代谢综合征患者的心率变异性

Kostiantyn Apykhtin, Svitlana Drozdovska, Olha Hurenko, Anastasiia Nahorna, Anatoly Pisaruk, Yuliia Panchenko, Olena Andrieieva
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引用次数: 0

摘要

代谢综合征(MS)以碳水化合物和脂肪代谢紊乱为特征,可导致心脏自主神经病变(can)的发展。心率变异性(HRV)分析用于评估自主调节状态。HRV的下降表明自主调节和CAN的发展发生了不利的变化。本研究的目的是比较代谢综合征患者和无MS体征的健康人的HRV参数。我们检查了74例代谢综合征患者(平均年龄54.4±1.1岁)和61例健康受试者(平均年龄57.0±1.6岁)。研究结果表明,ms患者的HRV显著降低,但他们的SDNN指数显著降低(26%),该指数表征了神经体液调节心率的总体能力。表征短期迷走神经影响的指标差异尤其明显:在MS患者中,RMSSD(减少44%)和HF(减少69%)低于对照组。通过低频波(LF)的频谱功率评估,MS患者的延髓压力反射中心的活动比对照组低55%。MS患者R-R间隔的平均持续时间、甚低频(VLF)波的频谱功率、低频与高频(LF/HF、LFn、HFn)频谱功率之比与对照组相比无显著差异。ms患者自主神经平衡向交感张力方向未见明显变化,方差分析证实代谢综合征因素对HRV有显著影响。因此,获得的数据表明,在代谢综合征患者中CAN的发展,这是一个不利的预后迹象。为了评估多发性硬化症对衰老速度的影响,我们计算了多发性硬化症患者的生物年龄(BA)。采用多元逐步回归的方法,对未患多发性硬化症的人群进行分析,得到BA的计算公式。衰老率计算为生物年龄和实足年龄(CA)之差。MS组平均BA为63,20±1,81年,对照组平均BA为- 53.99±1.71年(p < 0.05);0.05)。MS组BA与CA的差异为8.81±0.94年,对照组BA与CA的差异为-1.01±0.61年(p < 0.05);0.05)。由此我们可以得出结论,多发性硬化症可能是加速衰老的一个因素。_________________________________________________________________________________________ 关键词:代谢综合征、心率变异性、生物年龄
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Heart rate variability in people with metabolic syndrome
Metabolic syndrome (MS) is characterized by disorders of carbohydrate and fat metabolism, which can lead to the development of cardiac autonomic neuropathy (CAN). Heart rate variability (HRV) analysis is used to assess the state of autonomic regulation. A decrease in HRV indicates unfavourable changes in autonomic regulation and the development of CAN. The purpose of this study was to compare HRV parameters in patients with metabolic syndrome and healthy individuals without signs of MS. We examined 74 patients with metabolic syndrome (mean age 54.4 ± 1.1 years) and 61 healthy subjects (without signs of MS) (mean age 57.0 ± 1.6 years). The results of the study indicate a significant decrease in HRV in people with MS. However, they had significantly lower values of the SDNN index (by 26%), which characterizes the overall power of neurohumoral regulation of heart rate. Differences in the indicators characterizing short-term, vagal influences were especially pronounced: in patients with MS, RMSSD (by 44%) and HF (by 69%) were lower than in controls. The activity of the baroreflex center of the medulla oblongata, assessed by the spectral power of low-frequency waves (LF), was 55% lower in patients with MS compared to controls. There were no significant differences in the mean duration of the R-R interval, the spectral power of very low frequency (VLF) waves, or the ratio of the spectral powers of low and high frequencies (LF/HF, LFn, HFn) in patients with MS compared to controls. No significant shift in the autonomic balance towards sympathicotonia was found in patients with MS. The analysis of variance confirmed the significant effect of the metabolic syndrome factor on HRV. Thus, the data obtained indicate the development of CAN in people with metabolic syndrome, which is an unfavourable prognostic sign. To assess the effect of MS on the rate of aging, the biological age (BA) of the examined people with MS was calculated. The formula for calculating BA was obtained on a group of people without MS. The method of multiple stepwise regression was used. The aging rate was calculated as the difference between biological and chronological age (CA). The average BA in the group of people with MS was 63,20 ± 1,81 years, in the control group – 53.99 ± 1.71 years (p< 0.05). The difference between BA and CA is 8,81 ± 0,94 years in the group of people with MS and -1.01 ± 0.61 in control group (p< 0.05). From this we can conclude that MS can be a factor accelerating aging. _________________________________________________________________________________________ Keywords: metabolic syndrome, heart rate variability, biological age
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