The Metabolic Syndrome And Its Different Components Of Heart Rate Variability Relationship

Objective To investigate the earlier diagnostic method of cardiac autonomic neuropathy(ANP). Methods To analyze relationship of the indices of heart rate variability(HRV) and Ewing's test in 188 cases. And compared with the change of HRV in 34 normal individuals control ,the negative group (111 cases) and positive group(43 cases) of Ewing' s test. Results (1) RMSSD, PNN50 and HF were positively related to respiration difference and Valsalva value, and HF was aslo positively related to 30s/15s significantly (P<0．05) . SDNN, SDANN and LF was negatively related to difference of stand-decubitus systolic blood pressure significantly (P<0．05)。(2) From normal control, negative group of Ewing' s test to positive group of Ewing' s test, indices of HRV significantly decreased gradually (P<0．01) . (3) Those which were borderline or abnormality of respiration difference were at most (81．8%) in indices of Ewing s test. Conclusion (1) There were statistical correlationship between the indices of HRV and Ewing' s test, the positive correlation between indices that reflect pneumogastric nerve of RMSSD, PNN50, HF and respiration difference, Valsalva value significantly, and the negative correlation between indices that reflect sympathetic nerve of SDNN, SDANN, LF and gradient pressure of stand-decubitus systolic blood pressure. (2) HRV was sensitive method in earily diagnosing ANP (3) In the indices of Ewing' s test, respiration difference was the most sensitive one. Objective To investigate the relationship on dyslipoidoses, obesity and heart rate variability (HRV), and influential factor of HRV. Methods In medical examination, time domain and frequency domain of HRV, cholestorol(TC), triglycerides(TG), low density lipoprotein cholesterol (LDL-C), high density lipoprotein cholesterol(HDL-C), fat concentration (FATc), fat proportion(FATp), fast plasma glucose (FPG) , uric acid etc were measured in 125 health adults without obviously clinical disease. Comparing HRV among individuals without (49cases) and with dyslipoidoses (76cases), and non-obesity (76cases) and obesity (49cases), and the influential factor of HRV will be investigated by stepwise multiple regression analysis. Results (1) It was found that RMSDD, PNN50% and HF were lower in group with dyslipidemia than in group without dyslipidemia significantly (P<0．01) . After adjusting confounding effects of smoking, waist circumference(WC)and waist-to-hip ratio(WHR) by covariance analysis, the statistical differences of RMSDD, PNN50% and HF between the two groups were existed as before(P<0．05) . (2) It was found that PNN50% were lower in group with obesity than in group non-obesity significantly (P<0．01) . After adjusting confounding effects of FPG and UA by covariance analysis, the statistical differences of PNN50% between the two groups were existed as before(P<0．05) . (3) Corelation analysis showed that there was relationship between the indices of HRV and effects of age, gender, TG, HDL-C, FATc, FATp and UA. Conclusion (1) dyslipoidoses and obesity may significantly influence HRV ,mainly manifesting as the decrease of indices representing pneumogastric nerve function. The effects of dyslipoidoses and obesity on autonomic nervous function may be a factor contributing to pathogenic mechanisms of cardiovascular disease.(3) In the crowd of healthy medical examination, the level of blood uric acide was also influential factors of HRV except for age, gender, TG, HDL-C, FATc and FATp. Objective To investigate the influence of diabetes mellitus(DM) and essential hypertension (EH) on heart rate variability. Methods To detect HRV by 24-hour dynamic electrocardiogram and to analyze HRV of DM group (22 cases), EH group(34 cases) and normal control (34cases). Results (1) DM group and EH group compared with normal control , SDNN (105．27±35．76,115．50±33．20 vs 141．91±31．09ms),SDANN (94．32±33．85,103．44±32．95 vs 128．32±29．01ms),SDNNindex(41．09±14．36,45．09±12．87 vs 57．24±14．81ms) and HF (9．18±3．88,10．54±4．95 vs 15．40±6．22ms) all statistically decreased (P<0．01) . After adjusting confounding effects of gender, age, smoking WC, WHR, body mass index (BMI) , FATc, TG, HDL-C and UA by covariance analysis, the statistical differences of above indices were existed as before between DM group and normal control, between EH group and normal control (P<0．05) . (2) DM group compared with EH group, every indice decreased , but no statistical difference(P>0．05) . Conclusion (1) HRV all decreased in the patients of DM and EH, manifesting as the damage of sympathetic nerve and pneumogastric nerve, and the regulation of autonomic nerve imbalanced. (2) The decreasing of HRV were uniform in the patients of DM and EH . DM and EH may be contribute to happening and developing of cardiovascular disease through effecting on HRV. Objective To investigate the influence of metabolic syndrome(MS) to heart rate variability. Methods To detect time domain and frequency domain of HRV on 43 patients with MS(using the criteria of CDS) and 34 normal control, and to analyze the difference of their HRV. Results (1) MS group compared with normal control, every indices of HRV statistically decreased (P<0．01) .After adjusting confounding effects of gender, age, smoking and UA by covariance analysis, SDNN(111．24±32．61 vs 141．91 ±31．09ms), SDANN(99．22±30．11 vs 128．32±29．01ms), SDNNindex(43．60±16．57 vs 57．24±14．81ms), VLF(25．42±12．12 vs 31．05±8．43ms), LF(14．41±7．41 vs 20．12±6．99ms) and HF(9．78±4．85 vs 15．40±6．22ms) still had statistical differences as before. (2) It was found that age, smoking , blood pressure , WC, WHR, BMI, FATc, FATp ,FPG, TG, HDL-C, and UA were statistically higher in MS group than in normal control(P<0．01) . Conclusion (1) HRV decreased in patients with MS, and manifesting as the damage of sympathetic nerve and pneumogastric nerve. (2) The patients with MS existed the phenomenon of clustering of many cardiovascular risk factors. (3) The decreasing of HRV and the clustering of many cardiovascular risk factors in MS patients may be a reason of high incidence rate of cardiovascular disease. Objective To explore the influence of MS with differently diagno-stic criterias, and the different compositons clustering of MS on HRV. Methods To detect and analyze the indices of HRV in patients with MS under the criteria of WHO (32cases), ATPII (43cases), CDS (43cases) and IDF (37cases) from 224 subjects, and compared with detection rate of dif-ferent MS criterias. 224 subjects were divided into four groups by dia-betes mellitus, essential hypertension, dyslipidemia, overweight or obesity): non-composition of them(group 0,34 cases), one composition (group 1, 66 cases), two compositions (group 2, 62 cases), three compos-itions and above three compositions (group 3, 62 cases); and to analyse their HRV and the factors that maybe influence HRV by stepwise multiple regression analysis. Results (1) After adjusting confounding effects of gender, age, smoking and UA, the groups of WHO, ATPIII, CDS and IDF compared with normal control, SDNN, SDANN, SDNNindex,VLF, LF and HF statistically decreased (P<0．05) .But The difference of each parameter of HRV had no significance in the four groups of MS. The lowest detection rate of MS was 14．29% in WHO, 16．52% in IDF, and highest detection was 19．20% in ATPIII and CDS, but no statistical difference. (2) After adjusting con-founding effects of gender, age, smoking and UA, PNN50 and HF in group 1 were statistically lower than group 0 (P<0．05) ; SDNN, SDANN, RMSSD, PNN50, LF and HF in group 2 and group 3 were statistically lower than group 0 (P<0．05) ; VLF and LF in group 2 were statistically lower than group 1 (P<0．05) ; SDNN,SDANN,SDNNindex,VLF and LF in group 3 were statistically lower than group 1 (P<0．05) ; but the differences of all indices of HRV had no statistical significance between group 3 and group 2．(3) Stepwise multiple regression analysis of the crowed of different compositions clustering of MS showed that there are relationship to age, gender, TC, TG, HDL-C, WC, WHR, FATp, FPG and the indices of HRV. Concl-usion (1) The patients with MS in WHO,ATPIII, IDF as same as CDS, HRV all statistically decreased. (2) The detection rate of MS under four diagnostic criterias had no statistical difference. (2) HRV was reducing with the increasing of the compositions of MS. When the compositions of MS increased, the incidence rate of cardiovascular disease were high, that concerned with the decreasing of HRV. (3) The influential factors of HRV included age, gender, TC, TG, HDL-C, WC, WHR, FATp and FPG.