Autonomic dysfunction in individuals with metabolically healthy obesity: a cross-sectional study

The identification of autonomic alterations in metabolically healthy obesity could be an additional parameter for elucidating if this phenotype of obesity only represents a transition stage to the development of metabolically unhealthy obesity. So, this study aimed to assess the presence of autonomic dysfunction in individuals with metabolically healthy obesity. We conducted a cross-sectional study that randomly recruited individuals (≥18 years old), being excluded those on sick leave, pregnant or lactating women. According to the body mass index and International Diabetes Federation criteria for metabolic syndrome, the individuals, stratified as metabolically healthy eutrophic; metabolically healthy obesity; or metabolically unhealthy obesity were included in the analysis. Heart rate variability (HRV), electrocardiography, orthostatic test, and orthostatic hypotension test were used to evaluate autonomic function. Our findings evidenced that metabolically healthy obesity individuals exhibited alterations in HRV, in orthostatic hypotension test and in electrocardiographic parameters for ventricular repolarization, compared to metabolically healthy eutrophic individuals. Therefore, we concluded that metabolically healthy obesity is associated with the occurrence of autonomic dysfunction, which suggests that it can be, in fact, a transition stage to the development of metabolically unhealthy obesity.