Dysregulation of the Autonomic Nervous System Predicts the Development of the Metabolic Syndrome

Abstract

Context:Stress is suggested to lead to metabolic dysregulations as clustered in the metabolic syndrome. Although dysregulation of the autonomic nervous system is found to associate with the metabolic syndrome and its dysregulations, no longitudinal study has been performed to date to examine the predictive value of this stress system in the development of the metabolic syndrome.Objective: We examined whether autonomic nervous system functioning predicts 2-year development of metabolic abnormalities that constitute the metabolic syndrome.Design: Data of the baseline and 2-year follow-up assessment of a prospective cohort: the Netherlands Study of Depression and Anxiety was used.Setting: Participants were recruited in the general community, primary care, and specialized mental health care organizations.Participants: A group of 1933 participants aged 18 -65 years. Main outcome measures:The autonomic nervous system measures included heart rate (HR), respiratory sinus arrhythmia (RSA; high RSA reflecting high parasympathetic activity), pre-ejection period (PEP; high PEP reflecting low sympathetic activity), cardiac autonomic balance (CAB), and cardiac autonomic regulation (CAR). Metabolic syndrome was based on the updated Adult Treatment Panel III criteria and included high waist circumference, serum triglycerides, blood pressure, serum glucose, and low high-density lipoprotein (HDL) cholesterol.Results: Baseline short PEP, low CAB, high HR, and CAR were predictors of an increase in the number of components of the metabolic syndrome during follow-up. High HR and low CAB were predictors of a 2-year decrease in HDL cholesterol, and 2-year increase in diastolic and systolic blood pressure. Short PEP and high CAR also predicted a 2-year increase in systolic blood pressure, and short PEP additionally predicted 2-year increase in diastolic blood pressure. Finally, a low baseline RSA was predictive for subsequent decreases in HDL cholesterol. Conclusion:Increased sympathetic activity predicts an increase in metabolic abnormalities over time. These findings suggest that a dysregulation of the autonomic nervous system is an important predictor of cardiovascular diseases and diabetes through dysregulating lipid metabolism and blood pressure over time.

Bidirectional Prospective Associations of Metabolic Syndrome Components With Depression, Anxiety, and Antidepressant Use

“…This may indicate that possible shared pathophysiological aspects involved. For instance, higher baseline parasympathetic nervous system activity and shortened telomere length have been associated with worsening metabolic dysregulation after 2 years in NESDA participants 18, 61…”

Target-based biomarker selection – Mineralocorticoid receptor-related biomarkers and treatment outcome in major depression

“…We measured respiratory sinus arrhythmia (RSA), a form of heart rate variability (HRV) determination which is regarded as a marker for the status of the vegetative nervous system. It has been shown that RSA is reduced in patients with major depression compared to controls (Licht et al, 2008(Licht et al, , 2013. A recent meta-analysis has demonstrated an association between increasing depression severity and lower HRV (Kemp et al, 2010;Licht et al, 2008).…”

Análisis de variabilidad del ritmo cardiaco y su relación con la sensibilidad insulínica en pacientes obesos y con sobrepeso

“…Por otra parte, la RI se define como una disminución a la respuesta fisiológica a la insulina por parte de los tejidos, particularmente a nivel del tejido muscular y adiposo 27 . Si se considera a la obesidad y el sobrepeso como la característica principal de la muestra del presente estudio, se presume que existe un estilo de vida poco saludable, caracterizado por el desbalance entre el gasto y el consumo calóri-co, constituyendo una serie de factores de riesgo para el desarrollo de anormalidades metabólicas, disautonomía y síndrome metabólico 7,28 . Sumado a esto, existen estudios epidemioló-gicos que han demostrado que la obesidad y RI, se asocian con un incremento de la FC de reposo debido a un estímulo adrenérgico 20 .…”

“…La obesidad ha sido asociada a alteraciones en la función del Sistema Nervioso Autónomo (SNA), demostrando la existencia de una alteración del balance autonómico sobre el nódulo sinusal [2][3][4] . La disautonomía ha sido frecuentemente mencionada como nexo causal entre un estilo de vida poco saludable y el desbalance energético, el sedentarismo y anormalidades metabólicas como lo evidencia el síndrome metabólico [5][6][7] . En sujetos obesos se ha demostrado una disminución de la actividad vagal asociada a un mayor riesgo de enfermedad coronaria 8 .…”