Effect of weight gain on cardiac autonomic control during wakefulness and sleep.
Effect of weight gain on cardiac autonomic control during wakefulness and sleep.
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DOI：
10.1161/hypertensionaha.110.163147
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发表时间：
2011-04
期刊：
影响因子：
--
通讯作者：
Somers VK
中科院分区：
文献类型：
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作者：
Adachi T;Sert-Kuniyoshi FH;Calvin AD;Singh P;Romero-Corral A;van der Walt C;Davison DE;Bukartyk J;Konecny T;Pusalavidyasagar S;Sierra-Johnson J;Somers VK
肥胖与清醒期间心脏交感神经激活增加有关，但对睡眠相关交感神经调节的影响尚不清楚。本研究的目的是调查脂肪增加对人类清醒和睡眠期间心脏自主控制的影响。我们进行了一项随机对照研究，以评估脂肪增加对心率变异性（HRV）的影响。我们招募了36名健康志愿者，他们被随机分配到标准化饮食组（n=20），在8周内增加约4 kg，然后进行8周的减肥期，或者作为体重维持者对照组（n=16）。在基线、体重增加后和体重减轻后进行整夜多导睡眠图和HRV功率谱分析，以确定低频（LF）与高频（HF）功率的比值，并检查HRV变化与胰岛素、瘦素和脂联素水平变化之间的关系。脂肪增加组的平均体重增加为3.9 kg，而保持组为0.1 kg。在脂肪增加组，LF/HF在清醒和睡眠期间增加，在脂肪减少后恢复到基线水平，而对照组没有变化。胰岛素、瘦素和脂联素也在增脂后增加，在减脂后下降，但没有观察到与HRV变化一致的明确变化模式。健康受试者的短期脂肪增加与清醒和睡眠期间心脏交感神经激活增加有关，但机制仍不清楚。
Obesity has been associated with increased cardiac sympathetic activation during wakefulness, but the effect on sleep-related sympathetic modulation is not known. The aim of this study was to investigate the effect of fat gain on cardiac autonomic control during wakefulness and sleep in humans. We performed a randomized controlled study to assess the effects of fat gain on heart rate variability (HRV). We recruited 36 healthy volunteers, who were randomized to either a standardized diet to gain approximately 4 kg over 8 weeks followed by an 8 week weight loss period (n=20), or to serve as a weight-maintainer control (n=16). An overnight polysomnogram with power spectral analysis of HRV was performed at baseline, after weight gain, and after weight loss to determine the ratio of low frequency (LF) to high frequency (HF) power, and to examine the relationship between changes in HRV and changes in insulin, leptin and adiponectin levels. Mean weight gain was 3.9 kg in the fat gain group versus 0.1 kg in the maintainer group. LF/HF increased both during wakefulness and sleep after fat gain and returned to baseline after fat loss in the fat gain group, and did not change in the control group. Insulin, leptin and adiponectin also increased after fat gain and fell after fat loss, but no clear pattern of changes were seen that correlated consistently with changes in HRV. Short-term fat gain in healthy subjects is associated with increased cardiac sympathetic activation during wakefulness and sleep but the mechanisms remain unclear.