Clinical implication of body size phenotype on heart rate variability

Hye Jin Yoo, Soon Young Hwang, Kyung Mook Choi, Sei Hyun Baik, Eun Mi Lee, Eung Joo Kim, Seung Woon Rha, Chang Gyu Park, Dong Joo Oh, Hong Seog Seo

Research output: Contribution to journalArticlepeer-review

16 Citations (Scopus)


We compared heart rate variability (HRV) values according to the following body size phenotypes: metabolically healthy normal weight (MHNW), metabolically unhealthy but normal weight (MUNW), metabolically healthy but obese (MHO), and metabolically unhealthy obese (MUO). We retrospectively analyzed a dataset from 1200 participants who had visited the Cardiovascular Center at Korea University Guro Hospital between March 2009 and February 2014 and underwent Holter monitoring for 24 h. HRV was calculated from standard deviation of normal-to-normal R-R intervals (SDNN), standard deviation of the average normal-to-normal intervals (SDANN), and root mean square of successive differences (rMSSD) measurements, and study subjects were classified according to body mass index (BMI) and presence or absence of metabolic syndrome. Various HRV indices, including SDNN, SDANN, and rMSSD, were significantly lower in MUNW subjects than in MHNW or MHO subjects, while there were no significant differences between MUNW and MUO subjects. Although BMI had no significant correlation with any HRV indices, SDNN, SDANN, and rMSSD values had significant negative correlations with waist circumference and levels of C-reactive proteins, AST, ALT, fasting glucose, and HOMA-IR. A significant positive correlation was observed between HRV index and HDL level. Furthermore, the SDNN value significantly decreased with an increase in the number of metabolic syndrome components after adjusting for other covariates. Compared to MHNW or MHO subjects, Korean men and women with the MUNW phenotype exhibited decreased HRV, suggesting that low HRV is related to adverse cardiovascular outcomes in MUNW individuals.

Original languageEnglish
Pages (from-to)1589-1596
Number of pages8
JournalMetabolism: Clinical and Experimental
Issue number11
Publication statusPublished - 2016 Nov 1

Bibliographical note

Funding Information:
Dr. H. J. Yoo was supported by the Basic Science Research Program through the National Research Foundation of Korea (NRF), which is funded by the Ministry of Education, Science and Technology (2015R1A1A1A05001173). Dr. H. S. Seo was supported by a grant from the Korea Institute of Science and Technology Institutional Program (Project No. 2E26110) and by a grant from the Korea University-Korea Institute of Science and Technology (KU-KIST) Graduate School of Converging Science and Technology (R1435291).

Publisher Copyright:
© 2016 Elsevier Inc.


  • Body size phenotype
  • Cardiac autonomic dysfunction
  • Heart rate variability
  • Metabolic syndrome
  • Obesity

ASJC Scopus subject areas

  • Endocrinology, Diabetes and Metabolism
  • Endocrinology


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