Dysregulation of the Autonomic Nervous System Predicts the Development of the Metabolic Syndrome
Dysregulation of the Autonomic Nervous System Predicts the Development of the Metabolic Syndrome
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DOI：
10.1210/jc.2012-3104
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发表时间：
2013-06-01
影响因子：
5.8
通讯作者：
Penninx, Brenda W. J. H.
中科院分区：
文献类型：
--
作者：
Licht, Carmilla M. M.;de Geus, Eco J. C.;Penninx, Brenda W. J. H.
背景：应激被认为会导致代谢紊乱，就像代谢综合征中聚集的那样。虽然自主神经系统的失调被发现与代谢综合征及其失调有关，但到目前为止还没有进行纵向研究来检验这种应激系统在代谢综合征的发展中的预测价值。目的：我们检查了自主神经系统功能是否可以预测构成代谢综合征的代谢异常的两年发展。设计：前瞻性队列的基线和两年随访评估的数据：使用荷兰关于抑郁和焦虑的研究。背景：参与者在普通社区、初级保健、参与者：1933名年龄在18-65岁的参与者。主要观察指标：自主神经系统测量包括心率(HR)、呼吸性窦性心律失常(RSA；高RSA反映高副交感神经活动)、射血前期(PEP；高PEP反映低交感活动)、心脏自主神经平衡(CAB)和心脏自主神经调节(CAR)。代谢综合征以更新的成人治疗委员会III标准为基础，包括高腰围、血清甘油三酯、血压、血糖和低高密度脂蛋白胆固醇。结果：基线短PEP、低CAB、高HR和CAR是预测随访期间代谢综合征成分数量增加的预测因素。高心率和低CAB是高密度脂蛋白胆固醇在两年内下降，舒张压和收缩压在两年内上升的预测因素。短PEP和高CAR也预示着两年内收缩压的上升，而短PEP还预示着舒张压的两年上升。最后，低基线RSA预示着随后高密度脂蛋白胆固醇的降低。结论：交感神经活性的增加预示着代谢异常的增加。这些发现表明，自主神经系统的失调是心血管疾病和糖尿病的重要预测指标，因为随着时间的推移，脂代谢和血压会出现失调。
Context: Stress is suggested to lead to metabolic dysregulations as clustered in the metabolic syndrome. Although dysregulation of the autonomic nervous system is found to associate with the metabolic syndrome and its dysregulations, no longitudinal study has been performed to date to examine the predictive value of this stress system in the development of the metabolic syndrome.Objective: We examined whether autonomic nervous system functioning predicts 2-year development of metabolic abnormalities that constitute the metabolic syndrome.Design: Data of the baseline and 2-year follow-up assessment of a prospective cohort: the Netherlands Study of Depression and Anxiety was used.Setting: Participants were recruited in the general community, primary care, and specialized mental health care organizations.Participants: A group of 1933 participants aged 18-65 years.Main outcome measures: The autonomic nervous system measures included heart rate (HR), respiratory sinus arrhythmia (RSA; high RSA reflecting high parasympathetic activity), pre-ejection period (PEP; high PEP reflecting low sympathetic activity), cardiac autonomic balance (CAB), and cardiac autonomic regulation (CAR). Metabolic syndrome was based on the updated Adult Treatment Panel III criteria and included high waist circumference, serum triglycerides, blood pressure, serum glucose, and low high-density lipoprotein (HDL) cholesterol.Results: Baseline short PEP, low CAB, high HR, and CAR were predictors of an increase in the number of components of the metabolic syndrome during follow-up. High HR and low CAB were predictors of a 2-year decrease in HDL cholesterol, and 2-year increase in diastolic and systolic blood pressure. Short PEP and high CAR also predicted a 2-year increase in systolic blood pressure, and short PEP additionally predicted 2-year increase in diastolic blood pressure. Finally, a low baseline RSA was predictive for subsequent decreases in HDL cholesterol.Conclusion: Increased sympathetic activity predicts an increase in metabolic abnormalities over time. These findings suggest that a dysregulation of the autonomic nervous system is an important predictor of cardiovascular diseases and diabetes through dysregulating lipid metabolism and blood pressure over time.