Preprint Review Version 1 Preserved in Portico This version is not peer-reviewed

Autonomic Function in Obese Children and Adolescents: Systematic Review and Meta-Analysis

Georgios E. Papadopoulos
ORCID logo ,
Foteini Balomenou
ORCID logo ,
Xenofon M Sakellariou
ORCID logo ,
Christos Tassopoulos
,
Dimitrios N Nikas
ORCID logo ,
Vasileios Giapros
,
Theofilos M Kolettis
* ORCID logo
Version 1 : Received: 17 January 2024 / Approved: 17 January 2024 / Online: 17 January 2024 (10:16:30 CET)

A peer-reviewed article of this Preprint also exists.

Papadopoulos, G.E.; Balomenou, F.; Sakellariou, X.M.; Tassopoulos, C.; Nikas, D.N.; Giapros, V.; Kolettis, T.M. Autonomic Function in Obese Children and Adolescents: Systematic Review and Meta-Analysis. J. Clin. Med. 2024, 13, 1854. Papadopoulos, G.E.; Balomenou, F.; Sakellariou, X.M.; Tassopoulos, C.; Nikas, D.N.; Giapros, V.; Kolettis, T.M. Autonomic Function in Obese Children and Adolescents: Systematic Review and Meta-Analysis. J. Clin. Med. 2024, 13, 1854.

Abstract

Obesity is invariably accompanied by autonomic dysfunction, although data in pediatric populations are conflicting. We conducted a systematic review and meta-analysis of 12 studies (totaling 1102 participants) comparing obese and normal-weight subjects (5-18 years of age), defined as body mass index >95th or <85th percentile, respectively. Using a random-effects model, we report the standardized mean differences (SMD) of sympathetic and vagal indices, calculated by heart rate variability. Autonomic dysfunction was present in the obese group, based on the average SMD in the standard deviation of sinus intervals (at -0.5340), and on the ratio of low (LF) to high (HF) frequency spectra (at 0.5735). There was no difference in sympathetic activity, but the heterogeneity among the relevant studies weakens this result. SMD in HF (at 0.5876), in the root mean square of successive differences between intervals (at -0.6333), and in the number of times successive intervals exceeded 50ms divided by the total number of intervals (at -0.5867) indicated lower vagal activity in the obesity group. Thus, autonomic dysfunction is present in obese children and adolescents, attributed to lower vagal activity. Further studies on autonomic function are needed in various pediatric cohorts, placing emphasis on sympathetic activity.

Keywords

obesity; heart rate variability; autonomic nervous system; sympathetic activity; vagal activity; children; adolescents

Subject

Medicine and Pharmacology, Clinical Medicine

Copyright: This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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