Cardiac autonomic regulation in response to a mixed meal is impaired in obese children and adolescents: The role played by insulin resistance

Domenico Cozzolino, Katherine Esposito, Giuseppe Palmiero, Annamaria De Bellis, Raffaello Furlan, Silverio Perrotta, Laura Perrone, Daniele Torella, Emanuele Miraglia Del Giudice

Research output: Contribution to journalArticlepeer-review


Context: Obesity in children/adolescents has been associated with subtle cardiac abnormalities, including myocardial dysfunction and cardiac autonomic dysregulation at rest, both likely responsible for a higher mortality in adulthood. Food intake induces remarkable adjustments of cardiovascular autonomic activity in healthy subjects. Copyright

Objective: The objective of the study was to evaluate in obese children/adolescents meal-induced cardiac autonomic response and the role played by insulin resistance.

Design and Setting: Sixty-eight obese and 30 matched normal-weight children/adolescents underwent blood sampling and cardiovascular autonomic analysis while recumbent and 20 minutes after a mixed meal ingestion. Spectrum analysis of the R-R interval and systolic blood pressure (SBP) variability provided the indices of sympathetic [low frequency (LFRR)] and vagal [high frequency (HFRR)] modulation of the sinoatrial node and the low frequency component of SBP. The homeostasis model assessment of insulin resistance served to separate insulin resistant (n = 35) from non insulin resistant (n = 33) obese children/adolescents.

Results: At baseline, C-reactive protein, the LFRR to HFRR ratio, SBP, and low frequency oscillatory component of SBP variability in obese children/adolescents were significantly (P

Conclusions: Autonomic modulation of the heart was impaired after eating in obese children/ adolescents. This abnormality was exaggerated among insulin resistant subjects and strongly correlated with the degree of insulin resistance.

Original languageEnglish
Pages (from-to)3199-3207
Number of pages9
JournalJournal of Clinical Endocrinology and Metabolism
Issue number9
Publication statusPublished - Sep 1 2014

ASJC Scopus subject areas

  • Biochemistry
  • Clinical Biochemistry
  • Endocrinology
  • Biochemistry, medical
  • Endocrinology, Diabetes and Metabolism
  • Medicine(all)


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