Friederich H-C, Schild S, Schellberg D, Quenter A, Bode C, Herzog W, Zipfel S
Department of Internal Medicine II - Internal and Psychosomatic Medicine, University of Heidelberg, 69120 Heidelberg, Germany.
Int J Obes (Lond). 2006 Mar;30(3):534-42. doi: 10.1038/sj.ijo.0803181.
Obese individuals with a binge eating disorder (BED) differ from obese non-binge eaters (NBED) with respect to (a) eating behaviour, (b) psychiatric comorbidity and (c) level of psychosocial distress. The aim of the study was to explore whether these three factors have an influence on cardiac parasympathetic function, that is independent of obesity: as alterations in cardiac parasympathetic function may have a role in the higher cardiovascular mortality that is present in obese individuals.
In total, 38 obese women (BMI>30 kg/m(2)), with a BED and 34 age and BMI matched healthy controls (NBED) completed a laboratory stress protocol that incorporated a baseline resting period, Head-up Tilt Testing (HUT) and two challenging mental tasks. Heart rate and blood pressure were measured continuously during the protocol. Parasympathetic cardiac regulation was assessed as the high frequency component of heart rate variability (HRV-HF).
Mental challenge led to an augmented reduction of HRV-HF in obese binge eaters, which was linked to the binge eating frequency and hunger perception, but not to psychiatric comorbidity. During baseline conditions and HUT, no significant differences in parasympathetic measures were observed between the two subject groups.
Subjects with a BED showed greater reduction in parasympathetic cardiac control (HRV-HF) during mental stress, suggesting higher stress vulnerability in women with a BED. Longitudinal investigations are necessary to evaluate whether this is associated with an increased cardiovascular mortality.
患有暴饮暴食症(BED)的肥胖个体在以下方面与非暴饮暴食的肥胖者(NBED)存在差异:(a)饮食行为,(b)精神疾病共病情况,以及(c)心理社会困扰程度。本研究的目的是探讨这三个因素是否对心脏副交感神经功能有独立于肥胖的影响:因为心脏副交感神经功能的改变可能在肥胖个体较高的心血管死亡率中起作用。
共有38名患有BED的肥胖女性(BMI>30 kg/m²)以及34名年龄和BMI匹配的健康对照者(NBED)完成了一项实验室应激方案,该方案包括基线静息期、头高位倾斜试验(HUT)和两项具有挑战性的心理任务。在方案实施过程中持续测量心率和血压。将心率变异性的高频成分(HRV-HF)作为副交感神经心脏调节的评估指标。
心理挑战导致肥胖暴饮暴食者的HRV-HF下降幅度增大,这与暴饮暴食频率和饥饿感有关,但与精神疾病共病情况无关。在基线条件和HUT期间,两个受试者组之间在副交感神经测量方面未观察到显著差异。
患有BED的受试者在心理应激期间副交感神经心脏控制(HRV-HF)的下降幅度更大,这表明患有BED的女性具有更高的应激易感性。需要进行纵向研究以评估这是否与心血管死亡率增加有关。