背景:改变了自主调制,通过心率变异性(HRV)测量,已发现与老年人痴呆风险有关。然而,评估中年时自主神经调节与痴呆发病率之间关联的长期随访研究受到了限制.
方法:该回顾性队列分析了台湾国民健康保险数据库中2001年至2017年的数据,并与台南市进行的全市范围的健康检查有关,台湾。我们包括45-64岁的受试者。平均随访时间为15.75±3.40年。HRV的测量包括静息心率,高频(HF),低频(LF),正常到正常R-R间隔(SDNN)的标准偏差,从仰卧位站起来后第30和第15个R-R间隔之间的比率(30/15比率),呼气和吸气期间R-R间隔之间的比率,和LF/HF比率。主要研究结果是痴呆的发病率。我们进行了多变量Cox比例风险回归模型,以比较不同HRV亚组之间的痴呆风险。
结果:我们包括565名参与者,平均年龄为53(SD:6)岁,其中44%是男性。与较低的副交感神经HRV调节相关的痴呆风险显著增加,包括SDNN(HR:3.23,95%CI:1.55-6.73)和30/15比值(HR:3.52,95CI:1.67-7.42)。此外,LF/HF比值较高的受试者患痴呆的风险增加(HR:2.05,95%CI:1.12~3.72).
结论:中年患者副交感神经活动减少和交感神经-迷走神经失衡增加与痴呆风险相关。
BACKGROUND: Altered autonomic modulation, measured by heart rate variability (HRV), has been found to be associated with dementia risk in the elderly. However, long-term follow-up
study evaluating the association between autonomic modulation from middle-age and the incidence of dementia has been limited.
METHODS: This retrospective cohort analyzed data from Taiwan\'s National Health Insurance Database covering the period from 2001 to 2017, with a linkage to citywide health examinations conducted by Tainan Metropolitan City, Taiwan. We included subjects aged 45-64 years. The mean follow-up period was 15.75 ± 3.40 years. The measurements of HRV included resting heart rate, high frequency (HF), low frequency (LF), standard deviation of normal-to-normal R-R intervals (SDNN), ratio between the 30th and 15th R-R interval after standing up from the supine position (30/15 ratio), ratio between the R-R intervals during expiration and inspiration, and the ratio between the high- and low-frequency components (LF/HF). The main
study outcome was the incidence of dementia. We performed multivariable Cox proportional hazard regression models to compare the risk of dementia among different HRV subgroups.
RESULTS: We included 565 participants with a mean age of 53 (SD: 6) years, of whom 44% were male. The risk of dementia was significantly increased in association with lower parasympathetic HRV modulation, including SDNN (HR: 3.23, 95% CI: 1.55-6.73) and 30/15 ratio (HR: 3.52, 95%CI: 1.67-7.42). Moreover, the risk of dementia was increased in subjects with higher LF/HF ratios (HR: 2.05, 95% CI: 1.12-3.72).
CONCLUSIONS: Lower parasympathetic activity and higher sympathetic-vagal imbalance in middle-age were associated with dementia risk.