Influence of Non-Alcoholic Fatty Liver Disease on Autonomic Changes Evaluated by the Time Domain, Frequency Domain, and Symbolic Dynamics of Heart Rate Variability

被引：65

作者：

Liu, Yu-Chen ^{[1
,2
,3
]}

Hung, Chi-Sheng ^{[1
,2
]}

Wu, Yen-Wen ^{[3
,4
,5
,6
,7
]}

Lee, Yi-Chin ^{[8
]}

Lin, Yen-Hung ^{[1
,2
]}

Lin, Chen ^{[9
,10
]}

Lo, Men-Tzung ^{[9
,10
]}

Chan, Chun-Chieh ^{[11
]}

Ma, Hsi-Pin ^{[11
]}

Ho, Yi-Lwun ^{[1
,2
]}

Chen, Chien-Hung ^{[12
,13
]}

机构：

[1] Natl Taiwan Univ Hosp, Dept Internal Med, Div Cardiol, Taipei 100, Taiwan

[2] Natl Taiwan Univ, Coll Med, Taipei 10764, Taiwan

[3] Far Eastern Poly Clin, Dept Internal Med, Taipei, Taiwan

[4] Far Eastern Mem Hosp, Dept Med Imaging, Taipei, Taiwan

[5] Far Eastern Mem Hosp, Div Cardiol, Cardiovasc Med Ctr, Taipei, Taiwan

[6] Natl Yang Ming Univ, Sch Med, Taipei 112, Taiwan

[7] Natl Taiwan Univ Hosp, Dept Internal Med, Taipei 100, Taiwan

[8] Natl Taiwan Univ, Grad Inst Epidemiol & Prevent Med, Coll Publ Hlth, Div Biomed Stat, Taipei 10764, Taiwan

[9] Natl Cent Univ, Ctr Dynam Biomarkers & Translat Med, Tao Yuan, Taiwan

[10] Natl Cent Univ, Res Ctr Adapt Data Anal, Tao Yuan, Taiwan

[11] Natl Tsing Hua Univ, Dept Elect Engn, Hsinchu, Taiwan

[12] Natl Taiwan Univ Hosp, Dept Internal Med, Div Gastroenterol, Taipei 100, Taiwan

[13] Natl Taiwan Univ, Coll Med, Taipei 10764, Taiwan

来源：

PLOS ONE | 2013年 / 8卷 / 04期

关键词：

ASIA-PACIFIC REGION; METABOLIC-SYNDROME; LEPTIN CONCENTRATIONS; SYSTEM ACTIVITY; NERVOUS-SYSTEM; RISK; POPULATION; ATHEROSCLEROSIS; MANAGEMENT; PLASMA;

D O I：

10.1371/journal.pone.0061803

中图分类号：

O [数理科学和化学]; P [天文学、地球科学]; Q [生物科学]; N [自然科学总论];

学科分类号：

07 ; 0710 ; 09 ;

摘要：

Background: Non-alcoholic fatty liver disease (NAFLD) is associated with cardiovascular atherosclerosis independent of classical risk factors. This study investigated the influence of NAFLD on autonomic changes, which is currently unknown. Methods: Subjects without an overt history of cardiovascular disease were enrolled during health checkups. The subjects diagnosed for NAFLD using ultrasonography underwent 5-min heart rate variability (HRV) measurements that was analyzed using the following indices: (1) the time domain with the standard deviation of N-N (SDNN) intervals and root mean square of successive differences between adjacent N-N intervals (rMSSD); (2) the frequency domain with low frequency (LF) and high frequency (HF) components; and (3) symbolic dynamics analysis. Routine blood biochemistry data and serum leptin levels were analyzed. Homeostasis model assessment of insulin resistance (HOMA-IR) was measured. Results: Of the 497 subjects (mean age, 46.2 years), 176 (35.4%) had NAFLD. The HRV indices (Ln SDNN, Ln rMSSD, Ln LF, and Ln HF) were significantly decreased in the NAFLD group (3.51 vs 3.62 ms, 3.06 vs 3.22 ms, 5.26 vs 5.49 ms(2), 4.49 vs 5.21 ms 2, respectively, all P<0.05). Ln SDNN was significantly lower in the NAFLD group after adjustment for age, sex, hypertension, dyslipidemia, metabolic syndrome, body mass index, smoking, estimated glomerular filtration rate, HOMA-IR, and leptin (P<0.05). In the symbolic dynamic analysis, 0 V percentage was significantly higher in the NAFLD group (33.8% vs 28.7%, P = 0.001) and significantly correlated with linear HRV indices (Ln SDNN, Ln rMSSD, and Ln HF). Conclusions: NAFLD is associated with decreased Ln SDNN and increased 0 V percentage. The former association was independent of conventional cardiovascular risk factors and serum biomarkers (insulin resistance and leptin). Further risk stratification of autonomic dysfunction with falls or cardiovascular diseases by these HRV parameters is required in patients with NAFLD.

引用

页数：6

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