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Low heart rate variability from 10-s electrocardiograms is associated with development of non-alcoholic fatty liver disease

Low heart rate variability from 10-s electrocardiograms is associated with development of non-alcoholic fatty liver disease
Low heart rate variability from 10-s electrocardiograms is associated with development of non-alcoholic fatty liver disease

Reduced heart rate variability (HRV) is reflective of autonomic imbalance. However, its impact on non-alcoholic fatty liver disease (NAFLD) is unknown. We investigated the association between 10-s HRV and incident NAFLD. A cohort of 154,286 Korean adults with no NAFLD at baseline were followed up. 10-s electrocardiograms were used to estimate two time-domain HRV, the standard deviation of normal-to-normal intervals (SDNN) and the root mean square of successive differences in RR intervals (RMSSD). Hepatic steatosis (HS) and liver fibrosis were assessed using ultrasonography and the fibrosis-4 index (FIB-4). A total of 27,279 incident HS (median follow up of 4.2 years) and 1250 incident HS plus high FIB-4 (median follow up of 4.2 years) cases were identified at follow-up. The multivariable adjusted hazard ratios (aHRs) (95% confidence intervals [CIs]) in a model with time-dependent variables for incident HS, comparing the lowest quintile to the highest and reference quintile of the RMSSD, was 1.43 (1.37–1.49), and the corresponding HR for incident HS plus intermediate/high FIB-4 was 1.70 (1.35–2.15). Similarly, SDNN was inversely associated with incident HS and HS plus intermediate/high FIB-4. The results were similar using the NAFLD fibrosis score. Autonomic imbalance assessed by HRV may help to identify individuals at a high risk of HS and its progression and warrant further studies.


2045-2322
Choi, In Young
58937d8a-5385-4459-8e5a-fde68ccf1f14
Chang, Yoosoo
de8b0c06-8cab-4bb2-8453-2970a7b1cd69
Kang, Geonggyu
789f7ced-056b-405c-a1f9-936e774570e1
Jung, Hyun-Suk
62a53a50-6b56-4593-ad06-a423df557e1b
Shin, Hocheol
33810163-7ce0-4453-8701-6df1036ec141
Wild, Sarah H
56535c8c-c361-4540-af26-4af718ee68f2
Byrne, Christopher
1370b997-cead-4229-83a7-53301ed2a43c
Ryu, Seungho
5ff64522-9da2-4e4f-8166-621bcce83934
Choi, In Young
58937d8a-5385-4459-8e5a-fde68ccf1f14
Chang, Yoosoo
de8b0c06-8cab-4bb2-8453-2970a7b1cd69
Kang, Geonggyu
789f7ced-056b-405c-a1f9-936e774570e1
Jung, Hyun-Suk
62a53a50-6b56-4593-ad06-a423df557e1b
Shin, Hocheol
33810163-7ce0-4453-8701-6df1036ec141
Wild, Sarah H
56535c8c-c361-4540-af26-4af718ee68f2
Byrne, Christopher
1370b997-cead-4229-83a7-53301ed2a43c
Ryu, Seungho
5ff64522-9da2-4e4f-8166-621bcce83934

Choi, In Young, Chang, Yoosoo, Kang, Geonggyu, Jung, Hyun-Suk, Shin, Hocheol, Wild, Sarah H, Byrne, Christopher and Ryu, Seungho (2022) Low heart rate variability from 10-s electrocardiograms is associated with development of non-alcoholic fatty liver disease. Scientific Reports, 12 (1), [1062]. (doi:10.1038/s41598-022-05037-w).

Record type: Article

Abstract

Reduced heart rate variability (HRV) is reflective of autonomic imbalance. However, its impact on non-alcoholic fatty liver disease (NAFLD) is unknown. We investigated the association between 10-s HRV and incident NAFLD. A cohort of 154,286 Korean adults with no NAFLD at baseline were followed up. 10-s electrocardiograms were used to estimate two time-domain HRV, the standard deviation of normal-to-normal intervals (SDNN) and the root mean square of successive differences in RR intervals (RMSSD). Hepatic steatosis (HS) and liver fibrosis were assessed using ultrasonography and the fibrosis-4 index (FIB-4). A total of 27,279 incident HS (median follow up of 4.2 years) and 1250 incident HS plus high FIB-4 (median follow up of 4.2 years) cases were identified at follow-up. The multivariable adjusted hazard ratios (aHRs) (95% confidence intervals [CIs]) in a model with time-dependent variables for incident HS, comparing the lowest quintile to the highest and reference quintile of the RMSSD, was 1.43 (1.37–1.49), and the corresponding HR for incident HS plus intermediate/high FIB-4 was 1.70 (1.35–2.15). Similarly, SDNN was inversely associated with incident HS and HS plus intermediate/high FIB-4. The results were similar using the NAFLD fibrosis score. Autonomic imbalance assessed by HRV may help to identify individuals at a high risk of HS and its progression and warrant further studies.


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Accepted/In Press date: 28 December 2021
e-pub ahead of print date: 20 January 2022
Published date: 20 January 2022
Additional Information: Funding Information: This study was supported by SKKU Excellence in Research Award Research Fund, Sungkyunkwan University, 2020 and by the National Research Foundation of Korea (NRF) funded by the Ministry of Science, ICT and Future Planning (NRF-2017R1A2B2008401). CDB is supported in part by the Southampton NIHR Biomedical Research Centre (IS-BRC-20004), UK. Publisher Copyright: © 2022, The Author(s). Copyright: Copyright 2022 Elsevier B.V., All rights reserved.

Identifiers

Local EPrints ID: 454034
URI: http://eprints.soton.ac.uk/id/eprint/454034
ISSN: 2045-2322
PURE UUID: 1c00d0c1-d143-44b6-bf57-e014a2e8e49e
ORCID for Christopher Byrne: ORCID iD orcid.org/0000-0001-6322-7753

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Date deposited: 27 Jan 2022 18:48
Last modified: 27 May 2022 01:35

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Contributors

Author: In Young Choi
Author: Yoosoo Chang
Author: Geonggyu Kang
Author: Hyun-Suk Jung
Author: Hocheol Shin
Author: Sarah H Wild
Author: Seungho Ryu

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