Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Original Article
  • Published:

Plasticity of heart rate signalling and complexity with exercise training in obese individuals with and without type 2 diabetes

International Journal of Obesity volume 33, pages 1198–1206 (2009)Cite this article

Abstract

Objective:

To examine the responsiveness of cardiac autonomic function and baroreflex sensitivity (BRS) to exercise training in obese individuals without (OB) and with type 2 diabetes (ObT2D).

Design:

Subjects were tested in the supine position and in response to a sympathetic challenge before and after a 16-week aerobic training program. All testing was conducted in the morning following a 12-h fast.

Subjects:

A total of 34 OB and 22 ObT2D men and women (40–60 years of age) were studied.

Measurements:

Heart rate variability (HRV) was measured at rest via continuous ECG (spectral analysis with the autoregressive approach) and in response to upright tilt. The dynamics of heart rate complexity were analyzed with sample entropy and Lempel–Ziv entropy, and BRS was determined via the sequence technique. Subjects were aerobically trained 4 times per week for 30–45 min for 16 weeks.

Results:

Resting HR decreased and total power (lnTP, ms2) of HRV increased in response to exercise training (P<0.05). High frequency power (lnHF) increased in OB subjects but not in OBT2D, and no changes occurred in ln low frequency/HF power with training. Upright tilt decreased lnTP and lnHF and increased LF/HF (P<0.01) but there were no group differences in the magnitude of these changes nor were they altered with training in either group. Tilt also decreased complexity (sample entropy and Lempel–Ziv entropy; P<0.001), but there was no group or training effect on complexity. BRS decreased with upright tilt (P<0.01) but did not change with training. Compared to OB subjects the ObT2D had less tilt-induced changes in BRS.

Conclusion:

Exercise training improved HRV and parasympathetic modulation (lnHF) in OB subjects but not in ObT2D, indicating plasticity in the autonomic nervous system in response to this weight-neutral exercise program only in the absence of diabetes. HR complexity and BRS were not altered by 16 weeks of training in either OB or ObT2D individuals.

This is a preview of subscription content, access via your institution

Access options

Buy this article

  • Purchase on Springer Link
  • Instant access to full article PDF
Buy now

Prices may be subject to local taxes which are calculated during checkout

Figure 1
Figure 2
Figure 3

Similar content being viewed by others

References

  1. Maser RE, Lenhard MJ . Obesity is not a confounding factor for performing autonomic function tests in individuals with diabetes mellitus. Diabetes Obes Metab 2002; 4: 113–117.

    Article  CAS  PubMed  Google Scholar 

  2. Emdin M, Gastaldelli A, Muscelli E, Macerata A, Natali A, Camastra S et al. Hyperinsulinemia and autonomic nervous system dysfunction in obesity: effects of weight loss. Circulation 2001; 103: 513–519.

    Article  CAS  Google Scholar 

  3. Task Force of the European Society of Cardiology and the North American Society of Pacing and Electrophysiology. Heart rate variability: Standards of measurement, physiological interpretation, and clinical use. Eur Heart J 1996; 17: 354–381.

  4. Reland S, Ville N S, Wong S, Senhadji L, Carre F . Does the level of chronic physical activity alter heart rate variability in healthy older women? Clin Sci (Lond) 2004; 107: 29–35.

    Article  Google Scholar 

  5. De Meersman RE . Respiratory sinus arrhythmia alteration following training in endurance athletes. Eur J Appl Physiol Occup Physiol 1992; 64: 434–436.

    Article  CAS  PubMed  Google Scholar 

  6. Gamelin FX, Berthoin S, Sayah H, Libersa C, Bosquet L . Effect of training and detraining on heart rate variability in healthy young men. Int J Sports Med 2007; 28: 564–570.

    Article  CAS  PubMed  Google Scholar 

  7. Lee CM, Wood RH, Welsch MA . Influence of short-term endurance exercise training on heart rate variability. Med Sci Sports Exerc 2003; 35: 961–969.

    Article  PubMed  Google Scholar 

  8. Melanson EL, Freedson PS . The effect of endurance training on resting heart rate variability in sedentary adult males. Eur J Appl Physiol 2001; 85: 442–449.

    Article  CAS  PubMed  Google Scholar 

  9. Loimaala A, Huikuri K, Kööbi T, Rinne M, Vuori I . Exercise training improves baroreflex sensitivity in type 2 diabetes. Diabetes 2003; 52: 1837–1842.

    Article  CAS  PubMed  Google Scholar 

  10. Zoppini G, Cacciatori V, Gemma ML, Moghetti P, Targher G, Zamboni C et al. Effect of moderate aerobic exercise on sympatho-vagal balance in Type 2 diabetic patients. Diabet Med 2007; 24: 370–376.

    Article  CAS  PubMed  Google Scholar 

  11. Amano M, Kanda T, Ue H, Moritani T . Exercise training and autonomic nervous system activity in obese individuals. Med Sci sports and Exerc 2001; 33: 1287–1291.

    Article  CAS  Google Scholar 

  12. Yamamoto K, Miyachi M, Saitoh T, Yoshioka A, Onodera S . Effects of endurance training on resting and post-exercise cardiac autonomic control. Med Sci Sports Exerc 2001; 33: 1496–1502.

    Article  CAS  PubMed  Google Scholar 

  13. Lipsitz LA . Age-related changes in the ‘complexity’ of cardiovascular dynamics: A potential marker of vulnerability to disease. Chaos 1995; 5: 102–109.

    Article  PubMed  Google Scholar 

  14. Keizer H, Kuipers H, de Hann J, Beckers E, Habets L . Multiple hormonal responses to physical exercise in eumenorrheic trained and untrained women. Int J Sports Med 1987; 8: 139–150.

    Article  CAS  PubMed  Google Scholar 

  15. Stein PK, Domitrovich PP, Huikuri HV, Kleiger RE . Traditional and nonlinear heart rate variability are each independently associated with mortality after myocardial infarction. J Cardiovasc Electrophysiol 2005; 16: 13–20.

    Article  PubMed  Google Scholar 

  16. Gastaldelli A, Mammoliti R, Muscelli E, Camastra S, Landini L, Ferrannini E et al. Linear and nonlinear properties of heart rate variability: influence of obesity. Ann N Y Acad Sci 1999; 879: 249–254.

    Article  CAS  PubMed  Google Scholar 

  17. Shlipak MG, Simon JA, Vittinghoff E, Lin F, Barrett-Connor E, Knopp RH et al. Estrogen and progestin, lipoprotein (a) and the risk of recurrent coronayr heart disease events after menopause. Jama 2000; 283: 1845–1852.

    Article  CAS  PubMed  Google Scholar 

  18. Bjoro T, Hallen JK, Inoue S . Very-low-calorie diet-induced weight reduction reverses impaired growth hormone secretion responses to growth hormone-releasing hormone, arginine, and L-dopa in obesity. Metabolism 1990; 39: 892–896.

    Article  Google Scholar 

  19. Schuit AJ, van Amelsvoort LG, Verheij TC, Rijneke RD, Maan AC, Swenne CA et al. Exercise training and heart rate variability in older people. Med Sci Sports Exerc 1999; 31: 816–821.

    Article  CAS  PubMed  Google Scholar 

  20. Seals DR, Chase PB . Influence of physical training on heart rate variability and baroreflex circulatory control. J Appl Physiol 1989; 66: 1886–1895.

    Article  CAS  PubMed  Google Scholar 

  21. American Heart Association Statistics Committee and Stroke Statistics Committee. Heart disease and stroke statistics – 2007 update: a report from the American Heart Association Statistics Committee and Stroke Statistics Committee. Circulation 2007; 115: e69–e171.

  22. Kanaley JA, Baynard T, Franklin RM, Weinstock RS, Goulopoulou S, Carhart Jr R et al. The effects of a glucose load and sympathetic challenge on autonomic function in obese women with and without type 2 diabetes mellitus. Metabolism 2007; 56: 778–785.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  23. Kanaley JA, Dall R, Moller N, Nielsen SC, Christiansen JS, Jensen MD et al. Acute exposure to GH during exercise stimulates the turnover of free fatty acids in GH-deficient men. J Appl Physiol 2004; 96: 747–753.

    Article  CAS  PubMed  Google Scholar 

  24. McArdle WD, Katch FI, Katch VL . Exercise Physiology: Energy, Nutrition, and Human Performance, 4th ed Williams & Wilkins: Philadelphia, 2001.

    Google Scholar 

  25. Huikuri HV, Linnaluoto MK, Seppanen T, Airaksinen KE, Kessler KM, Takkunen JT et al. Circadian rhythm of heart rate variability in survivors of cardiac arrest. Am J Cardiol 1992; 70: 610–615.

    Article  CAS  PubMed  Google Scholar 

  26. Huikuri HV, Valkama JO, Airaksinen KE, Seppänen T, Kessler KM, Takkunen JT et al. Frequency domain measures of heart rate variability before the onset of nonsustained and sustained ventricular tachycardia in patients with coronary artery disease. Circulation 1993; 87: 1220–1228.

    Article  CAS  PubMed  Google Scholar 

  27. Cooke WH, Hoag JB, Crossman AA, Kuusela TA, Tahvanainen KU, Eckberg DL et al. Human responses to upright tilt: a window on central autonomic integration. J Physiol 1999; 517: 617–628.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  28. Richman JS, Moorman JR . Physiological time-series analysis using approximate entropy and sample entropy. Am J Physiol Heart Circ Physiol 2000; 278: H2039–H2049.

    Article  CAS  PubMed  Google Scholar 

  29. Heffernan KS, Fahs CA, Shinsako KK, Jae SY, Fernhall B . Heart rate recovery and heart rate complexity following resistance exercise training and detraining in young men. Am J Physiol Heart Circ Physiol 2007; 293: H3180–H3186.

    Article  CAS  PubMed  Google Scholar 

  30. Heffernan KS, Sosnoff JJ, Jae SY, Gates GJ, Fernhall B . Acute resistance exercise reduces heart rate complexity and increases QTc interval. Int J Sports Med 2008; 29: 289–293.

    Article  CAS  PubMed  Google Scholar 

  31. Batchinsky AI, Cooke WH, Kuusela T, Cancio LC . Loss of complexity characterizes the heart rate response to experimental hemorrhagic shock in swine. Crit Care Med 2007; 35: 519–525.

    Article  PubMed  Google Scholar 

  32. Hautala AJ, Makikallio TH, Kiviniemi A . Heart rate dynamics after controlled training followed by a home-based exercise program. Eur J Appl Physiol 2004; 92: 289–297.

    Article  PubMed  Google Scholar 

  33. Vannien E, Uusitupa M, Lämsimies E, Siitonen O, Laitinen J . Effect of metabolic control on autonomic function in obese patients with newly diagnosed type 2 diabetes. Diab Med 1993; 10: 66–73.

    Article  Google Scholar 

  34. Earnest CP, Lavie CJ, Blair SN, Church TS . Heart rate variability characteristics in sedentary postmenopausal women following six months of exercise training: the DREW study. LoS ONE 2008; 3: e2288.

    Article  Google Scholar 

  35. Boutcher SH, Stein P . Association between heart rate variability and training response in sedentary middle-aged men. Eur J Appl Physiol Occup Physiol 1995; 70: 75–80.

    Article  CAS  PubMed  Google Scholar 

  36. Iellamo F, Legramante JM, Raimonde G, Castrucci F, Massaro M, Peruzzi G . Evaluation of reproducibility of spontaneous baroreflex sensitivity at rest and during laboratory tests. J Hyperten 1996; 14: 1099–1104.

    Article  CAS  Google Scholar 

  37. Pagkalos M, Koutlianos N, Kouidi E, Pagkalos E, Mandroukas K, Deligiannis A et al. Heart rate variability modifications following exercise training in type 2 diabetic patients with definite cardiac autonomic neuropathy. Br J Sports Med 2008; 42: 47–54.

    Article  CAS  PubMed  Google Scholar 

Download references

Acknowledgements

We thank all of our subjects who were truly committed to our study and who put in a tremendous amount of time and effort. We thank Rose Kingsbury, RN, NP for her dedication to the study and placing all of the catheters. This project was supported by NIH Grant R21DK063179.

Author information

Authors and Affiliations

  1. Department of Exercise Science, Syracuse University, Syracuse, NY, USA

    J A Kanaley, S Goulopoulou, R M Franklin & M E Holmstrup

  2. Department of Kinesiology, University of Illinois, Urbana-Champaign, IL, USA

    T Baynard & B Fernhall

  3. Department of Medicine, SUNY Upstate Medical University, Syracuse, NY, USA

    R Carhart Jr & R S Weinstock

  4. Department of Veterans Affairs Medical Center, Syracuse, NY, USA

    R S Weinstock

Authors
  1. J A Kanaley
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. S Goulopoulou
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. R M Franklin
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. T Baynard
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. M E Holmstrup
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. R Carhart Jr
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. R S Weinstock
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. B Fernhall
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to J A Kanaley.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Kanaley, J., Goulopoulou, S., Franklin, R. et al. Plasticity of heart rate signalling and complexity with exercise training in obese individuals with and without type 2 diabetes. Int J Obes 33, 1198–1206 (2009). https://doi.org/10.1038/ijo.2009.145

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/ijo.2009.145

Keywords

This article is cited by

Search

Advanced search

Quick links