Improvement of heart rate variability after decreased insulin resistance after sleeve gastrectomy for morbidly obesity patients

The effects of weight loss following bariatric surgery on autonomic balance, arrhythmias and insulin resistance are still of interest. We prospectively investigated 50 patients with BMI > 40 kg/m2, aged 36.5 (18–56) years who underwent laparoscopic sleeve gastrectomy. Among other examinations, all subjects had 24-h Holter monitoring with heart rate variability (HRV) and heart rate turbulence (HRT) evaluation. After a median of 15 months, BMI decreased from 43.9 to 29.7 kg/m2, the incidence of hypertension decreased from 54 to 32% (p = 0.04) and any carbohydrate disorders decreased from 24 to 6% (p = 0.02). Fasting insulin concentration and insulin resistance index improved significantly (p < 0.001). Improvements in HRV parameters related to the sympathetic autonomic division were also observed (p < 0.001), while HRT evaluation was not conclusive. The enhancement of autonomic tone indices was correlated with reduction of BMI (SDNN-I r = 0.281 p = 0.04; SDNN r = 0.267 p = 0.05), but not with reduction of waist circumference, and it was also associated with decrease of mean heart rate (OR 0.02, 95%CI 0.0–0.1, p < 0.001). The incidence of arrhythmias was low and similar before and after follow-up. In conclusion, improvement of homeostasis of carbohydrate metabolism and autonomic function is observed in relatively young patients after weight loss due to laparoscopic sleeve gastrectomy.

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Sex differences in associations between insulin resistance, heart rate variability, and arterial stiffness in healthy women and men: a physiology study

Canadian Journal of Physiology and Pharmacology ◽

10.1139/cjpp-2016-0122 ◽

2017 ◽

Vol 95 (4) ◽

pp. 349-355 ◽

Cited By ~ 6

Author(s):

Luke Anthony Rannelli ◽

Jennifer M. MacRae ◽

Michelle C. Mann ◽

Sharanya Ramesh ◽

Brenda R. Hemmelgarn ◽

...

Keyword(s):

Insulin Resistance ◽

Heart Rate ◽

Heart Rate Variability ◽

Sex Differences ◽

Arterial Stiffness ◽

Spectral Power ◽

Applanation Tonometry ◽

Healthy Population ◽

Model Assessment ◽

Healthy Women

Diabetes confers greater cardiovascular risk to women than to men. Whether insulin-resistance-mediated risk extends to the healthy population is unknown. Measures of insulin resistance (fasting insulin, homeostatic model assessment, hemoglobin A1c, quantitative insulin sensitivity check index, glucose) were determined in 48 (56% female) healthy subjects. Heart rate variability (HRV) was calculated by spectral power analysis and arterial stiffness was determined using noninvasive applanation tonometry. Both were measured at baseline and in response to angiotensin II infusion. In women, there was a non-statistically significant trend towards increasing insulin resistance being associated with an overall unfavourable HRV response and increased arterial stiffness to the stressor, while men demonstrated the opposite response. Significant differences in the associations between insulin resistance and cardiovascular physiological profile exist between healthy women and men. Further studies investigating the sex differences in the pathophysiology of insulin resistance in cardiovascular disease are warranted.

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Influence of Insulin Resistance on the Association Between Physical Activity and Heart Rate Variability: The Toon Health Study

Journal of Physical Activity and Health ◽

10.1123/jpah.2020-0110 ◽

2020 ◽

Vol 17 (11) ◽

pp. 1075-1082

Author(s):

Isao Saito ◽

Koutatsu Maruyama ◽

Tadahiro Kato ◽

Yasunori Takata ◽

Kiyohide Tomooka ◽

...

Keyword(s):

Physical Activity ◽

Insulin Resistance ◽

Heart Rate ◽

Heart Rate Variability ◽

Frequency Standard ◽

Population Based ◽

Health Study ◽

Model Assessment ◽

Partial Regression Coefficient ◽

Validated Questionnaire

Background: Autonomic activity is possibly influenced by physical activity (PA). However, it remains unclear whether this association is modified by insulin resistance. Methods: This population-based study between 2009 and 2012 included 2016 men and women aged 30–79 years. The PA was assessed using a validated questionnaire based on sleep, occupation, transportation, household characteristics, and leisure-time PA. Heart rate (HR) and heart rate variability (HRV) in the sitting position were determined from 5-minute recordings of pulse waves detected by a fingertip sensor. The HRV was calculated as frequency (standard deviation of normal-to-normal [NN] intervals [SDNN]), root mean square of successive differences (RMSSD), and percentage differences between normal NN intervals >50 milliseconds [pNN50]) and time domains. Insulin resistance was evaluated using the homeostasis model assessment index (HOMA-IR). Results: HR, RMSSD, and pNN50 were related to the total and moderate/vigorous PA tertiles in models that included HOMA-IR. The partial regression coefficient of total PA per 1-SD increase was .05 (P = .019) for log-transformed RMSSD and 1.86 (P = .001) for pNN50. No interactive associations were observed between PA and HOMA-IR. Conclusions: Low total PA was associated with increased HR and low levels of RMSSD and pNN50, reflecting parasympathetic modulation that was not modified by insulin resistance.

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Resting Heart Rate Variability, Inflammation, and Insulin Resistance in Overweight and Obese Adolescents

Metabolic Syndrome and Related Disorders ◽

10.1089/met.2015.0140 ◽

2016 ◽

Vol 14 (6) ◽

pp. 291-297 ◽

Cited By ~ 13

Author(s):

Roy C. Parish ◽

Steven Todman ◽

Sushil K. Jain

Keyword(s):

Insulin Resistance ◽

Heart Rate ◽

Heart Rate Variability ◽

Resting Heart Rate ◽

Obese Adolescents ◽

Resting Heart Rate Variability

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Associations Between Heart Rate Variability, Metabolic Syndrome Risk Factors and Insulin Resistance

Canadian Journal of Cardiology ◽

10.1016/j.cjca.2013.07.539 ◽

2013 ◽

Vol 29 (10) ◽

pp. S320-S321

Author(s):

M.I. Stuckey ◽

A. Kiviniemi ◽

D.P. Gill ◽

R.J. Petrella

Keyword(s):

Risk Factors ◽

Insulin Resistance ◽

Metabolic Syndrome ◽

Heart Rate ◽

Heart Rate Variability

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Does the autonomic nervous system play a role in the development of insulin resistance? A study on heart rate variability in first-degree relatives of Type 2 diabetes patients and control subjects

Diabetic Medicine ◽

10.1046/j.1464-5491.2003.00920.x ◽

2003 ◽

Vol 20 (5) ◽

pp. 399-405 ◽

Cited By ~ 68

Author(s):

S. Lindmark ◽

U. Wiklund ◽

P. Bjerle ◽

J. W. Eriksson

Keyword(s):

Insulin Resistance ◽

Type 2 Diabetes ◽

Heart Rate ◽

Heart Rate Variability ◽

Nervous System ◽

Autonomic Nervous System ◽

Autonomic Nervous ◽

Control Subjects ◽

And Control

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Body weight, BMI and insulin resistance as influential factors on heart rate variability - Reply

Respirology ◽

10.1111/resp.12561 ◽

2015 ◽

Vol 20 (5) ◽

pp. 846-847

Author(s):

Marceli Rocha Leite ◽

Ercy Mara Cipulo Ramos ◽

Carlos Augusto Kalva-Filho ◽

Fernanda Maria Machado Rodrigues ◽

Ana Paula Coelho Figueira Freire ◽

...

Keyword(s):

Insulin Resistance ◽

Heart Rate ◽

Heart Rate Variability ◽

Body Weight ◽

Influential Factors

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Associations between heart rate variability, metabolic syndrome risk factors, and insulin resistance

Applied Physiology Nutrition and Metabolism ◽

10.1139/apnm-2014-0528 ◽

2015 ◽

Vol 40 (7) ◽

pp. 734-740 ◽

Cited By ~ 13

Author(s):

Melanie I. Stuckey ◽

Antti Kiviniemi ◽

Dawn P. Gill ◽

J. Kevin Shoemaker ◽

Robert J. Petrella

Keyword(s):

Risk Factors ◽

Insulin Resistance ◽

Metabolic Syndrome ◽

Heart Rate ◽

Heart Rate Variability ◽

Standard Deviation ◽

Waist Circumference ◽

Frequency Domain ◽

Model Assessment ◽

Poincaré Plot

The purpose of this study was to examine differences in heart rate variability (HRV) in metabolic syndrome (MetS) and to determine associations between HRV parameters, MetS risk factors, and insulin resistance (homeostasis model assessment for insulin resistance (HOMA-IR)). Participants (n = 220; aged 23–70 years) were assessed for MetS risk factors (waist circumference, blood pressure, fasting plasma glucose, triglycerides, and high-density lipoprotein cholesterol) and 5-min supine HRV (time and frequency domain and nonlinear). HRV was compared between those with 3 or more (MetS+) and those with 2 or fewer MetS risk factors (MetS–). Multiple linear regression models were built for each HRV parameter to investigate associations with MetS risk factors and HOMA-IR. Data with normal distribution are presented as means ± SD and those without as median [interquartile range]. In women, standard deviation of R–R intervals 38.0 [27.0] ms, 44.5 [29.3] ms; p = 0.020), low-frequency power (5.73 ± 1.06 ln ms2, 6.13 ± 1.05 ln ms2; p = 0.022), and the standard deviation of the length of the Poincaré plot (46.8 [31.6] ms, 58.4 [29.9] ms; p = 0.014) were lower and heart rate was higher (68 [13] beats/min, 64 [12] beats/min; p = 0. 018) in MetS+ compared with MetS–, with no differences in men. Waist circumference was most commonly associated with HRV, especially frequency domain parameters. HOMA-IR was associated with heart rate. In conclusion, MetS+ women had a less favourable HRV profile than MetS– women, but there were no differences in men. HOMA-IR was associated with heart rate, not HRV.

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