Influence of non-alcoholic fatty liver disease on autonomic changes evaluated by the time domain, frequency domain, and symbolic dynamics of heart rate variability.
Influence of non-alcoholic fatty liver disease on autonomic changes evaluated by the time domain, frequency domain, and symbolic dynamics of heart rate variability.
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非酒精性脂肪肝病的影响对由时域，频域和心率变异性的符号动态评估的自主变化的影响。
DOI：
10.1371/journal.pone.0061803
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发表时间：
2013
期刊：
影响因子：
3.7
通讯作者：
Chen CH
中科院分区：
文献类型：
--
作者：
Liu YC;Hung CS;Wu YW;Lee YC;Lin YH;Lin C;Lo MT;Chan CC;Ma HP;Ho YL;Chen CH
非酒精性脂肪性肝病（NAFLD）与心血管动脉粥样硬化相关，与经典危险因素无关。这项研究调查了非酒精性脂肪肝对自主神经变化的影响，这一点目前尚不清楚。健康检查期间入组无明显心血管疾病史的受试者。对经超声诊断为NAFLD的受试者进行5 min心率变异性（HRV）测定，并采用以下指标进行分析：（1）时域N-N间期标准差（SDNN）和相邻N-N间期连续差值的均方根（rMSSD），（2）频域低频（LF）和高频（HF）分量，（3）频域N-N间期标准差（SDNN）和相邻N-N间期连续差值的均方根（rMSSD）。符号动力学分析。分析两组患者的血生化及血清瘦素水平。测定胰岛素抵抗稳态模型（HOMA-IR）。在497例受试者（平均年龄46.2岁）中，176例（35.4%）患有NAFLD。非酒精性脂肪性肝病组的心率变异性指标（Ln SDNN、Ln rMSSD、Ln LF、Ln HF）分别为3.51和3.62 ms、3.06和3.22 ms、5.26和5.49 ms 2、4.49和5.21 ms 2，差异均有统计学意义（P<0.05）。校正年龄、性别、高血压、血脂异常、代谢综合征、体重指数、吸烟、估计肾小球滤过率、HOMA-IR和瘦素后，NAFLD组Ln SDNN显著降低（P<0.05）。在符号动力学分析中，NAFLD组的0 V百分比显著较高（33.8%比28.7%，P = 0.001），并与线性HRV指标（Ln SDNN，Ln rMSSD和Ln HF）显著相关。 NAFLD与Ln SDNN降低和0 V百分比增加相关。前者的关联是独立的传统的心血管危险因素和血清生物标志物（胰岛素抵抗和瘦素）。在NAFLD患者中，需要通过这些HRV参数对伴有福尔斯或心血管疾病的自主神经功能障碍进行进一步的风险分层。
Non-alcoholic fatty liver disease (NAFLD) is associated with cardiovascular atherosclerosis independent of classical risk factors. This study investigated the influence of NAFLD on autonomic changes, which is currently unknown. Subjects without an overt history of cardiovascular disease were enrolled during health checkups. The subjects diagnosed for NAFLD using ultrasonography underwent 5-min heart rate variability (HRV) measurements that was analyzed using the following indices: (1) the time domain with the standard deviation of N-N (SDNN) intervals and root mean square of successive differences between adjacent N-N intervals (rMSSD); (2) the frequency domain with low frequency (LF) and high frequency (HF) components; and (3) symbolic dynamics analysis. Routine blood biochemistry data and serum leptin levels were analyzed. Homeostasis model assessment of insulin resistance (HOMA-IR) was measured. Of the 497 subjects (mean age, 46.2 years), 176 (35.4%) had NAFLD. The HRV indices (Ln SDNN, Ln rMSSD, Ln LF, and Ln HF) were significantly decreased in the NAFLD group (3.51 vs 3.62 ms, 3.06 vs 3.22 ms, 5.26 vs 5.49 ms2, 4.49 vs 5.21 ms2, respectively, all P<0.05). Ln SDNN was significantly lower in the NAFLD group after adjustment for age, sex, hypertension, dyslipidemia, metabolic syndrome, body mass index, smoking, estimated glomerular filtration rate, HOMA-IR, and leptin (P<0.05). In the symbolic dynamic analysis, 0 V percentage was significantly higher in the NAFLD group (33.8% vs 28.7%, P = 0.001) and significantly correlated with linear HRV indices (Ln SDNN, Ln rMSSD, and Ln HF). NAFLD is associated with decreased Ln SDNN and increased 0 V percentage. The former association was independent of conventional cardiovascular risk factors and serum biomarkers (insulin resistance and leptin). Further risk stratification of autonomic dysfunction with falls or cardiovascular diseases by these HRV parameters is required in patients with NAFLD.
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影响因子：
37.8
作者：
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