Impact of metabolic syndrome and its components on heart rate variability during hemodialysis: a cross-sectional study

Cardiovascular Diabetology

Original Investigation

Show-Chin Leu¹  I-Ling Chen¹  Chuan-Lan Yang¹  Hung-Li Su¹  Ya-Ting Huang²  Rong-Na Jhen³  Shih-Ching Tsai³  Yu-Ming Chang³  Jsun-Liang Kao³  Chih-Chung Shiao⁴  Ching-Cherng Uen⁵ 

[1] Department of Nursing, Saint Mary’s Hospital Luodong, No. 160 Chong-Cheng South Road, 265, Loudong, Yilan, Taiwan, ROC;Department of Nursing, Saint Mary’s Hospital Luodong, No. 160 Chong-Cheng South Road, 265, Loudong, Yilan, Taiwan, ROC;Graduate Institute of Clinical Medical Sciences, Chang Gung University, No.259, Wenhua 1st Rd., Guishan Dist., 33302, Taoyuan, Taiwan, ROC;Division of Nephrology, Department of Internal Medicine, Saint Mary’s Hospital Luodong, No. 160 Chong-Cheng South Road, 265, Loudong, Yilan, Taiwan, ROC;Division of Nephrology, Department of Internal Medicine, Saint Mary’s Hospital Luodong, No. 160 Chong-Cheng South Road, 265, Loudong, Yilan, Taiwan, ROC;Saint Mary’s Medicine, Nursing and Management College, No. 100, Ln. 265, Sec. 2, Sanxing Rd., 266, Sanxing Township, Yilan County, Taiwan, ROC;Division of Neurology, Department of Internal Medicine, Saint Mary’s Hospital Luodong, No. 160 Chong-Cheng South Road, 265, Loudong, Yilan, Taiwan, ROC;

关键词: Autonomic nervous system;    Diabetes mellitus;    Fasting plasma glucose;    Heart rate variability;    Hemodialysis;    Impaired fasting glucose;    Metabolic syndrome;   

DOI  :  10.1186/s12933-016-0328-2

 received in 2015-09-02, accepted in 2016-01-04,  发布年份 2016

来源: Springer

【 摘 要 】

BackgroundBoth uremia and metabolic syndrome (MetS) affect heart rate variability (HRV) which is a risk factor of poor prognoses. The aim of this study was to evaluate the impact of MetS on HRV among chronic hemodialysis patients.MethodsThis cross-sectional study was carried out in a teaching hospital in Northern Taiwan from June to August, 2010. Adult patients on chronic hemodialysis without active medical conditions were enrolled. HRV were measured for 4 times on the index hemodialysis day (HRV-0, -1, -2, and -3 at before, initial, middle, and late phases of hemodialysis, respectively), and the baseline demographic data and clinical parameters during the hemodialysis session were documented. Then we evaluated the impacts of MetS and its five components on HRV.ResultsOne hundred and seventy-five patients (100 women, mean age 65.1 ± 12.9 years) were enrolled and included those with MetS (n = 91, 52 %) and without MetS (n = 84, 48 %). The patients with MetS(+) had significantly lower very low frequency, total power, and variance in HRV-0, total power and variance in HRV-2, and variance in HRV-3. (all p ≦ 0.05) When using the individual components of MetS to evaluate the impacts on HRV indices, the fasting plasma glucose (FPG) criterion significantly affected most indices of HRV while other four components including “waist circumference”, “triglycerides”, “blood pressure”, and “high-density lipoprotein” criteria exhibited little impacts on HRV. FPG criterion carried the most powerful influence on cardiac ANS, which was even higher than that of MetS. The HRV of patients with FPG(+) increased initially during the hemodialysis, but turned to decrease dramatically at the late phase of hemodialysis.ConclusionsThe impact of FPG(+) outstood the influence of uremic autonomic dysfunction, and FPG criterion was the most important one among all the components of MetS to influence HRV. These results underscored the importance of interpretation and management for abnormal glucose metabolism.

【 授权许可】

CC BY   
© Chang et al. 2016