Postprandial cardiac autonomic function in Prader–Willi syndrome

Authors

  • Louise Purtell,

    Corresponding author
    1. Neuroscience Research Program, Garvan Institute of Medical Research, Sydney-Darlinghurst, NSW, Australia
    • Diabetes & Obesity Research Program, Garvan Institute of Medical Research, Sydney-Darlinghurst, NSW, Australia
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  • Arthur Jenkins,

    1. Diabetes & Obesity Research Program, Garvan Institute of Medical Research, Sydney-Darlinghurst, NSW, Australia
    2. School of Health Sciences, University of Wollongong, Wollongong, NSW, Australia
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  • Alexander Viardot,

    1. Diabetes & Obesity Research Program, Garvan Institute of Medical Research, Sydney-Darlinghurst, NSW, Australia
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  • Herbert Herzog,

    1. Neuroscience Research Program, Garvan Institute of Medical Research, Sydney-Darlinghurst, NSW, Australia
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  • Amanda Sainsbury,

    1. Sydney Medical School, The University of Sydney, Sydney, NSW, Australia
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  • Arabella Smith,

    1. Department of Cytogenetics, The Children's Hospital, Westmead Clinical School, Westmead, NSW, Australia
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  • Georgina Loughnan,

    1. Prader-Willi Syndrome Clinic, Department for Metabolism and Obesity, Royal Prince Alfred Hospital, Sydney-Camperdown, NSW, Australia
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  • Katharine Steinbeck,

    1. Prader-Willi Syndrome Clinic, Department for Metabolism and Obesity, Royal Prince Alfred Hospital, Sydney-Camperdown, NSW, Australia
    2. Academic Department of Adolescent Medicine, University of Sydney, Sydney, NSW, Australia
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  • Lesley V Campbell,

    1. Diabetes & Obesity Research Program, Garvan Institute of Medical Research, Sydney-Darlinghurst, NSW, Australia
    2. Department of Endocrinology, St Vincent's Hospital, Sydney-Darlinghurst, NSW, Australia
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  • Lisa Sze

    1. Division of Endocrinology and Diabetes, Kantonsspital St. Gallen, St. Gallen, Switzerland
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Correspondence: Louise Purtell, Diabetes & Obesity Research Program, Garvan Institute of Medical Research, 384 Victoria Street, Sydney-Darlinghurst, NSW 2010, Australia. Tel.: +61 2 9295 8301; Fax: +61 2 9295 8281; E-mail: l.purtell@garvan.org.au

Summary

Context

Individuals with Prader–Willi syndrome (PWS) have a high cardiovascular risk, the mechanism of which is unclear. There may be dysfunction in the autonomic nervous system (ANS) in PWS.

Objective

To measure, as indicators of cardiac autonomic function, postprandial heart rate variability (HRV) and arterial stiffness in adults with PWS.

Methods

Ten adults with PWS were compared with 11 matched healthy obese subjects and 9 healthy lean subjects. Electrocardiographic traces and arterial stiffness were recorded over a period of 10 minutes at −60, 0, 30, 60, 120 and 240 minutes after consumption of a standardized 600-kCal breakfast. Frequency domain analysis was performed using fast Fourier transform to estimate power spectral density in the full spectrum and in low-frequency (LF 0·04–0·15 Hz) and high-frequency (HF 0·15–0·40 Hz) bands.

Results

ANCOVA revealed a reduced LF HRV meal response in adults with PWS compared with obese controls, with no differences in HF HRV, LF/HF ratio, heart rate, total power or arterial stiffness meal responses.

Conclusions

This study assessed cardiac autonomic function in adults with PWS compared with matched obese and lean subjects in response to a meal. Results suggest impaired postprandial ANS responsiveness in PWS, which could contribute to both the known increased cardiovascular risk and obesity.

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