Improvement of heart rate variability after decreased insulin resistance after sleeve gastrectomy for morbidly obesity patients
Journal
Surgery for Obesity and Related Diseases
Journal Volume
11
Journal Issue
3
Pages
557-563
Date Issued
2015
Author(s)
Abstract
Background Morbidly obese patients display both an autonomic nervous imbalance and impaired glucose metabolism, and both of these conditions can be partially reversed after bariatric surgery. The aim of the present study was to investigate changes in heart rate variability (HRV) and glucose metabolism in patients after laparoscopic sleeve gastrectomy (SG). Methods Eighteen morbidly obese patients who underwent SG were examined before surgery and at 7, 30, 90, and 180 days after surgery. Indices of HRV included time-domain, frequency-domain, and nonlinear parameters. Glucose metabolism was evaluated by the measuring levels of insulin resistance, glycated hemoglobin (HbA1c), and gut hormones. Results The study included 9 men and 9 women with a mean age of 34 years. In the HRV study, the average R-R interval, median R-R interval, standard deviation of the R-R intervals, root mean squared successive difference of the R-R intervals (RMSSD), and the number of pairs of successive normal-to-normal beat intervals that differed by>50 ms significantly increased at 180 days after surgery. Regarding the frequency-domain indices, the low frequency (LF)/high frequency (HF) ratio was more balanced at 90 days after SG compared with baseline, and increases in the total power, LF band, and HF band were observed at 180 days. The assessments of insulin resistance, glucose metabolism, and gut hormones revealed not only improvements in the homeostasis model assessment of insulin resistance and HbA1c levels but also increases in the levels of glucagon-like peptide-1 at 90 and 180 days after surgery compared with baseline. A multivariable regression model revealed significantly negative associations between the perioperative changes in HOMA-IR and changes in both the RMSSD and HF band. Conclusions SG leads to early improvements in insulin resistance and glucose metabolism that are followed by improvements in HRV indices. Improvements in insulin resistance were associated with increases in the RMSSD and HF band index, but the mechanism of these changes require further study. ? 2015 Published by Elsevier Inc. on behalf of American Society for Metabolic and Bariatric Surgery.
SDGs
Other Subjects
gastric inhibitory polypeptide; gastrointestinal hormone; glucagon like peptide 1; glucose; hemoglobin A1c; insulin; triacylglycerol; glucose blood level; glycosylated hemoglobin; acanthosis nigricans; adult; Article; body mass; clinical article; dyslipidemia; female; glucose homeostasis; glucose metabolism; heart rate variability; hemoglobin blood level; hormone blood level; human; hypertension; insulin blood level; insulin resistance; lipid metabolism; male; morbid obesity; non insulin dependent diabetes mellitus; postoperative period; preoperative evaluation; priority journal; RR interval; sleep disordered breathing; sleeve gastrectomy; treatment outcome; triacylglycerol blood level; virus hepatitis; weight reduction; circadian rhythm; electrocardiography; follow up; gastrectomy; glucose blood level; heart rate; insulin resistance; metabolism; Obesity, Morbid; pathophysiology; physiology; procedures; time factor; Adult; Blood Glucose; Body Mass Index; Circadian Rhythm; Electrocardiography; Female; Follow-Up Studies; Gastrectomy; Heart Rate; Hemoglobin A, Glycosylated; Humans; Insulin Resistance; Male; Obesity, Morbid; Time Factors
Publisher
Elsevier Inc.
Type
journal article