Ying-Chih Cheng1, Yu-Chen Huang2, Wei-Lieh Huang3. 1. Department of Psychiatry, Taoyuan Psychiatric Center Ministry of Health and Welfare, 71, Longshou Street, Taoyuan District, Taoyuan City 33058, Taiwan, ROC; Department of Public Health and Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, No. 17, Xu-Zhou Road, Taipei 10055, Taiwan, ROC; Research Center of Big Data and Meta-Analysis, Wan Fang Hospital, Taipei Medical University, No. 250 Wuxing St., Taipei 11031, Taiwan, ROC. 2. Research Center of Big Data and Meta-Analysis, Wan Fang Hospital, Taipei Medical University, No. 250 Wuxing St., Taipei 11031, Taiwan, ROC; Department of Dermatology, Wan Fang Hospital, Taipei Medical University, 111, Hsing-Long Road Sec. 3, Wenshan District, Taipei City 11696, Taiwan, ROC; Department of Dermatology, School of Medicine and College of Medicine, Taipei Medical University, No. 250 Wuxing St., Taipei 11031, Taiwan, ROC. 3. Department of Psychiatry, National Taiwan University Hospital, Yun-Lin Branch, No. 579, Sec. 2, Yunlin Rd., Douliu City, Yunlin County 64041, Taiwan, ROC; Department of Psychiatry, National Taiwan University Hospital, No. 7, Zhongshan S. Rd., Zhongzheng Dist., Taipei City 10002, Taiwan, ROC; Department of Psychiatry, College of Medicine, National Taiwan University, No. 1, Sec. 1, Ren'ai Rd., Zhongzheng Dist., Taipei City 10051, Taiwan, ROC; Graduate Institute of Clinical Medicine, College of Medicine, National Taiwan University, No. 7, Zhongshan S. Rd., Zhongzheng Dist., Taipei City 10002, Taiwan, ROC. Electronic address: Y03046@ms1.ylh.gov.tw.
Abstract
BACKGROUND: Alcohol use disorders (AUDs) have been found to be associated with elevated cardiovascular risk. The autonomic nervous system is considered to play a role in this association. Heart rate variability (HRV) has been employed to measure parasympathetic activity in AUDs patients in some studies; however, the results are not consistent, and the adopted HRV indices vary across studies. A meta-analysis should be helpful for clarifying this topic. METHODS: We gathered studies about measuring HRV in AUDs patients and healthy participants from databases. HRV was analyzed in several ways: parasympathetic function in hierarchical order (main analysis), total variability, and specific parasympathetic indices. Specific parasympathetic indices were further separated into high-frequency power (HF) and root mean square of the successive differences (RMSSD). For comparing the above values in patients with AUDs and in healthy individuals, we adopted the random effects model to calculate the standardized mean difference. RESULTS: Of the 144 screened studies, 15 were included in the quantitative analysis. In the comparison of parasympathetic function in hierarchical order, HRV in AUDs patients was significantly lower than in healthy individuals (Hedges'g = -0.4301, 95% CI [-0.7601 to -0.1000], p=0.0106, I2 = 83.8%). Regarding total variability and RMSSD, AUDs patients also had significantly lower values than healthy controls. However, the differences of specific parasympathetic indices and HF were not significantly different. CONCLUSION: Our results support the view that AUDs patients have reduced parasympathetic activity. Total variability and RMSSD are suitable indices for presenting reduced HRV in patients with AUDs.
BACKGROUND:Alcohol use disorders (AUDs) have been found to be associated with elevated cardiovascular risk. The autonomic nervous system is considered to play a role in this association. Heart rate variability (HRV) has been employed to measure parasympathetic activity in AUDs patients in some studies; however, the results are not consistent, and the adopted HRV indices vary across studies. A meta-analysis should be helpful for clarifying this topic. METHODS: We gathered studies about measuring HRV in AUDs patients and healthy participants from databases. HRV was analyzed in several ways: parasympathetic function in hierarchical order (main analysis), total variability, and specific parasympathetic indices. Specific parasympathetic indices were further separated into high-frequency power (HF) and root mean square of the successive differences (RMSSD). For comparing the above values in patients with AUDs and in healthy individuals, we adopted the random effects model to calculate the standardized mean difference. RESULTS: Of the 144 screened studies, 15 were included in the quantitative analysis. In the comparison of parasympathetic function in hierarchical order, HRV in AUDs patients was significantly lower than in healthy individuals (Hedges'g = -0.4301, 95% CI [-0.7601 to -0.1000], p=0.0106, I2 = 83.8%). Regarding total variability and RMSSD, AUDs patients also had significantly lower values than healthy controls. However, the differences of specific parasympathetic indices and HF were not significantly different. CONCLUSION: Our results support the view that AUDs patients have reduced parasympathetic activity. Total variability and RMSSD are suitable indices for presenting reduced HRV in patients with AUDs.
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