Assessing Metabolic Syndrome Through Increased Heart Rate During Exercise
-
Masoumeh Sadeghi
,
Mojgan Gharipour
,
Pouya Nezafati
,
Davood Shafie
,
Esmaeil Aghababaei
,
Nizal Sarrafzadegan
Abstract
The present study aimed to assess changes in resting and maximum heart rates as primary indicators of cardiac autonomic function in metabolic syndrome (MetS) patients and to determine their value for discriminating MetS from non-MetS. 468 participants were enrolled in this cross-sectional study and assessed according to the updated adult treatment panel III (ATP-III) definition of MetS. Resting and maximum heart rates were recorded following the Bruce protocol during an exercise. A receiver operating characteristic (ROC) curve was used to identify the best cutoff point for discriminating MetS from the non-MetS state. 194 participants (41.5%) were diagnosed as MetS. The mean resting heart rate (RHR) was not statistically different between the two groups (P=0.078). However, the mean maximum heart (MHR) rate was considerably higher in participants with MetS (142.37±14.84 beats per min) compared to the non-MetS group (134.62±21.63 beats per min) (P<0.001). In the MetS group, the MHR was positively correlated with the serum triglyceride level (β=0.185, P=0.033) and was inversely associated with age (β=-0.469, P<0.001). The MHR had a moderate value for discriminating MetS from the non-MetS state (c=0.580, P=0.004) with the optimal cutoff point of 140 beats per min. In MetS patients, the MHR was significantly greater compared to non-MetS subjects and was directly correlated with serum triglyceride levels and inversely with advanced age. Moreover, MHR can be used as a suspicious indicator for identifying MetS.
Wang JH, Lee CJ, Hsieh JC, Chen YC, Hsu BG. Inverse association of long-acting natriuretic peptide with metabolic syndrome in congestive heart failure patients.Diabetol Metab Syndr 2013;5:19.
Yoon HJ, Ahn Y, Kim KH, Park JC, Choi DJ, Han S, et al. The prognostic implication of metabolic syndrome in patients with heart failure. Korean Circ J 2013;43:87-92.
Kranjcec D, Altabas V. Metabolic syndrome influencing infarct size and heart failure in patients with acute coronary syndrome: does gender matter? Endocr J 2012;59:1065-76.
Chang JJ, Chu CM, Wang PC, Lin YS, Pan KL, Jang SJ, et al. Differences in prevalence and severity of coronary artery disease by three metabolic syndrome definitions. Can J Cardiol 2012;28:208-14 .
Gharipour M, Sadeghi M, Dianatkhah M, Bidmeshki Sh, Ahmadi Ar, Taheri M, et al. The Cut-Off Values of Anthropometric Indices for Identifying Subjects at Risk for Metabolic Syndrome in Iranian Elderly Men. J Obes 2014;20147:907149.
Alberti KGMM, Eckel RH, Grundy SM, Zimmet PZ, Cleeman JI, Donato KA, et al. Harmonizing the metabolic syndrome: a joint interim statement of the International Diabetes Federation Task Force on Epidemiology and Prevention; National heart, Lung, and Blood Institute; American Heart Association; World Heart Federation; International Atherosclerosis Society; and International Association for the Study of Obesity. Circulation 2009;120:1640-5.
Talaei M, Sadeghi M, Marshall T, Thomas GN, Kabiri P, Hoseini S, et al. Impact of metabolic syndrome on ischemic heart disease - a prospective cohort study in an Iranian adult population: Isfahan Cohort Study. Nutr Metab Cardiovasc Dis 2012;22:434-41.
Gharipour M, Sarrafzadegan N, Sadeghi M, Khosravi A, Hoseini M, Khosravi-Boroujeni H, et al. The metabolic syndrome and associated lifestyle factors among the Iranian population. Adv Biomed Res 2015;4:84.
Gharipour M, Sarrafzadegan N, Sadeghi M, Andalib E, Talaie M, Shafie D, et al. Predictors of metabolic syndrome in the Iranian population: waist circumference, body mass index, or waist to hip ratio? Cholesterol 310290:0202;3102.
Grassi G, Arenare F, Quarti-Trevano F, Seravalle G, Mancia G. Heart rate, sympathetic cardiovascular influences, and the metabolic syndrome. Prog Cardiovasc Dis 2009;52:31-7.
Kim MK, Tanaka K, Kim MJ, Matsuo T, Ajisaka R.Exercise training-inducedchanges in heart rate recovery in obese men with metabolic syndrome. Metab Syndr Relat Disord 2009;7:469-76.
Perlini S, Naditch-Brule L, Farsang C, Zidek W, Kjeldsen SE. Pulse pressure and heart rate in patients with metabolic syndrome across Europe: insights from the GOOD survey. J Hum Hypertens 2013;27:412-6.
Roohafza Hr, Sadeghi M, Naghnaian M, Shokouh P, Ahmadi A, Sarrafzadegan N. Relationship between Metabolic Syndrome and Its Components with Psychological Distress. Int J Endocrinol 2014;2014:203463.
Bayanfar Z, Sadeghi M, Heidari R, Gharipour M, Talaie M, Sedaghat A. Carotid intima-media thickness and plasma fibrinogen among subjects with metabolic syndrome: Isfahan cohort study, Iran. ARYA Atheroscler 2014;10:238-43.
Mottillo S, Filion KB, Genest J, Joseph L, Pilote L, Poirier P, et al. The metabolic syndrome and cardiovascular risk a systematic review and metaanalysis. J Am Coll Cardiol 2010;56:1113-32.
Kangas P, Tikkakoski AJ, Tahvanainen AM, Leskinen MH, Viitala JM, Kähönen M, et al. Metabolic syndrome may be associated with increased arterial stiffness even in the absence of hypertension: A study in 84 cases and 82 controls. Metabolism 2013;62:1114-22.
Gharipour M, Sadeghi M, Mansourian M, Andalib E, Talaie M, Mohamadifard N, et al. Correlation of circulating inflammatory markers, ghrelin, adiponectin with obesity indices in subjects with metabolic syndrome. Pak J Med Sci 2013;29:264-68.
Liao D, Sloan RP, Cascio WE, Folsom AR, Liese AD, Evans GW, et al. Multiple metabolic syndrome is associated with lower heart rate variability. The Atherosclerosis Risk in Communities Study. Diabetes Care 1998;21:2116-22.
Sarraf-Zadegan N, Sadri G, Malek Afzali H, Baghaei M, Mohammadi Fard N, Shahrokhi S, et al. Isfahan healthy heart programme: a comprehensive integrated community-based programme for cardiovascular disease prevention and control. Design, methods and initial experience. Acta Cardiologica 2003;58:309-20.
Sarrafzadegan N, Baghaei A, Sadri G, Kelishadi R, Malekafzali H, Boshtam M, et al. Isfahan healthy heart program: evaluation of comprehensive, community-based interventions for non-communicable disease prevention. Prev Control 2006;2:73-84.
Talaei M, Sarrafzadegan N, Sadeghi M,Oveisgharan S, Marshall T, Thomas GN, et al. Incidence of cardiovascular diseases in an Iranian population: The Isfahan cohort study. Arch Iran Med. 2013; 16(3): 138 – 144.
Barrett-Connor E, Giardina EGV, Gitt AK, Gudat U, Steinberg HO, Tschoepe D. Women and heart disease: the role of diabetes and hyperglycemia. Arch Intern Med 2004;164:934-42.
Wood D, De Backer G, Faergeman O, Graham I, Mancia G, Pyörälä K. Prevention of coronary heart disease in clinical practice. Recommendations of the second joint task force of European and other societies on coronary prevention. Eur Heart J 1998;19:1434-503.
Chalmers MS J, Mancia G, Whitworth J, Whitworth J, Beilin L, Hansson L, et al. World health organization- international society of hypertension guidelines for the management of hypertension. Guidelines sub-committee of the world health organization. Clin Exp Hypertens 1999;21:1009-60.
American Diabetes Association. Diagnosis and classification of diabetes mellitus. Diabetes Care 2008;31:S55-60.
Rossi AM, Davies E, Lavoie KL, Arsenault A, Gordon JL, Meloche B, et al. The impact of metabolic syndrome and endothelial dysfunction on exercise-induced cardiovascular changes. Obesity (Silver Spring)2013;21:E143-8.
Bruce RA, Blackmon JR, Jones JW, Strait G. Exercising Testing in Adult Normal Subjects and Cardiac Patients. Pediatrics 2004;32:742-56.
Pierpont GL, Voth EJ. Assessing autonomic function by analysis of heart rate recovery from exercise in healthy subjects. Am J Cardiol 2000;94:64-8.
Rana JS, Hardison RM, Pop-Busui R, Brooks MM, Jones TL, Nesto RW, et al. BARI 2D Investigators. Resting heart rate and metabolic syndrome in patients with diabetes and coronary artery disease in bypass angioplasty revascularization investigation 2 diabetes (BARI 2D) trial. Prev Cardiol 2010;13:112-6.
Zidek W, Naditch-Brûlé L, Perlini S, Farsang C, Kjeldsen SE. Blood pressure control and components of the metabolic syndrome: the GOOD survey. Cardiovasc Diabetol 2009;8:51.
Licht CM, de Geus EJ, Penninx BW. Dysregulation of the autonomic nervous system predicts the development of the metabolic syndrome. J Clin Endocrinol Metab2013;98:2484-93.
Dorresteijn JA, Visseren FL, Spiering W. Mechanisms linking obesity to hypertension. Obes Rev 2012;13:17-26.
Koivistoinen T, Aatola H, Hutri-Kähönen N, JuonalaM, Viikari JS, Laitinen T, et al. Systemic hemodynamics in young adults with the metabolic syndrome: the Cardiovascular Risk in Young Finns Study. Ann Med2010;42:612-21.
Gong HP, Tan HW, Fang NN, Song T, Li SH, Zhong M, et al. Impaired left ventricular systolic and diastolic function in patients with metabolic syndrome as assessed by strain and strain rate imaging. Diabetes Res Clin Pract2009;83:300-7
| Files | ||
| Issue | Vol 54, No 11 (2016) | |
| Section | Original Article(s) | |
| Keywords | ||
| Metabolic syndrome Maximum heart rate Resting heart rate Exercise test Serum triglyceride | ||
| Rights and permissions | |
|
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |
