肥胖儿童心率变异特征与血脂代谢、脂肪细胞因子含量的相关性分析

Correlations of heart rate variability with lipid metabolism and adipocytokines in obese children

摘要:

目的分析肥胖儿童心率变异特征与血脂代谢、脂肪细胞因子含量的相关性。方法选取2014年6月-2016 年7 月该院收治的肥胖儿童260 例作为观察组，另取同期在该院接受疫苗接种的健康儿童200 例作为对照组。采用24 h 动态心电图获取两组研究对象的心率变异性指标，测定血液血脂代谢及脂肪细胞因子含量。进一步采用Pearson 检验分析肥胖儿童心率变异特征与血脂代谢、脂肪细胞因子含量的相关性。结果观察组儿童的窦性心搏RR 间期标准差（SDNN）、每5 分钟RR 间期平均值的标准差（SDANN）、全部相邻RR 间期之差的均方根（RSMSSD）和每5分钟内RR 间期标准差的平均值（SDNN Index）等心率变异性指标值均低于对照组儿童（p <0.05）；观察组儿童的外周血脂质代谢指标中总胆固醇（TC）、三酰甘油（TG）及低密度脂蛋白胆固醇（LDL-C）含量均高于对照组儿童，高密度脂蛋白胆固醇（HDL-C）含量低于对照组儿童（p <0.05）；观察组儿童的血清脂肪细胞因子瘦素（Leptin）、脂联素（APN）和视黄醇结合蛋白4（RBP-4）含量低于对照组儿童，白介素6（IL-6）含量高于对照组儿童（p <0.05）；肥胖儿童的心率变异性指标SDNN、SDANN、RSMSSD及SDNN Index水平与脂质代谢指标及脂肪细胞因子含量均存在直接相关性（p <0.05）。结论肥胖儿童心率变异特征与机体脂质代谢及脂肪细胞因子含量间存在相关性，过度肥胖是导致儿童心功能异常的重要原因。

Abstract:

Objective To analyze the correlation between heart rate variability and lipid metabolism, adipocytokines in obese children. Methods Two hundred and sixty obese children in our hospital from June 2014 to July 2016 were selected as observation group, two hundred healthy children in the same period were taken as control group. Twenty-four hour dynamic electrocardiogram was used to obtain the index of heart rate variability in two groups. Blood lipid metabolism and adipocytokines were measured. Pearson test was used to analyze the relationships of heart rate variability with lipid metabolism and adipocytokines in obese children. Results heart rate variability indexs such as standard diviation of NN intervals (SDNN), standard diviation of the 5 minute mean cycle lengths (SDANN), root mean square of successive differences (RSMSSD),standard diviation of NN intervals index (SDNN Index) were significantly lower in observation group than those in control group (p < 0.05); peripheral blood lipid such as total cholesterol (TC), triglyceride (TG), low density lipoprotein cholesterol (LDL-C) levels were significantly higher. high density lipoprotein cholesterol (HDL-C) was lower in observation group than in control group (p < 0.05); serum adipocytokines such as leptin (Leptin),adiponectin (APN), retinol binding protein-4 (RBP-4) were lower in observation group than those in control group, interleukin-6 (IL-6) was higher in observation group than that in control group (p < 0.05); Heart rate variability indexs including SDNN, SDANN, RSMSSD and SDNN were in direct correlation with lipid metabolism indexes and adipocytokines (p < 0.05). Conclusions There are direct correlations between heart rate variability and body lipid metabolism, adipocytokines in obese children. Obesity is an important cause of abnormal heart function.