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The effect of insulin on cardiac autonomic balance predicts weight reduction after gastric bypass.

Abstract：

AIMS/HYPOTHESIS:The aim of this study was to assess the predictive role of autonomic reactivity in body weight loss induced by gastric bypass. METHODS:A group of 22 morbidly obese subjects, who were due to undergo a gastric bypass, were submitted, before surgery, to a euglycaemic-hyperinsulinaemic clamp, during which a continuous recording of the ECG was performed. The effect of insulin on cardiac autonomic balance was evaluated by performing power spectral analysis of heart rate variability. The low-to-high frequency ratio was calculated before and during the clamp and its modifications were expressed as % delta low-to-high frequency ratio (%Delta L: H). RESULTS:Preoperative %Delta L: H showed a significant (p=0.0009, r2=0.43), positive relationship to the reduction of body weight, measured 1 year after surgery and expressed as % excess weight loss (% EWL). Preoperative BMI was also significantly (p=0.0009, r2=0.43) negatively related to the 12-month % EWL. In a multiple regression analysis, %Delta L: H remained a significant (p=0.003), independent predictor of body weight loss, even when preoperative BMI or age, % fat mass, insulinaemia and glucose disposal were taken into account. CONCLUSIONS/INTERPRETATION:The best correction of excess body weight was achieved by those obese subjects who had a preserved capacity to shift their cardiac autonomic balance towards a sympathetic prevalence in response to an euglycaemic-hyperinsulinaemic clamp. Further studies are needed to elucidate the mechanisms through which the autonomic nervous system influences weight reduction.

journal_name

Diabetologia

journal_title

Diabetologia

authors

Bobbioni-Harsch E,Sztajzel J,Barthassat V,Lehmann TN,Sievert K,Chassot G,Huber O,Morel P,Golay A,Assimacopoulos-Jeannet F

doi

10.1007/s00125-005-1792-5

subject

Has Abstract

pub_date

2005-07-01 00:00:00

pages

1258-63

issue

7

eissn

0012-186X

issn

1432-0428

journal_volume

48

pub_type

杂志文章

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