 04/12/2021] [Accepted: 04/13/2021] [Indexed: 12/15/2022] Open
Abstract
Heart rate variability (HRV) represents the activity and balance of the autonomic nervous system and its capability to react to internal and external stimuli. As a measure of general body homeostasis, HRV is linked to lifestyle factors and it is associated with morbidity and mortality. It is easily accessible by heart rate monitoring and gains interest in the era of smart watches and self-monitoring. In this review, we summarize effects of weight loss, training, and nutrition on HRV with a special focus on obesity. Besides weight reduction, effects of physical activity and dietary intervention can be monitored by parameters of HRV, including its time and frequency domain components. In the future, monitoring of HRV should be included in any weight reduction program as it provides an additional tool to analyze the effect of body weight on general health and homeostasis. HRV parameters could, for example, be monitored easily by implementation of an electrocardiogram (ECG) every two to four weeks during weight reduction period. Indices presumibly showing beneficial changes could be a reduction in heart rate and the number of premature ventricular complexes as well as an increase in standard deviation of normal-to-normal beat intervals (SDNN), just to name some.
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Affiliation(s)
- Anna Strüven
- Department of Medicine I, University Hospital Munich, Ludwig Maximilians University Munich, Marchioninistr. 15, 81377 Munich, Germany; (A.S.); (C.S.)
- German Center for Cardiovascular Research (DZHK), Partner Site: Munich Heart Alliance, Marchioninistr. 15, 81377 Munich, Germany
| | - Christina Holzapfel
- Institute for Nutritional Medicine, School of Medicine, Technical University of Munich, Ismaninger Strasse 22, 81675 Munich, Germany;
| | - Christopher Stremmel
- Department of Medicine I, University Hospital Munich, Ludwig Maximilians University Munich, Marchioninistr. 15, 81377 Munich, Germany; (A.S.); (C.S.)
- German Center for Cardiovascular Research (DZHK), Partner Site: Munich Heart Alliance, Marchioninistr. 15, 81377 Munich, Germany
| | - Stefan Brunner
- Department of Medicine I, University Hospital Munich, Ludwig Maximilians University Munich, Marchioninistr. 15, 81377 Munich, Germany; (A.S.); (C.S.)
- German Center for Cardiovascular Research (DZHK), Partner Site: Munich Heart Alliance, Marchioninistr. 15, 81377 Munich, Germany
- Department of Medicine I, University Hospital Munich, Ziemssenstrasse 1, 80336 Munich, Germany
- Correspondence: ; Tel.: +49-89-4400-52248; Fax: +49-89-4400-75251
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Pongkan W, Jitnapakarn W, Phetnoi W, Punyapornwithaya V, Boonyapakorn C. Obesity-Induced Heart Rate Variability Impairment and Decreased Systolic Function in Obese Male Dogs. Animals (Basel) 2020; 10:ani10081383. [PMID: 32785083 PMCID: PMC7460129 DOI: 10.3390/ani10081383] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Revised: 08/04/2020] [Accepted: 08/04/2020] [Indexed: 01/02/2023] Open
Abstract
Simple Summary Obesity in dogs can induce many adverse health effects including musculoskeletal problems, respiratory distress, metabolic syndrome, and cardiovascular diseases. In humans with obesity, heart rate variability (HRV) is used to identify and predict the risk of cardiovascular diseases. However, this predictive tool has never been used in veterinary medicine, and the relationship between obesity and HRV has rarely been investigated. In this study, we investigated HRV, plasma oxidative stress (MDA), and cardiac function in obese male dogs. We hypothesized that obese male dogs have decreased cardiac function and impaired HRV compared to non-obese dogs. Our study found that obese dogs have decreased cardiac systolic function and impaired HRV, as indicated by reduced percentages of cardiac contraction and impaired cardiac autonomic activity compared to non-obese dogs. We concluded that obesity can decrease systolic function and cause HRV impairment, which might increase the risk of cardiovascular disease in dogs. In addition, HRV might be used as a predictive or prognostic tool in the prevention of cardiovascular disease in obese dogs. Abstract Obesity can induce cardiovascular diseases in both humans and animals. Heart rate variability (HRV) is an indicator of sympathovagal balance and is used to identify cardiovascular diseases in humans. However, HRV and cardiac function have rarely been investigated in obese dogs. This study investigated the effect of obesity on oxidative stress, HRV, and cardiac function in obese and non-obese dogs. The nine-scale body condition score (BCS) system was used to determine obesity. Thirty small breed dogs were divided into a normal weight group (n = 15) and an obese group (n = 15). All dogs underwent physical examination, plasma malondialdehyde (MDA) measurement, electrocardiography, echocardiography, and two hours of Holter monitoring. This study found that obese dogs had increased plasma MDA and sympathovagal imbalance, which was indicated by impaired time and frequency domains compared to normal weight dogs. Although cardiac function was within normal limits, the echocardiographic study found that the obese dogs had reduced cardiac wall thickness and lower systolic function, as indicated by a reduction in %ejection fraction, %fractional shortening, increased left ventricular (LV) internal diameter during systole, and LV end-systolic volume compared to normal weight dogs. This study concluded that obesity in dogs can induce increased plasma oxidative stress, impaired HRV, and reduced cardiac systolic function compared to non-obese dogs.
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Affiliation(s)
- Wanpitak Pongkan
- Department of Veterinary Biosciences and Veterinary Public Health, Faculty of Veterinary Medicine, Chiang Mai University, Chiang Mai 50100, Thailand; (W.P.); (W.J.); (W.P.)
- Integrative Research Center for Veterinary Circulatory Sciences, Faculty of Veterinary Medicine, Chiang Mai University, Chiang Mai 50100, Thailand
- Veterinary Cardiopulmonary Clinic, Small Animal Hospital, Faculty of Veterinary Medicine, Chiang Mai University, Chiang Mai 50100, Thailand
| | - Wannida Jitnapakarn
- Department of Veterinary Biosciences and Veterinary Public Health, Faculty of Veterinary Medicine, Chiang Mai University, Chiang Mai 50100, Thailand; (W.P.); (W.J.); (W.P.)
| | - Warunee Phetnoi
- Department of Veterinary Biosciences and Veterinary Public Health, Faculty of Veterinary Medicine, Chiang Mai University, Chiang Mai 50100, Thailand; (W.P.); (W.J.); (W.P.)
| | - Veerasak Punyapornwithaya
- Department of Food Animal Clinic, Faculty of Veterinary Medicine, Chiang Mai University, Chiang Mai 50100, Thailand;
| | - Chavalit Boonyapakorn
- Integrative Research Center for Veterinary Circulatory Sciences, Faculty of Veterinary Medicine, Chiang Mai University, Chiang Mai 50100, Thailand
- Veterinary Cardiopulmonary Clinic, Small Animal Hospital, Faculty of Veterinary Medicine, Chiang Mai University, Chiang Mai 50100, Thailand
- Department of Companion Animal and Wildlife Clinic, Faculty of Veterinary Medicine, Chiang Mai University, Chiang Mai 50100, Thailand
- Correspondence: ; Tel.: +66-53-948-015
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Oliveira C, Silveira EA, Rosa L, Santos A, Rodrigues AP, Mendonça C, Silva L, Gentil P, Rebelo AC. Risk Factors Associated with Cardiac Autonomic Modulation in Obese Individuals. J Obes 2020; 2020:7185249. [PMID: 32318288 PMCID: PMC7152942 DOI: 10.1155/2020/7185249] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2020] [Accepted: 03/07/2020] [Indexed: 12/18/2022] Open
Abstract
Obesity leads to an imbalance in the autonomic nervous system, especially in increased sympathetic modulation and decreased vagal tone, and some anthropometric, metabolic, and lifestyle variables may increase the risk of developing cardiovascular disease. Objective. To analyze the association between cardiovascular autonomic modulation and biochemical and anthropometric markers, food intake, and physical activity level in severely obese individuals. Methodology. The present study is a cutout of a randomized clinical trial "Effect of nutritional intervention and olive oil in severe obesity" (DieTBra Trial), where the baseline data were analyzed. Anthropometric data, biochemical exams, heart rate variability (HRV), accelerometry, and 24 h recall (R24H) of obese patients (body mass index BMI ≥35 kg/m2) were collected. Results. 64 obese patients were analyzed, with a mean age of 39.10 ± 7.74 years (27 to 58 years). By HRV analysis, in the frequency domain, the obese had a higher predominance of sympathetic autonomic modulation (low frequency (LF) 56.44 ± 20.31 nu) and lower parasympathetic modulation (high frequency (HF) 42.52 ± 19.18 nu). A negative association was observed between the variables Homeostasis Evaluation Model (HOMA-IR) and HF (p = 0.049). In the physical activity analysis, there was a negative association between moderate to vigorous physical activity and the sympathetic component (p = 0.043), and for sedentary time (ST), there was a negative association with HF (p = 0.049) and LF/HF (p = 0.036) and a positive association with LF (p = 0.014). For multiple linear regression, waist circumference (WC) and HOMA-IR values were negatively associated with HF (β = -0.685, p = 0.010; β = -14.989, p = 0.010; respectively). HOMA-IR (β = 0.141, p = 0.003) and the percentage of lipids ingested (β = -0.030, p = 0.043) were negatively associated with LF/HF. Conclusion. Among the cardiovascular risk variables studied, insulin resistance and central adiposity showed the greatest influence on cardiac autonomic modulation of obese, increasing the risk for cardiovascular disease.
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Affiliation(s)
- Camila Oliveira
- Medicine Faculty, Health Science Post-Graduation Program, Universidade Federal de Goiás, Goiânia, Goiás, Brazil
| | - Erika Aparecida Silveira
- Medicine Faculty, Coordinator of the Severe Obesity Study Group, Federal University of Goiás, Goiânia, Brazil
| | - Lorena Rosa
- Medicine Faculty, Health Science Post-Graduation Program, Universidade Federal de Goiás, Goiânia, Goiás, Brazil
| | - Annelisa Santos
- Medicine Faculty, Health Science Post-Graduation Program, Universidade Federal de Goiás, Goiânia, Goiás, Brazil
| | - Ana Paula Rodrigues
- Medicine Faculty, Health Science Post-Graduation Program, Universidade Federal de Goiás, Goiânia, Goiás, Brazil
| | - Carolina Mendonça
- Medicine Faculty, Health Science Post-Graduation Program, Universidade Federal de Goiás, Goiânia, Goiás, Brazil
| | - Lucas Silva
- Medicine Faculty, Health Science Post-Graduation Program, Universidade Federal de Goiás, Goiânia, Goiás, Brazil
| | - Paulo Gentil
- College of Physical Education and Dance, Federal University of Goiás, Goiânia, Brazil
| | - Ana Cristina Rebelo
- Department of Morphology, Biological Sciences Institute, Federal University of Goiás, Goiânia, Goiás, Brazil
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Dutheil F, Chaplais E, Vilmant A, Courteix D, Duche P, Abergel A, Pfabigan DM, Han S, Mobdillon L, Vallet GT, Mermillod M, Boudet G, Obert P, Izem O, Miolanne-Debouit M, Farigon N, Pereira B, Boirie Y. Stress management in obesity during a thermal spa residential programme (ObesiStress): protocol for a randomised controlled trial study. BMJ Open 2019; 9:e027058. [PMID: 31874865 PMCID: PMC7008425 DOI: 10.1136/bmjopen-2018-027058] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
INTRODUCTION Stress and obesity are two public health issues. The relationship between obesity and stress is biological through the actions of stress on the major hormones that regulate appetite (leptin and ghrelin). Many spa resorts in France specialise in the treatment of obesity, but no thermal spa currently proposes a specific programme to manage stress in obesity. The ObesiStress protocol has been designed to offer a new residential stress management programme. This thermal spa treatment of obesity implements stress management strategies as suggested by international recommendations. METHODS AND ANALYSIS 140 overweight or obese participants with a Body Mass Index of >25 kg/m2 and aged over 18 years will be recruited. Participants will be randomised into two groups: a control group of usual practice (restrictive diet, physical activity and thermal spa treatment) and an intervention group with stress management in addition to the usual practice. In the present protocol, parameters will be measured on five occasions (at inclusion, at the beginning of the spa (day 0), at the end of the spa (day 21), and at 6 and 12 months). The study will assess the participants' heart rate variability, cardiac remodelling and function, electrodermal activity, blood markers, anthropometric profile, body composition, psychology and quality of life via the use of questionnaires and bone parameters. ETHICS AND DISSEMINATION The ObesiStress protocol complies with the ethics guidelines for Clinical Research and has been approved by the ethics committee (CPP Sud-Est VI, Clermont-Ferrand - ANSM: 2016-A01774-47). This study aimed to highlight the efficacy of a 21-day thermal spa residential programme of stress management in obesity through objective measurements of well-being and cardiovascular morbidity. Results will be disseminated during several research conferences and articles published in peer-reviewed journals. TRIAL REGISTRATION NUMBER NCT03578757.
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Affiliation(s)
- Frédéric Dutheil
- Université Clermont Auvergne, CNRS, LaPSCo, Physiological and Psychosocial Stress, University Hospital of Clermont-Ferrand, CHU Clermont-Ferrand, Preventive and Occupational Medicine, WittyFit, Clermont-Ferrand, France
| | - Elodie Chaplais
- Université de Lorraine, Laboratory "Development, Adaption and Disability" (DevAH - EA 3450), Nancy, France
- University Hospital of Clermont-Ferrand, CHU Clermont-Ferrand, Biostatistics Unit, Clinical research and Innovation Department (DRCI), Biostatistics, Clermont-Ferrand, France
| | - Audrey Vilmant
- Université Clermont Auvergne, CNRS, LaPSCo, Physiological and Psychosocial Stress, University Hospital of Clermont-Ferrand, CHU Clermont-Ferrand, Preventive and Occupational Medicine, WittyFit, Clermont-Ferrand, France
| | - Daniel Courteix
- Université Clermont Auvergne, Laboratory of the Metabolic Adaptations to Exercise under Physiological and Pathological Conditions (AME2P - EA 3533), Clermont-Ferrand, France
| | - Pascale Duche
- Université de Toulon, Laboratory of Impact of Physical Activity on Health (IAPS), Toulon, France
| | - Armand Abergel
- Université Clermont Auvergne, CNRS, UMR 6284, University Hospital of Clermont-Ferrand, CHU Clermont-Ferrand, Hepatology Gastroenterology, Clermont-Ferrand, France
| | - Daniela M Pfabigan
- School of Psychological and Cognitive Sciences, PKU-IDG/McGovern Institute for Brain Research, Beijing Key Laboratory of Behavior and Mental Health, Peking University, Beijing, China
| | - Shihui Han
- School of Psychological and Cognitive Sciences, PKU-IDG/McGovern Institute for Brain Research, Beijing Key Laboratory of Behavior and Mental Health, Peking University, Beijing, China
| | - Laurie Mobdillon
- Université Clermont Auvergne, CNRS, LaPSCo, Physiological and Psychosocial Stress, Clermont-Ferrand, France
| | - Guillaume T Vallet
- Université Clermont Auvergne, CNRS, LaPSCo, Physiological and Psychosocial Stress, Clermont-Ferrand, France
| | - Martial Mermillod
- Université Grenoble Alpes, Université Savoie Mont Blanc, LPNC, CNRS, Grenoble, France
- Institut Universitaire de France, Paris, France
| | - Gil Boudet
- Université Clermont Auvergne, CNRS, LaPSCo, Physiological and Psychosocial Stress, University Hospital of Clermont-Ferrand, CHU Clermont-Ferrand, Preventive and Occupational Medicine, WittyFit, Clermont-Ferrand, France
| | - Philippe Obert
- Université d'Avignon, Laboratory of Cardiovascular Pharm-ecology (LaPEC EA4278), Avignon, France
| | - Omar Izem
- Université d'Avignon, Laboratory of Cardiovascular Pharm-ecology (LaPEC EA4278), Avignon, France
| | - Magalie Miolanne-Debouit
- University Hospital of Clermont-Ferrand, CHU Clermont-Ferrand, Unit of Human Nutrition, Clermont-Ferrand, France
| | - Nicolas Farigon
- University Hospital of Clermont-Ferrand, CHU Clermont-Ferrand, Unit of Human Nutrition, Clermont-Ferrand, France
| | - Bruno Pereira
- University Hospital of Clermont-Ferrand, CHU Clermont-Ferrand, Biostatistics Unit, Clinical research and Innovation Department (DRCI), Biostatistics, Clermont-Ferrand, France
| | - Yves Boirie
- Université Clermont Auvergne, INRA, CRNH, University Hospital of Clermont-Ferrand, CHU Clermont-Ferrand, Unit of Human Nutrition, Clermont-Ferrand, France
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Jandackova VK, Scholes S, Britton A, Steptoe A. Healthy Lifestyle and Cardiac Vagal Modulation Over 10 Years: Whitehall II Cohort Study. J Am Heart Assoc 2019; 8:e012420. [PMID: 31547790 PMCID: PMC6806037 DOI: 10.1161/jaha.119.012420] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Background Increased vagal modulation is a mechanism that may partially explain the protective effect of healthy lifestyles. However, it is unclear how healthy lifestyles relate to vagal regulation longitudinally. We prospectively examined associations between a comprehensive measure of 4 important lifestyle factors and vagal modulation, indexed by heart rate variability (HRV) over 10 years. Methods and Results The fifth (1997-1999), seventh (2002-2004), and ninth (2007-2009) phases of the UK Whitehall II cohort were analyzed. Analytical samples ranged from 2059 to 3333 (mean age: 55.7 years). A healthy lifestyle score was derived by giving participants 1 point for each healthy factor: physically active, not smoking, moderate alcohol consumption, and healthy body mass index. Two vagally mediated HRV measures were used: high-frequency HRV and root mean square of successive differences of normal-to-normal R-R intervals. Cross-sectionally, a positively graded association was observed between the healthy lifestyle score and HRV at baseline (Poverall≤0.001). Differences in HRV according to the healthy lifestyle score remained relatively stable over time. Compared with participants who hardly ever adhered to healthy lifestyles, those with consistent healthy lifestyles displayed higher high-frequency HRV (β=0.23; 95% CI, 0.10-0.35; P=0.001) and higher root mean square of successive differences of normal-to-normal R-R intervals (β=0.15; 95% CI, 0.07-0.22; P≤0.001) at follow-up after covariate adjustment. These differences in high-frequency HRV and root mean square of successive differences of normal-to-normal R-R intervals are equivalent to ≈6 to 20 years differences in chronological age. Compared with participants who reduced their healthy lifestyle scores, those with stable scores displayed higher subsequent high-frequency HRV (β=0.24; 95% CI, 0.01-0.48; P=0.046) and higher root mean square of successive differences of normal-to-normal R-R intervals (β=0.15; 95% CI, 0.01-0.29; P=0.042). Conclusions Maintaining healthy lifestyles is positively associated with cardiac vagal functioning, and these beneficial adaptations may be lost if not sustained.
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Affiliation(s)
- Vera K Jandackova
- Department of Epidemiology and Public Health University of Ostrava CZ.,Department of Human Movement Studies University of Ostrava CZ.,Research Department of Epidemiology and Public Health University College London United Kingdom
| | - Shaun Scholes
- Research Department of Epidemiology and Public Health University College London United Kingdom
| | - Annie Britton
- Research Department of Epidemiology and Public Health University College London United Kingdom
| | - Andrew Steptoe
- Research Department of Epidemiology and Public Health University College London United Kingdom.,Department of Behavioural Science and Health University College London United Kingdom
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Lundqvist MH, Almby K, Abrahamsson N, Eriksson JW. Is the Brain a Key Player in Glucose Regulation and Development of Type 2 Diabetes? Front Physiol 2019; 10:457. [PMID: 31133864 PMCID: PMC6524713 DOI: 10.3389/fphys.2019.00457] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2018] [Accepted: 04/01/2019] [Indexed: 01/08/2023] Open
Abstract
Ever since Claude Bernards discovery in the mid 19th-century that a lesion in the floor of the third ventricle in dogs led to altered systemic glucose levels, a role of the CNS in whole-body glucose regulation has been acknowledged. However, this finding was later overshadowed by the isolation of pancreatic hormones in the 20th century. Since then, the understanding of glucose homeostasis and pathology has primarily evolved around peripheral mechanism. Due to scientific advances over these last few decades, however, increasing attention has been given to the possibility of the brain as a key player in glucose regulation and the pathogenesis of metabolic disorders such as type 2 diabetes. Studies of animals have enabled detailed neuroanatomical mapping of CNS structures involved in glucose regulation and key neuronal circuits and intracellular pathways have been identified. Furthermore, the development of neuroimaging techniques has provided methods to measure changes of activity in specific CNS regions upon diverse metabolic challenges in humans. In this narrative review, we discuss the available evidence on the topic. We conclude that there is much evidence in favor of active CNS involvement in glucose homeostasis but the relative importance of central vs. peripheral mechanisms remains to be elucidated. An increased understanding of this field may lead to new CNS-focusing pharmacologic strategies in the treatment of type 2 diabetes.
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Affiliation(s)
| | - Kristina Almby
- Department of Medical Sciences, Uppsala University, Uppsala, Sweden
| | | | - Jan W Eriksson
- Department of Medical Sciences, Uppsala University, Uppsala, Sweden
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Weinreich T, Filz HP, Gresser U, Richartz BM. Effectiveness of A Four-Week Diet Regimen, Exercise and Psychological Intervention for Weight Loss. J Clin Diagn Res 2017; 11:LC20-LC24. [PMID: 28511417 DOI: 10.7860/jcdr/2017/24112.9553] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2016] [Accepted: 11/19/2016] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Obesity is accompanied by restriction in the quality of life and an increased risk of morbidity and mortality. Cardiovascular, orthopedic, and metabolic disorders are among the possible consequences. In the management of obesity, a combination therapy that includes dietary, exercise, and behaviour modules has proven its worth. AIM To evaluate the effect of weight-associated parameters, circulation associated parameters, glucose metabolism, body composition and life quality changes within a four-week inpatient rehabilitation program. MATERIALS AND METHODS Fifty-two patients underwent a 4-week inpatient rehabilitation program consisting of nutrition therapy, behavioural therapy and exercise therapy modules at the Eleonoren Clinic of Winterkasten, Germany. RESULTS The mean weight reduction of 52 obese patients 40 (76.9%) males, 12 (23.1%) females; mean age 46 years; mean Body Mass Index (BMI) 43,79 kg/m2) achieved was 7.1 kg (from 1.20 kg to 17.50 kg), and the BMI reduction was 2.3 kg/m2 (from 0.40 kg/m2 to 5.40 kg/m2). The excessive weight loss was highly significant (p<0.001). Weight reduction was accompanied by an improvement in the diabetic metabolic state (lowering of fasting blood-glucose 20 mg/dl, postprandial blood glucose 26 mg/dl, HbA1c 0.27%). In all 73% of the patients suffered from arterial hypertonia. The significant mean decline of systolic and diastolic blood pressure was 12.8 mmHg and 6.8 mmHg, respectively. The resting pulse was reduced by an average of 11 beats per minute. The Bioelectric Impedance Analysis (BIA) revealed a significant reduction of body fat content (p<0.001). The subjective impression of impaired life quality (SF-36 questionnaire) improved significantly. CONCLUSION The study clearly shows that the inpatient rehabilitation program at the Eleonoren Clinic was suitable to enhance the physical and mental state of people with obesity. In a two-year follow-up program the patients should take care of a permanent lifestyle change toward an improved dietary, movement and health behaviour.
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Affiliation(s)
- Tobias Weinreich
- Study Manager, Department of Internal Medicine, Eleonoren Clinic of Winterkasten, Lindenfels, Hessen, Germany
| | - Hans-Peter Filz
- Scientific Advisor, Head of Hospital, Department of Internal Medicine, Eleonoren Clinic of Winterkasten, Lindenfels, Hessen, Germany
| | - Ursula Gresser
- Scientific Advisor Endocrinology, Department of Internal Medicine, Member of the Medical Faculty University of Munich, Sauerlach, München, Germany
| | - Barbara M Richartz
- Scientific Advisor Cardiology, Department of Internal Medicine, Member of the Medical Faculty University of Munich, Bad Wiessee, München, Germany
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Michopoulos V, Vester A, Neigh G. Posttraumatic stress disorder: A metabolic disorder in disguise? Exp Neurol 2016; 284:220-229. [PMID: 27246996 PMCID: PMC5056806 DOI: 10.1016/j.expneurol.2016.05.038] [Citation(s) in RCA: 74] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2015] [Revised: 05/24/2016] [Accepted: 05/26/2016] [Indexed: 12/30/2022]
Abstract
Posttraumatic stress disorder (PTSD) is a heterogeneous psychiatric disorder that affects individuals exposed to trauma and is highly co-morbid with other adverse health outcomes, including cardiovascular disease and obesity. The unique pathophysiological feature of PTSD is the inability to inhibit fear responses, such that individuals suffering from PTSD re-experience traumatic memories and are unable to control psychophysiological responses to trauma-associated stimuli. However, underlying alterations in sympathetic nervous system activity, neuroendocrine systems, and metabolism associated with PTSD are similar to those present in traditional metabolic disorders, such as obesity and diabetes. The current review highlights existing clinical, translational, and preclinical data that support the notion that underneath the primary indication of impaired fear inhibition, PTSD is itself also a metabolic disorder and proposes altered function of inflammatory responses as a common underlying mechanism. The therapeutic implications of treating PTSD as a whole-body condition are significant, as targeting any underlying biological system whose activity is altered in both PTSD and metabolic disorders, (i.e. HPA axis, sympathetic nervous systems, inflammation) may elicit symptomatic relief in individuals suffering from these whole-body adverse outcomes.
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Affiliation(s)
- Vasiliki Michopoulos
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, United States; Yerkes National Primate Research Center, Atlanta, GA, United States
| | - Aimee Vester
- Department of Environmental Health Sciences, Rollins School of Public Health, Atlanta, GA, United States
| | - Gretchen Neigh
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, United States; Yerkes National Primate Research Center, Atlanta, GA, United States; Department of Physiology, Emory University School of Medicine, Atlanta, GA, United States.
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Ramadoss M, Ramanathan G, Subbiah AJ, Natrajan C. Heart Rate Changes in Electroacupuncture Treated Polycystic Ovary in Rats. J Clin Diagn Res 2016; 10:CF01-3. [PMID: 27134868 DOI: 10.7860/jcdr/2016/18303.7395] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2015] [Accepted: 01/31/2016] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Polycystic Ovary Syndrome (PCOS) is a common metabolic disorder, it affects both humans and animals. It may induce coronary heart disease, obesity and hyperandrogenism. Previous studies show that Low frequency Electroacupuncture (EA) have an effect on PCOS, however the exact pathway is unclear. AIM To find the effect of EA on autonomic activity of the heart in Estradiol Valerate (EV) induced PCOS rats. MATERIALS AND METHODS Heart rate variability (HRV) was assessed in 3 groups: 1) Control; 2) PCOS rats; and 3) PCOS rats after EA treatment (n=8 in each group). From the time domain analysis and frequency domain analysis (linear measures) HRV analysis was done. EA stimulation was given at low frequency of 2Hz for 15 min on alternate days for 4-5 weeks. Collected data were statistically analysed using One-Way Analysis of Variance with the application of multiple comparisons of Tukey test. RESULTS EA treatment group shows significant reduction in Heart Rate (HR) and low frequency, high frequency ratio (LF/HF); and increase in RR interval, Total Power (TP) when compared to PCOS group. CONCLUSION The study concludes that EA treatment has a significant effect on reducing sympathetic tone and decreasing HR in PCOS.
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Affiliation(s)
- Mukilan Ramadoss
- Senior Lecturer, Department of Physiology, CSI College of Dental Sciences and Research , Madurai, India
| | | | - Angelie Jessica Subbiah
- Senior lecturer, Department of Anatomy, CSI College of Dental Sciences and Research , Madurai, India
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Relationship between HRV measurements and demographic and clinical variables in a population of patients with atrial fibrillation. Heart Vessels 2016; 31:2004-2013. [DOI: 10.1007/s00380-016-0826-x] [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: 08/15/2015] [Accepted: 02/19/2016] [Indexed: 10/22/2022]
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