Relationship between heart rate variability,deceleration capacity and cardiovascular metabolic diseases in chil-dren and adolescents with normal weight obesity
Objective To investigate the relationship between heart rate variability(HRV),deceleration capacity(DC)and cardiovascular metabolic disease(CMD)in children and adolescents with normal weight obesity(NWO).Methods A total of 200 children and adolescents aged 6-17 who underwent normal physical examination in Chengdu Women's and Children's Central Hospital from December 2022 to June 2023 were included in this retrospective case-control study.They were divided into the NWO group,normal weight lean(NWL)group,and overweight-obesity(OW-OB)group according to their body mass index(BMI)and body fat percentage(BF％).Fifty children were enrolled into the NWO group;fifty-one children were enrolled into the NWL group;and 99 children were enrolled into the OW-OB group.All the subjects received 24-hour heart monitoring,and their HRV indexes,such as the standard deviation of N-N interval in normal sinus(SDNN),the standard deviation of the mean value N-N intervals every 5-minute(SDANN),the mean of the standard deviations of all N-N intervals for each 5-minute segment of 24 hours(SDNNindex),the root mean square of successive N-N interval difference(rMSSD),the proportion of N-N 50(the successive N-N interval differences＞50 ms)in the total number of N-N intervals(pNN50),and DC were automatically calculated.Blood pressure,fasting blood glucose and blood lipids were measured,and the cardiometabolic risk score(CRS)was obtained through the accumulation of relevant factors.The general data,SDNN,SDANN,SDNNindex,rMSSD,pNN50,DC and CRS of the three groups were compared by variance analysis.Spearman correlation and multivariate Logistic regression were used to analyze the risk factors affecting CRS.Results There was no significant difference in age,gender and other general information among the three groups(all P＞0.05).SDNN in the NWO,NWL,and OW-OB groups were(120.88±16.36)ms,(129.07±16.36)ms,and(109.29±16.38)ms,respectively(F=26.231,P＜0.001);SDANN were(64.44±11.61)ms,(66.25±8.34)ms,and(61.70±6.85)ms,respectively(F=5.048,P=0.007);rMSSD were(27.02±3.87)ms,(27.51±5.92)ms,and(25.12±6.78)ms,respectively(F=3.328,P=0.038);pNN50 were(12.62±4.04)％,(13.39±2.26)％,and(11.22±2.93)％,respectively(F=9.099,P＜0.001);DC were(4.83±0.20)ms,(4.94±0.33)ms,and(4.63±0.28)ms,respectively(F=23.496,P＜0.001)and CRS was 0.94±0.87,0.69±0.19 and 1.57±1.07,respectively(P＜0.01).The differences between the three groups were statistically significant.Spearman correlation analysis showed that BMI(r=0.211,P=0.003)and BF％(r=0.558,P＜0.001)were significantly positively correlated with CRS,while SDNN(r=-0.258,P＜0.001)and DC(r=-0.499,P＜0.001)were significantly negatively correlated with CRS.Multivariate Logistic regression analysis showed that BF％(95％CI:0.098-0.265,P＜0.001)and DC(95％CI:-3.962--1.391,P＜0.001)were independent risk factors for predicting CMD.Conclusions Increased BF％and decreased DC are independent risk factors for CMD.Analysis of body composition and HRV in children and adolescents can help to identify potentially high-risk groups more accurately,intervene early,and reduce the risk of CMD.
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