What is the clinical evidence from this study?

Study design: Cross-Sectional. Population: Obesity and Adiposity (n=325). Intervention: Adiposity (total and regional fat mass). Primary outcome: Association between total fat mass and root mean square of successive differences (RMSSD) (β = -0.558, 95% CI -0.941, -0.175, p=0.004).

July 10, 2025Open Access

Relationships Between Adiposity Measures and Heart Rate Variability in Children and Adolescents

Key Result

Higher total fat mass was significantly associated with reduced heart rate variability, including a decrease in RMSSD (β = -0.558) and pNN50 (β = -0.178), indicating worsened cardiac autonomic function.

Study Design

Type

Cross-Sectional (n=325)

Multicenter

Structured PICO

Population

325 children and adolescents aged 8-17 years with BMIs ranging from normal weight to obesity, free of type 2 diabetes and major cardiac disorders, assessed for adiposity and heart rate variability.

Outcome

Associations between specific adiposity depots (total fat, percent body fat, trunk fat, android fat, gynoid fat, visceral adipose tissue, subcutaneous abdominal adipose tissue) and cardiovascular autonomic function assessed via resting heart rate variability (RMSSD, pNN50, LF, HF, LF:HF).surrogate

Excess total and regional adiposity, particularly visceral fat, is associated with reduced heart rate variability in children and adolescents, suggesting early negative effects on cardiovascular autonomic function.

Main Result

Mean Difference: -0.558 (95% CI -0.941–-0.175)

p-value: p=0.004

Limitations

Predominately non-Hispanic White population, limiting generalizability to other racial/ethnic groups.
Tanner staging was performed using only visual inspection of pubic hair, which is a marker of adrenarche rather than puberty.
Cross-sectional design allows only for determination of associations rather than causation.
Inability to determine the role of socioeconomic status due to missing data.
Measures of physical fitness/activity were not accounted for in the analysis.

Abstract

Understanding relationships between specific measures of adiposity and heart rate variability (HRV) allows for better understanding obesity as a risk factor for cardiovascular and autonomic dysfunction. We sought to examine associations between specific adiposity depots and cardiovascular autonomic function assessed via HRV among children and adolescents. We performed a secondary cross-sectional analysis of a previously completed study of 8-17-year-olds (n = 325; 12.4 ± 2.7 years). Adiposity was assessed via dual x-ray absorptiometry. Resting HRV measures included root mean square of successive differences (RMSSD), percentage of successive normal-to-normal intervals differing by more than 50 ms (pNN50), low frequency power (LF), high frequency power (HF), and low frequency-to-high frequency ratio (LF:HF). Associations between adiposity and HRV were evaluated using linear regression modeling, adjusting for sex and Tanner stage. RMSSD and pNN50 were both negatively associated with total fat (β = - 0.558, p = 0.004; β = - 0.178, p = 0.034), percent body fat (β = - 0.790, p = 0.007; β = - 0.296, p = 0.019), trunk fat (β = - 1.024, p = 0.004; β = - 0.344, p = 0.022), android fat (β = - 0.005, p = 0.006; β = - 0.002, p = 0.028), gynoid fat (β = - 0.003, p = 0.005; β = - 0.001, p = 0.034), visceral adipose tissue (β = - 0.013, p = 0.016; β = - 0.005, p = 0.038) and subcutaneous abdominal adipose tissue (β = - 0.007, p = 0.004; β = - 0.003, p = 0.017). RMSSD was negatively associated with appendicular fat (β = - 1.152, p = 0.008). Visceral adipose tissue was associated positively with LF and LF: HF (β = 0.004, p = 0.028; β = 0.019, p = 0.033) and negatively with HF (β = - 0.004, p = 0.028). We found that excess total and regional adiposity may have negative effects on cardiovascular autonomic nervous system function in a large cohort of children and adolescents. Longitudinal studies are needed to confirm and determine how these relationships change over time.

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Cite This Study

Juckett et al. (Thu,) conducted a cross-sectional in Obesity and Adiposity (n=325). Adiposity (total and regional fat mass) was evaluated on Association between total fat mass and root mean square of successive differences (RMSSD) (β = -0.558, 95% CI -0.941, -0.175, p=0.004). Higher total fat mass was significantly associated with reduced heart rate variability, including a decrease in RMSSD (β = -0.558) and pNN50 (β = -0.178), indicating worsened cardiac autonomic function.

synapsesocial.com/papers/6a3f7e375df9781267077e49 https://doi.org/https://doi.org/10.1007/s00246-025-03924-3

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