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Alterations in the autonomic control of heart rate variability in patients with anorexia or bulimia nervosa: Correlations between sympathovagal activity, clinical features, and leptin levels

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Abstract

Changes in body composition, hormone secretions, and heart function with increased risk of sudden death occur in eating disorders. In this observational clinical study, we evaluated sympathovagal modulation of heart rate variability (HRV) and cardiovascular changes in response to lying-to-standing in patients with anorexia (AN) or bulimia nervosa (BN) to analyze: a) differences in autonomic activity between AN, BN, and healthy subjects; b) relationships between autonomic and cardiovascular parameters, clinical data and leptin levels in patients with eating disorders. HRV, assessed by power spectral analysis of R-R intervals, blood pressure (BP) and heart rate (HR) were studied by tilt-table test in 34 patients with AN, 16 with BN and 30 healthy controls. Autonomic and cardiovascular findings were correlated with clinical data, and serum leptin levels. Leptin levels were lowered in AN vs BN and healthy subjects (p<0.0001), but both AN and BN patients showed unbalanced sympathovagal control of HRV due to relative sympathetic failure, prevalent vagal activity, impaired sympathetic activation after tilting, independently from their actual body weight and leptin levels. No significant correlations were obtained between HRV data vs clinical data, BP and HR findings, and leptin levels in eating disorders. Body mass indices (BMI) (p<0.02), and leptin levels (p<0.04) correlated directly with BP values. Our data showed alterations of sympathovagal control of HRV in eating disorders. These changes were unrelated to body weight and BMI, diagnosis of AN or BN, and leptin levels despite the reported effects of leptin on the sympathetic activity.

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Authors and Affiliations

  1. Department of Endocrine and Medical Sciences, University of Genoa, Genoa, Italy

    G. Murialdo MD, M. Casu, A. Brugnolo, V. Patrone, P. Ameri, G. Andraghetti, L. Briatore, R. Cordera & G. Rodriguez

  2. Centre for Eating Disorders and Psychological Disturbances of Adolescence, Department of Mental Health, Azienda Sanitaria Locale 2 - Savonese, Savona, Italy

    M. Falchero, P. F. Cerro & A. M. Ferro

  3. Occupational Medicine Service, “San Martino” Hospital, Genoa, Italy

    F. Copello

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  1. G. Murialdo MD
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  2. M. Casu
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  3. M. Falchero
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  4. A. Brugnolo
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Correspondence to G. Murialdo MD.

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Murialdo, G., Casu, M., Falchero, M. et al. Alterations in the autonomic control of heart rate variability in patients with anorexia or bulimia nervosa: Correlations between sympathovagal activity, clinical features, and leptin levels. J Endocrinol Invest 30, 356–362 (2007). https://doi.org/10.1007/BF03346310

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  • DOI: https://doi.org/10.1007/BF03346310

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