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Association between obesity and heart rate variability indices: an intuition toward cardiac autonomic alteration – a risk of CVD

Authors Yadav RL, Yadav PK, Yadav LK, Agrawal K, Sah SK, Islam MN

Received 5 October 2016

Accepted for publication 18 November 2016

Published 17 February 2017 Volume 2017:10 Pages 57—64

DOI https://doi.org/10.2147/DMSO.S123935

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Amy Norman

Peer reviewer comments 2

Editor who approved publication: Professor Ming-Hui Zou


Video abstract presented by Ram Lochan Yadav.

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Ram Lochan Yadav,1 Prakash Kumar Yadav,1 Laxmi Kumari Yadav,2 Kopila Agrawal,3 Santosh Kumar Sah,4 Md Nazrul Islam1

1Department of Physiology, 2Department of Microbiology, Chitwan Medical College, Bharatpur, 3Department of Physiology, BP Koirala Institute of Health Sciences, Dharan, 4Department of Biochemistry, Janaki Medical College, Janakpur, Nepal

Background: Obese people have a higher prevalence of cardiovascular disease, which is supposed to be due to autonomic dysfunction and/or metabolic disorder. The alterations in cardiac autonomic functions bring out the changes in the heart rate variability (HRV) indicators, an assessing tool for cardiac autonomic conditions.
Objective: To compare the cardiac autonomic activity between obese and normal weight adults and find out the highest association between the indices of HRV and obesity.
Methods: The study was conducted in 30 adult obese persons (body mass index [BMI] >30 kg/m2) and 29 healthy normal weight controls (BMI 18–24 kg/m2). Short-term HRV variables were assessed using standard protocol. Data were compared between groups using Mann–Whitney U test. Obesity indices such as waist circumference, hip circumference, waist–hip ratio (WHR), and BMI were measured and calculated, and they were correlated with HRV indices using Spearman’s correlation analysis.
Results: In the obese group, there was a significant increase in the mean heart rate, whereas the HRV parasympathetic indicators were less (eg, root mean square of differences of successive RR intervals [28.75 {16.72–38.35} vs 41.55 {30.6–56.75} ms, p=0.018], number of RR intervals that differ by >50 ms, that is, NN50 [15.5 {2–39} vs 83.5 {32.75–116.25}, p=0.010], etc) and the sympathetic indicator low frequency (LF)/high frequency (HF) ratio (1.2 [0.65–2.20] vs 0.79 [0.5–1.02], p=0.045) was more than that of the normal weight group. Spearman’s correlation between HRV and obesity indices showed significant positive correlation of WHR with LF in normalized unit (r=0.478, p<0.01) and LF/HF ratio (r=0.479, p<0.01), whereas it had significant negative correlation with high frequency power ms2 (r=−0.374, p<0.05) and HF in normalized unit (r=−0.478, p<0.01). There was a nonsignificant correlation of BMI with HRV variables in obese individuals.
Conclusion: Increased WHR, by far an indicator of visceral adiposity, was strongly associated with reduced cardiac parasympathetic and increased sympathetic activity in obese individuals defined by BMI. However, BMI itself has a weak relationship with HRV cardiac autonomic markers. Thus, even with a slight increase in WHR in an individual, there could be a greater risk of cardiovascular morbidity and mortality brought about by cardiac autonomic alterations.

Keywords: obesity, heart rate variability, HRV, body mass index, BMI, waist–hip ratio, WHR, cardiac autonomic regulation

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