Metabolic syndrome burden in apparently healthy adolescents is adversely associated with cardiac autonomic modulation--Penn State Children Cohort.
Metabolic syndrome burden in apparently healthy adolescents is adversely associated with cardiac autonomic modulation--Penn State Children Cohort.
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DOI：
10.1016/j.metabol.2015.01.018
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发表时间：
2015-05
期刊：
影响因子：
--
通讯作者：
Liao D
中科院分区：
文献类型：
--
作者：
Rodríguez-Colón SM;He F;Bixler EO;Fernandez-Mendoza J;Vgontzas AN;Calhoun S;Zheng ZJ;Liao D
心脏自主调节 (CAM) 降低与成人代谢综合征 (MetS) 相关。然而，MetS 成分簇与 CAM 之间的关联尚未在青少年中进行研究。我们使用宾夕法尼亚州立大学儿童队列随访检查的数据进行了横断面分析。通过 39 小时 RR 间隔的心率变异性 (HRV) 分析来评估 CAM，包括频率（高频，HF；低频，LF；和 LF/HF 比率）和时间（SDNN，所有 RR 间隔的标准差；RMSSD，相邻 RR 间隔之间差值平方和的平均值的平方根；HR，心率）域变量。为了评估 MetS 负担，我们使用了连续 MetS 评分 (cMetS)——五种既定 MetS 组成部分的年龄和性别调整标准化残差 (Z 评分) 的总和。使用线性混合效应模型分析整个人群中 cMetS 和 CAM 之间的关联，并按性别分层。调整年龄、性别和种族后，cMetS 与 HRV 降低和 HR 升高显着相关。随着cMetS增加1个标准差，HF(−0.10(SE=0.02))、LF(−0.07(SE=0.01))、SDNN(−1.97(SE=0.50))和RMSSD(−1.70(SE=0.72))显着下降，而LF/HF(0.08(SE=0.02))和HR(1.40(SE=0.26))。除高密度脂蛋白 (HDL) 外，所有 cMetS 成分均与 HRV 显着降低和 HR 升高相关。高血压 (MAP) 和甘油三酯 (TG) 水平也与 LF/HF 增加和 RMSSD 减少相关。高密度脂蛋白的增加仅与较高的 LF 和 SDNN 相关。此外，cMetS 和 HRV 关联在男性中比在女性中更明显。 HRV 与 HRV 之间的关联。 MAP、TG 和 HDL 在女性中更为明显。 cMetS 评分与较低的 HRV 相关，表明对 CAM 产生不利影响，即使对于表面健康的青少年也是如此。
Reduced cardiac autonomic modulation (CAM) has been associated with metabolic syndrome (MetS) in adults. However, the association between MetS component cluster and CAM has not been examined in adolescents. We conducted a cross-sectional analysis using data from the Penn State Child Cohort follow-up examination. CAM was assessed by heart rate variability (HRV) analysis of 39-hour RR intervals, including frequency (high frequency, HF; low frequency, LF; and LF/HF ratio) and time (SDNN, standard deviation of all RR intervals; RMSSD, square root of the mean of the sum of the squares of differences between adjacent RR intervals; and HR, heart rate) domain variables. To assess the MetS burden, we used continuous MetS score (cMetS)–sum of the age and sex-adjusted standardized residual (Z-score) of five established MetS components. Linear mixed-effect models were used to analyze the association between cMetS and CAM in the entire population and stratified by gender. After adjusting for age, sex, and race, cMetS was significantly associated with reduced HRV and higher HR. With 1 standard deviation increase in cMetS, there was a significant decrease in HF(−0.10(SE=0.02)), LF(−0.07(SE=0.01)), SDNN(−1.97(SE=0.50)), and RMSSD(−1.70(SE=0.72)), and increase in LF/HF(0.08(SE=0.02)) and HR(1.40(SE=0.26)). All cMetS components, with the exception of high-density lipoprotein (HDL), were associated with significantly decreased HRV and increased HR. High blood pressure (MAP) and triglyceride (TG) levels were also associated with an increase in LF/HF and decrease in RMSSD. An increase in high-density lipoprotein was only associated with higher LF and SDNN. Moreover, cMetS and HRV associations were more pronounced in males than in females. The associations between HRV and. MAP, TG, and HDL were more pronounced in females. cMetS score is associated with lower HRV, suggesting an adverse impact on CAM, even in apparently healthy adolescents.