Low heart rate variability from ten-second electrocardiograms is associated with development of non-alcoholic fatty liver disease

In Young Choi, Yoosoo Chang*, Geonggyu Kang, Hyun-Suk Jung, Hocheol Shin, Sarah H Wild, Christopher D Byrne, Seungho Ryu*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract

Reduced heart rate variability (HRV) is reflective of autonomic imbalance. However, its impact on non-alcoholic fatty liver disease (NAFLD) is unknown. We investigated the association between 10-s HRV and incident NAFLD. A cohort of 154,286 Korean adults with no NAFLD at baseline were followed up. 10-s electrocardiograms were used to estimate two time-domain HRV, the standard deviation of normal-to-normal intervals (SDNN) and the root mean square of successive differences in RR intervals (RMSSD). Hepatic steatosis (HS) and liver fibrosis were assessed using ultrasonography and the fibrosis-4 index (FIB-4). A total of 27,279 incident HS (median follow up of 4.2 years) and 1250 incident HS plus high FIB-4 (median follow up of 4.2 years) cases were identified at follow-up. The multivariable adjusted hazard ratios (aHRs) (95% confidence intervals [CIs]) in a model with time-dependent variables for incident HS, comparing the lowest quintile to the highest and reference quintile of the RMSSD, was 1.43 (1.37-1.49), and the corresponding HR for incident HS plus intermediate/high FIB-4 was 1.70 (1.35-2.15). Similarly, SDNN was inversely associated with incident HS and HS plus intermediate/high FIB-4. The results were similar using the NAFLD fibrosis score. Autonomic imbalance assessed by HRV may help to identify individuals at a high risk of HS and its progression and warrant further studies.

Original languageEnglish
Article number1062
JournalScientific Reports
Volume12
Issue number1
DOIs
Publication statusPublished - 20 Jan 2022

Keywords / Materials (for Non-textual outputs)

  • Adult
  • Autonomic Nervous System/physiopathology
  • Cohort Studies
  • Electrocardiography
  • Female
  • Heart Rate/physiology
  • Humans
  • Liver Cirrhosis/diagnostic imaging
  • Male
  • Non-alcoholic Fatty Liver Disease/epidemiology
  • Republic of Korea/epidemiology
  • Risk Factors
  • Ultrasonography

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