Reduced heart rate variability is associated with altered clinical laboratory profile in people living with HIV

Yunqiu Zhang; Lei Han; Luqian Shi; Meiyang Gao; Jun Chen; Yingying Ding

doi:10.1016/j.bbih.2024.100858

Reduced heart rate variability is associated with altered clinical laboratory profile in people living with HIV

Brain Behav Immun Health. 2024 Sep 7:41:100858. doi: 10.1016/j.bbih.2024.100858. eCollection 2024 Nov.

Authors

Yunqiu Zhang¹, Lei Han², Luqian Shi¹, Meiyang Gao¹, Jun Chen³, Yingying Ding¹

Affiliations

¹ Department of Epidemiology, School of Public Health, And Key Laboratory of Public Health Safety of Ministry of Education, Fudan University, Shanghai, China.
² Jing'an District Center for Disease Control and Prevention, Shanghai, China.
³ Department of Infectious Diseases and Immunology, Shanghai Public Health Clinical Center, Fudan University, Shanghai, China.

Abstract

Background: We compared heart rate variability (HRV) indices between people living with HIV (PLWH) and HIV-negative individuals to ascertain the independent association between HIV infection and reduced HRV, and further investigated whether distinct clinical laboratory profiles exist between PLWH with and without reduced HRV.

Methods: This cross-sectional analysis included 304 PLWH and 147 HIV-negative individuals with comparable age and sex. Thirty-two routine clinical laboratory indices (including hematology and biochemistry) closest to the survey were extracted from the Electronic Medical Record System. HRV indices were divided into two categories: low (lowest quartile, Q1) and moderate-to-high (combined, Q2‒Q4).

Results: The time domain indices, ln(SDNN), ln(RMSSD), and ln(PNN50), as well as the frequency domain indices, ln(HF), ln(LF), and ln(VLF), were all significantly reduced in PLWH versus HIV-negative individuals (all p < 0.05). These associations remained for ln(SDNN), ln(PNN50), ln(HF) and ln(LF) even after adjusting for potential confounders in multivariable models. PLWH with low HRV indices exhibited distinct clinical laboratory profiles that were characterized by an elevation in fasting plasma glucose, white blood cell count, neutrophil count, neutrophil%, and a reduction in albumin, total protein, urine creatinine, lymphocyte%, red blood cell count (RBC) and nadir CD4 count. The final stepwise logistic regression models for low SDNN included older age, decreased total cholesterol levels, elevated neutrophil count, and the use of antidiabetic medications, whereas the final model for low LF included older age, reduced RBC and the use of antidiabetic medications.

Conclusion: PLWH exhibit impaired parasympathetic activity, as evidenced by reduced SDNN, PNN50, LF and HF. Furthermore, PLWH who have reduced HRV indices exhibits distinct clinical laboratory profiles that are related to systematic inflammatory response and diabetes.

Keywords: HIV infection; Heart rate variability; Laboratory indices; Leukocytes.