Longitudinal Autonomic Nervous System Measures Correlate With Stress and Ulcerative Colitis Disease Activity and Predict Flare
Longitudinal Autonomic Nervous System Measures Correlate With Stress and Ulcerative Colitis Disease Activity and Predict Flare
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DOI：
10.1093/ibd/izaa323
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发表时间：
2021-10-01
影响因子：
4.9
通讯作者：
Sands, Bruce E.
中科院分区：
文献类型：
--
作者：
Hirten, Robert P.;Danieletto, Matteo;Sands, Bruce E.
背景资料：通过心率变异性（HRV）测量的自主神经系统功能的差异已在炎症性肠病患者和健康对照患者之间观察到，并且在横断面研究中与全身炎症相关。高心率变异性与低stress.Methods：溃疡性结肠炎（UC）患者随访9个月。每4周使用VitalPatch测量他们的HRV，并在基线和每12周收集血液，评估皮质醇、促肾上腺皮质激素、白细胞介素-1 β、白细胞介素-6、肿瘤坏死因子-α和C-反应蛋白（CRP）。在入组时和每6周一次采集粪便，用于粪便钙卫蛋白。调查评估症状，压力，弹性，生活质量，焦虑和抑郁纵向collected.Results：纵向评估感知压力与全身炎症（CRP，P = 0.03）和UC症状（P = 0.02）显着相关。心率变异性与应激之间存在显著相关性（低频到高频功率[LFHF]，P = 0.04;连续差异的均方根[RMSSD]，P = 0.04）。HRV与UC症状（LFHF，P = 0.03）、CRP（高频，P < 0.001;低频，P <0.001; RMSSD，P < 0.001）和粪便钙卫蛋白（高频，P < 0.001;低频，P <0.001; RMSSD，P <0.001; LFHF，P < 0.001）相关。HRV指标较基线的显著变化发生在症状性或炎症性发作之前（P < 0.001）。结论：纵向评估的HRV与UC症状、炎症以及应激的感知和生理指标相关。在症状性或炎症性发作发生之前，观察到HRV的显著变化。
Background: Differences in autonomic nervous system function, measured by heart rate variability (HRV), have been observed between patients with inflammatory bowel disease and healthy control patients and have been associated in cross-sectional studies with systemic inflammation. High HRV has been associated with low stress.Methods: Patients with ulcerative colitis (UC) were followed for 9 months. Their HRV was measured every 4 weeks using the VitalPatch, and blood was collected at baseline and every 12 weeks assessing cortisol, adrenocorticotropin hormone, interleukin-1 beta, interleukin-6, tumor necrosis factor-alpha, and C-reactive protein (CRP). Stool was collected at enrollment and every 6 weeks for fecal calprotectin. Surveys assessing symptoms, stress, resilience, quality of life, anxiety, and depression were longitudinally collected.Results: Longitudinally evaluated perceived stress was significantly associated with systemic inflammation (CRP, P = 0.03) and UC symptoms (P = 0.02). There was a significant association between HRV and stress (low-frequency to high-frequency power [LFHF], P = 0.04; root mean square of successive differences [RMSSD], P = 0.04). The HRV was associated with UC symptoms (LFHF, P = 0.03), CRP (high frequency, P < 0.001; low frequency, P < 0.001; RMSSD, P < 0.001), and fecal calprotectin (high frequency, P < 0.001; low frequency, P < 0.001; RMSSD, P < 0.001; LFHF, P < 0.001). Significant changes in HRV indices from baseline developed before the identification of a symptomatic or inflammatory flare (P < 0.001).Conclusions: Longitudinally evaluated HRV was associated with UC symptoms, inflammation, and perceived and physiological measures of stress. Significant changes in HRV were observed before the development of symptomatic or inflammatory flare.