대사증후군 여성에서 요가운동이 심박동변이에 미치는 영향 = Effect of Yoga on Heart Rate Variability in Women with Metabolic Syndrome

다국어 초록 (Multilingual Abstract)

Background: The purpose of this study was to investigate the correlation between yoga and autonomic nervoussystem in women with metabolic syndrome.
Methods: A randomized controlled study was performed in participants recruited from a public center for managingchronic diseases located in Gyeong-gi Province. The 39 women participants diagnosed with metabolicsyndrome were randomly assigned to the 12-week yoga exercise group (n=22) or the wait-listed control group(n=17). Biochemical laboratory tests and heart rate variability were measured before and after the 12-weekprogram.
Results: In post-menopausal women, the low frequency power of frequency domain significantly decreased inthe yoga exercise group compared to the control group (P=0.07). On the time domain of heart rate variabilityand metabolic syndrome components, there were no significant differences between the groups.
Conclusions: Sympathetic activity was decreased in post-menopausal women with metabolic syndrome whopracticed yoga. Our results suggest that yoga might be beneficial in improving the autonomic nervous systemin post-menopausal women with metabolic syndrome.

국문 초록 (Abstract)

연구배경: 제2형 당뇨병 및 심혈관 질환의 위험과 관련이 있는 대사증후군의 개선 방법의 하나로 요가 등의 심신의학이 소개되고 있다. 본 연구에서는 대사증후군 여성에서 요가 운동이 자율 신경계의 기능에 미치는 효과를 심박동변이 측정을 통해 알아보고자 한다.
방법: 경기도 소재 만성질환관리센터에 등록되어 있는30-60세의 39명의 여성 대사증후군 환자를 대상으로 무작위 통제 연구를 시행하였으며, 대상자는 요가운동군(n=22)과 대기자 대조군(n=17)으로 할당되었다. 연구 시작전 혈액검사 및 심박동변이를 시행하였으며 운동군에게12주 간 주 2회, 회당 60분의 요가 프로그램을 시행하였고, 3개월 후 대조군과 운동군에게 혈액검사 및 심박동변이를 측정하였다.
결과: 전체 환자를 대상으로 요가운동 시행 전후의 심박동변이 지표를 비교해 보았을 때 LF값은 요가운동 후 감소되는 경향을 보였다(P=0.061). 폐경 전후 여성으로 나누어 분석하였을 때, 폐경 전 여성에서 요가운동 후 TP값이증가하는 경향을 보였다(P=0.090). 폐경 후 여성에서는 요가운동 시행 후 LF값은 요가운동군에서 대조군에 비해 통계적으로 유의하게 감소하였으며(P=0.007), LF/HF ratio는 대조군에서 요가운동군보다 더 증가하는 경향을 보였고, TP 값은 요가운동군에서 감소하고 대조군에서는 증가하는 경향을 보였다(P=0.062). 요가운동 후의 대사증후군 지표는 두 군 간에 통계적으로 유의한 차이를 보이지 않았다.
결론: 요가운동은 대사증후군을 가진 폐경 후 여성에서교감 신경계를 안정화시킬 수 있는 효과를 나타냈다. 추후대사증후군 여성환자를 대상으로 요가 운동을 통한 자율신경계의 안정화와 심혈관계질환 예방의 연관성에 대한 추가적 연구가 필요하다.

참고문헌 (Reference)

1 최영선, "노인 여성의 요가 운동과 심신기능의 개선" 대한임상건강증진학회 12 (12): 211-217, 2012

2 Lee SY, "ppropriate waist circumference cutoff points for central obesity in Korean adults" 75 (75): 72-80, 2007

3 Kirkwood G, "Yoga for anxiety: a systematic review of the research evidence" 39 (39): 884-891, 2005

4 서대윤, "Yoga Training Improves Metabolic Parameters in Obese Boys" 대한약리학회 16 (16): 175-180, 2012

5 Gallagher EJ, "The metabolic syndromefrom insulin resistance to obesity and diabetes" 95 (95): 855-873, 2011

6 Anderson JG, "The metabolic syndrome and mind-body therapies: a systematic review" 2011 : 276419-, 2011

7 Lee ST, "The fetal electrocardiogram. IV. unusual variations in the qrs complex during labor" 91 : 56-60, 1965

8 Derouich M, "The effect of physical exercise on the dynamics of glucose and insulin" 35 (35): 911-917, 2002

9 Grassi G, "Sympathetic overdrive and cardiovascular risk in the metabolic syndrome" 29 (29): 839-847, 2006

10 Singh S, "Role of yoga in modifying certain cardiovascular functions in type 2 diabetic patients" 52 : 203-206, 2004

11 Sahay BK, "Role of yoga in diabetes" 55 : 121-126, 2007

12 Innes KE, "Risk indices associated with the insulin resistance syndrome, cardiovascular disease, and possible protection with yoga: a systematic review" 18 (18): 491-519, 2005

13 Singh JP, "Reduced heart rate variability and new-onset hypertension:insights into pathogenesis of hypertension: the Framingham Heart Study" 32 (32): 293-297, 1998

14 Wijngaarden MA, "Obesity is associated with an altered autonomic nervous system response to nutrient restriction" 79 (79): 648-651, 2013

15 Kassi E, "Metabolic syndrome:definitions and controversies" 9 : 48-, 2011

16 Innes KE, "Menopause, the metabolic syndrome, and mind-body therapies" 15 (15): 1005-1013, 2008

17 Muralikrishnan K, "Measurement of the effect of Isha yoga on cardiac autonomic nervous system using short-term heart rate variability" 3 (3): 91-96, 2012

18 Lim S, "Increasing prevalence of metabolic syndrome in Korea: the Korean national health and nutrition examination survey for 1998-2007" 34 (34): 1323-1328, 2011

19 Task Force of The European Society of Cardiology, "Heart rate variability. Standards of measurement, physiological interpretation, and clinical use" 17 (17): 354-381, 1996

20 Perini R, "Heart rate variability and autonomic activity at rest and during exercise in various physiological conditions" 90 (90): 317-325, 2003

21 Büssing A, "Effects of yoga on mental and physical health: a short summary of reviews" 2012 : 165410-, 2012

22 Lee JA, "Effects of yoga exercise on serum adiponectin and metabolic syndrome factors in obese postmenopausal women" 19 (19): 296-301, 2012

23 Yildirir A, "Effects of menstrual cycle on cardiac autonomic innervation as assessed by heart rate variability" 7 (7): 60-63, 2002

24 Furlan R, "Early and late effects of exercise and athletic training on neural mechanisms controlling heart rate" 27 (27): 482-488, 1993

25 Grundy SM, "Diagnosis and management of the metabolic syndrome: an American Heart Association/National Heart, Lung, and Blood Institute scientific statement: executive summary" 4 (4): 198-203, 2005

26 Vinik AI, "Diabetic autonomic neuropathy" 26 (26): 1553-1579, 2003

27 Parati G, "Determinants of heart rate and heart rate variability" 21 (21): 477-480, 2003

28 Whang W, "Comparison of the prognostic value of RR-interval variability after acute myocardial infarction in patients with versus those without diabetes mellitus" 92 (92): 247-251, 2003

29 Lombardi F, "Clinical implications of present physiological understanding of HRV components" 6 (6): 245-249, 2002

30 O'Connor GT, "An overview of randomized trials of rehabilitation with exercise after myocardial infarction" 80 (80): 234-244, 1989

31 Yang K, "A review of yoga programs for four leading risk factors of chronic diseases" 4 (4): 487-491, 2007