The Relationship Between Cardiovascular Autonomic Dysfunction and Metabolic Parameters and hsCRP in Normoglycemia

Issue: 1/2014
Author: Dimova Rumyana, Tankova Tsvetalina, Chakarova Nevena, Groseva Greta,
Dakovska Lilia
Department of Diabetology, Clinical Centre of Endocrinology, Medical University, Sofia
Aim: The aim of the study was to evaluate the presence of cardiovascular autonomic dysfunction (CAD) at different stage of obesity and in the presence of metabolic syndrome, and its association with metabolic parameters and hsCRP in subjects with normal glucose tolerance (NGT).

Material and methods: A total of 111 subjects – 69 females and 42 males (mean age 42.8 14,7 years, mean BMI 30,0 ± 6,8kg/m2) with NGT, divided into 5 groups according to BMI: 28 normal weight, 32 overweight, 25 obesity class I, 15 class II, and 11 class III, and into 2 groups according the presence of Metabolic syndrome (MetS) – 47 with MetS and 64 controls were enrolled in a cross-sectional study. Glucose tolerance was studied during OGTT. Anthropometric indices, blood pressure and serum lipids were measured. Body composition was estimated by impedance analysis (InBody 720). The presence of CAD was assessed by ANX-3,0 using frequency-domain analysis during standard clinical tests – deep breathing, Valsalva and standing from a seated position.

Results: Sympathetic nervous system (SNS) and parasympathetic nervous system (PSNS) activity at rest and standing were significantly decreased in obesity class II (p = 0,005, p = 0,001 and p = 0,049, p = 0,004, resp.) and class III (p = 0,037, p = 0,019 and p = 0,019, p = 0,023, resp.) as compared to normal weight, and PSNS activity during deep breathing was diminished in all obesity groups (p = 0,018, p = 0,003 and p = 0,001, resp.) as compared to normal weight. In the presence of MetS SNS activity is significantly declined at rest (p = 0,035) and standing (p = 0,035), and increased during Valsalva (p = 0,002) as compared to controls, whilst PSNS activity is significantly lower during Deep breathing (p = 0,039) as compared to controls, and there was no statistically significant difference at rest and standing between groups. Significant negative correlation was observed between SNS and PSNS activity and BMI, waist, total body fat, visceral fat area, systolic and diastolic blood pressure, total and LDL cholesterol, and hsCRP.

Conclusion: Obesity is associated with cardiovascular autonomic function deterioration which worsen with the progression of obesity stage and the presence of MetS. Central obesity, blood pressure, total and LDL cholesterol and hsCRP correlate with autonomic dysfunction and increase cardiovascular risk in subjects with NGT.

Keywords: cardiovascular autonomic function, obesity, Metabolic syndrome, normal glucose tolerance, cardiovascular risk, hsCRP

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