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

Abstract

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.

Heart rate variability as an independent predictor for 8-year mortality among chronic hemodialysis patients

“…The baseline characteristic information, including demographic data, comorbid diseases, laboratory tests, and medications, were obtained from patients' medical charts at enrollment. The details of performing HRV measurement and obtaining patients' information were clearly stated in our previous work 16,17 . After the enrollment and HRV measurements, these participants were continuously followed for eight years until August 2018.…”

“…In this point of view, the work of Chen et al 15 was constructive and worthy of more attention. However, the real dynamic changes of HRV during the hemodialysis process are likely to be a "reverse V-shape, " which denotes "increase at the initial stage but decreases at a later stage [16][17][18] . The HRV measurements at two time-points before and after hemodialysis could not demonstrate the real dynamic changes of HRV during the hemodialysis.…”

Prevalence of Metabolic Syndrome and Associated Factors among Hemodialysis Patients Monitored at the National Teaching Hospital, Hubert Koutoucou Maga in 2015

“…In UCAR study, metabolic syndrome prevalence based on IDF criteria was 36% [17]. Higher metabolic syndrome prevalence among hemodialysis patients 52% was reported by Chang et al [5]. In that study metabolic syndrome was de-…”

“…Metabolic syndrome is an entity that brings together in the same individual, several metabolic abnormalities which predispose him to cardiovascular risks. Metabolic syndrome is itself one of the main risk factors for cardiovascular diseases [5].…”

“…The prevalence of metabolic syndrome among the general population is 13.3% in China in 2006 [6], 22% in the United States in 2012 [5]. Jalalzadeh observed among hemodialysis patients in Iran in 2011, 28.7% prevalence; Pérez in Spain in 2014, 29% and Maoujoud in Morocco recorded in 2011, 44% [7] [8] [9].…”