Korean Journal of Family Medicine (가정의학회지)

The Korean Academy of Family Medicine (대한가정의학회)
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Changes in Heart Rate Variability after Weight Reduction in the Obese

비만 환자에서 체중 감량 후 심박동수 변이의 단기적 변화

Joo, Nam-Seok;Park, Soo-Bum;Kim, Kwang-Min;Kim, Sang-Man;Lee, Duk-Joo;Kim, Bom-Taeck
주남석;박수범;김광민;김상만;이득주;김범택

  • Published : 20051100
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Abstract

Background: Obesity increases morbidities and mortalities due to cardiovascular diseases. In previous studies, decrease in heart rate variability was associated with cardiovascular death and reduced heart rate variability in the obese had been reported. The authors investigated immediate changes in the heart rate variability after weight reduction in obese individuals. ethods: The subjects for this study were 39 Korean adults (35 female, 4 male), who visited obesity clinic in a university hospital from January 2002 to July 2003. At first visit, weight, height, body mass index (BMI) and waist circumference of the subjects were measured. We also measured parameters of heart rate variability: Mean Heart Rate (MHR), Standard Deviation of N-N interval (SDNN), The Square Root of the Mean Squared Difference of successive NN intervals (RMSSD), Total Power (TP), Low Frequency (LF), High Frequency (HF), and LF/HF ratio. Weight reduction protocol included nutritional counseling, exercise, behavioral modification and anti-obesity medications, if needed. Results: At 12 weeks of intervention, weight, BMI, waist circumference, fat mass, and lean body mass significantly decreased (3.90$\pm$3.11 kg, -1.50$\pm$1.21 kg/$m^2$, -4.45$\pm$5.61 cm, -3.03$\pm$2.45 kg, -1.32$\pm$1.16 kg, P＜0.01, respectively). MHR (-6.17$\pm$9.65 bpm, P＜0.01) and LF/HF (-0.61$\pm$1.56, P＜0.05) showed significant reduction. Changes of weight and LF were positively correlated (r=0.338, P＜0.01). Changes of waist circumference was correlated with changes of SDNN (r=0.331, P＜0.05). Changes of BMI showed positive correlation with changes in TP (r=0.327, P＜0.05) and LF (r=0.345, P＜0.05). Conclusion: Short term intervention for obese people decreased sympathetic nervous activity.

연구 배경: 비만은 심혈관계 질환의 이환율 및 사망률을 증가시킨다. 기존연구에 의하면, 비만 환자들에서 심박동수 변이는 감소되어 있으며, 감소된 심박동수 변이는 심혈관계 질환으로 인한 사망과 관련이 있었다. 이에 저자들은 비만 환자에서 체중이 감소될 때, 심박동수 변이가 단기적으로 어떻게 변화하는지 연구하였다. 방법: 이 연구는 2002년 1월부터 2003년 7월 사이에 일개 대학병원 가정의학과 외래에 내원한 환자 39명을 대상으로 하였다. 첫 내원 시 신체계측으로 체중, 키, 체질량지수, 허리둘레를 측정하였고, 심박동수 변이의 지표는 Mean Heart Rate (MHR), Standard Deviation of N-N interval (SDNN), The Square Root of the Mean Squared Difference of successive NN intervals (RMSSD), Total Power (TP), Low Frequency (LF), High Frequency (HF), LF/HF ratio를 측정하였다. 비만 치료는 저열량 식사요법과 운동, 행동교정, 약물 치료를 병행하였다. 비만 치료 12주 후에 위의 검사를 다시 실시하였다. 결과: 체중감량을 12주간 실시 한 후, 체중, 체질량지수, 허리 둘레, 체지방량, 제지방량이 각각 유의하게 감소하였다. (각각 -3.90$\pm$3.11 kg, -1.50$\pm$1.21 kg/$m^2$, -4.45$\pm$5.61 cm, -3.03$\pm$2.45 kg, -1.32$\pm$1.16 kg, P＜.001). 심박 동수 변이는 MHR (-6.17$\pm$9.65 bpm, P＜.001), LF/HF (-0.61$\pm$1.56, P＜0.05)가 유의하게 감소되었다. 체중 감량과 LF (r=0.338, P=0.036)는 유의한 상관 관계를 보였다. 허리 둘레의 감소와 SDNN (r=0.331, P＜0.05)은 유의한 상관 관계를 보였다. 체질량지수와 TP (r=0.327, P＜0.05), LF (r=0.345, P＜0.05)가 유의한 상관 관계를 보였다. 결론: 비만 환자에서 체중 감량은 단기적으로 교감신경의 활성도를 감소시킨다.

Keywords

References

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