阻塞性睡眠呼吸暂停（OSA）高原移居者内脏脂肪面积与心率变异性的关系：胰岛素抵抗的中介作用

Association between visceral fat area and heart rate variability in high altitude migrants with OSA: the mediating effect of insulin resistance.

作者信息

Jia Shanshan, Fu Yongxing, Wu Yong, Li Hongwei, Hao Doudou, Wu Yunhong, Chen Xiaoping, Zhao Liming

机构信息

Department of Cardiology, West China Hospital of Sichuan University, Chengdu, China.

Department of Cardiology, Hospital of Chengdu Office of People's Government of Xizang Autonomous Region (Hospital.C.X.), Chengdu, China.

出版信息

Lipids Health Dis. 2025 Jul 28;24(1):253. doi: 10.1186/s12944-025-02626-2.

DOI:10.1186/s12944-025-02626-2

PMID:40721786

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12306044/

Abstract

OBJECTIVE

This study was conducted to investigate the association between visceral fat area (VFA) and heart rate variability (HRV) in high-altitude migrants with obstructive sleep apnea (OSA).

METHOD

We conducted a cross-sectional study comprising 152 OSA participants from 2022 to 2024. We employed multivariable linear regression to further elucidate the association between VFA and HRV. Mediation analysis was utilized to investigate the indirect effects of insulin resistance and white blood cell counts on this relationship. Sensitivity analysis assessed the robustness of the results. To explore the influence of gender on the results, we conducted gender-specific subgroup analyses and interaction tests.

RESULTS

Multivariable regression analysis revealed that for every 20-unit increase in VFA, there were significant reductions in SDNN (-4.00, 95% CI: -5.90, -2.11), SDANN (-3.51, 95% CI: -5.43, -1.60), SDNN index (-1.35, 95% CI: -2.13, -0.56), rMSSD (-0.92, 95% CI: -1.51, -0.33), and pNN50 (-0.58, 95% CI: -0.99, -0.17). Additionally, a significant positive association was found between VFA and the low-frequency/high-frequency ratio (LF/HF ratio) (0.25, 95% CI: 0.11, 0.39). Mediation analysis indicated a significant mediating effect of HOMA-IR on the VFA-HRV association, with proportions of 20.32%, 18.76%, and 26.23% for SDNN index, rMSSD, and LF/HF ratio, respectively. The mediating effect based on white blood cell count did not reach statistical significance. There was no gender difference in the association between VFA and HRV. The sensitivity analysis indicated that the findings remained robust.

CONCLUSION

Our findings indicated that visceral fat serves as a significant determinant of cardiovascular health among OSA patients residing at high altitudes and may represent a viable target for intervention and preventive strategies.

SUPPLEMENTARY INFORMATION

The online version contains supplementary material available at 10.1186/s12944-025-02626-2.

摘要

目的

本研究旨在调查患有阻塞性睡眠呼吸暂停（OSA）的高海拔移民的内脏脂肪面积（VFA）与心率变异性（HRV）之间的关联。

方法

我们在2022年至2024年期间进行了一项横断面研究，纳入了152名OSA参与者。我们采用多变量线性回归进一步阐明VFA与HRV之间的关联。中介分析用于研究胰岛素抵抗和白细胞计数对这种关系的间接影响。敏感性分析评估了结果的稳健性。为了探讨性别对结果的影响，我们进行了性别特异性亚组分析和交互检验。

结果

多变量回归分析显示，VFA每增加20个单位，SDNN（-4.00，95%CI：-5.90，-2.11）、SDANN（-3.51，95%CI：-5.43，-1.60）、SDNN指数（-1.35，95%CI：-2.13，-0.56）、rMSSD（-0.92，95%CI：-1.51，-0.33）和pNN50（-0.58，95%CI：-0.99，-0.17）均显著降低。此外，VFA与低频/高频比值（LF/HF比值）之间存在显著正相关（0.25，95%CI：0.11，0.39）。中介分析表明，HOMA-IR对VFA-HRV关联具有显著中介作用，对SDNN指数、rMSSD和LF/HF比值的中介比例分别为20.32%、18.76%和26.23%。基于白细胞计数的中介作用未达到统计学显著性。VFA与HRV之间的关联不存在性别差异。敏感性分析表明研究结果仍然稳健。