Dysfunction of Autonomic Nervous System in Childhood Obesity: A Cross-Sectional Study
Open Access
- 24 January 2013
- journal article
- research article
- Published by Public Library of Science (PLoS) in PLOS ONE
- Vol. 8 (1), e54546
- https://doi.org/10.1371/journal.pone.0054546
Abstract
To assess the distribution of autonomic nervous system (ANS) dysfunction in overweight and obese children. Parasympathetic and sympathetic ANS function was assessed in children and adolescents with no evidence of impaired glucose metabolism by analysis of heart rate variability (low frequency power ln(LF), high frequency power, ln(HF); ln(LF/HF) ratio, ratio of longest RR interval during expiration to shortest interval during inspiration (E/I ratio), root mean square of successive differences (RMSSD); sympathetic skin response (SSR); and quantitative pupillography (pupil diameter in darkness, light reflex amplitude, latency, constriction velocity, re-dilation velocity). The relationship of each ANS variable to the standard deviation score of body mass index (BMI-SDS) was assessed in a linear model considering age, gender and pubertal stage as co-variates and employing an F-statistic to compare the fit of nested models. Group comparisons between normal weight and obese children as well as an analysis of dependence on insulin resistance (as indexed by the Homeostasis Model Assessment of Insulin Resistance, HOMA-IR) were performed for parameters shown to correlate with BMI-SDS. Statistical significance was set at 5%. Measurements were performed in 149 individuals (mean age 12.0 y; 90 obese 45 boys; 59 normal weight, 34 boys). E/I ratio (p = 0.003), ln(HF) (p = 0.03), pupil diameter in darkness (p = 0.01) were negatively correlated with BMI-SDS, whereas ln(LF/HF) was positively correlated (p = 0.05). Early re-dilation velocity was in trend negatively correlated to BMI-SDS (p = 0.08). None of the parameters that depended significantly on BMI-SDS was found to be significantly correlated with HOMA-IR. These findings demonstrate extended ANS dysfunction in obese children and adolescents, affecting several organ systems. Both parasympathetic activity and sympathetic activity are reduced. The conspicuous pattern of ANS dysfunction raises the possibility that obesity may give rise to dysfunction of the peripheral autonomic nerves resembling that observed in normal-weight diabetic children and adolescents.This publication has 43 references indexed in Scilit:
- Cardiac Autonomic Functions in Obese ChildrenJournal of Clinical Research in Pediatric Endocrinology, 2011
- Age-specific stabilization in obesity prevalence in German children: A cross-sectional study from 1999 to 2008Pediatric Obesity, 2011
- Sympathetic Nervous System Activity Is Associated With Obesity-Induced Subclinical Organ Damage in Young AdultsHypertension, 2010
- Childhood obesityThe Lancet, 2010
- Microalbuminuria and Cardiovascular Autonomic Dysfunction Are Independently Associated With Cardiovascular Mortality: Evidence for Distinct PathwaysDiabetes Care, 2009
- CHANGES IN PUPILLARY DYNAMICS IN YOUNG MEN DURING PROLONGED SEVERE EXERCISEActa Ophthalmologica, 2009
- Pupil size in diabetes.Archives of Disease in Childhood, 1994
- Smoothing reference centile curves: The lms method and penalized likelihoodStatistics in Medicine, 1992
- Body Fat and the Activity of the Autonomic Nervous SystemThe New England Journal of Medicine, 1988
- Clinical longitudinal standards for height, weight, height velocity, weight velocity, and stages of puberty.Archives of Disease in Childhood, 1976