Journal List > Ann Clin Neurophysiol > v.21(2) > 1130271

Park, Kim, Kang, Oh, Sohn, Song, Shin, Kang, Cho, Jeong, Lee, Kim, Kim, and Park: Reference ranges for autonomic function tests in healthy Korean adults

초록

Background

The standardized autonomic function test has become widely available. How-ever, there are no reference data for this test for the Korean population. This study explored reference data for sudomotor and cardiovagal function tests for the Korean population.

Methods

The sweat volume by quantitative sudomotor axon reflex test, heart-rate response to deep breathing (HRdb), expiration:inspiration (E:I) ratio, and Valsalva ratio (VR) were measured in 297 healthy Korean volunteers aged from 20 to 69 years. Multivariate regression analysis was performed to evaluate the effects of age, sex, and body mass index on these variables. The 2.5th, 5th, 10th, 90th, 95th, and 97.5th percentile values were obtained for each investigation.

Results

The sweat volume was higher in males than in females. The HRdb and E:I ratio were negatively correlated with age, and were higher in males than in females. The VR was negatively correlated with age, but it was not correlated with sex.

Conclusions

This study has provided data on the reference ranges for sudomotor and cardiovagal function tests in healthy Korean adults.

REFERENCES

1.Low PA., Tomalia VA., Park KJ. Autonomic function tests: some clinical applications. J Clin Neurol. 2013. 9:1–8.
crossref
2.Low PA., Denq JC., Opfer-Gehrking TL., Dyck PJ., O’Brien PC., Slezak JM. Effect of age and gender on sudomotor and cardiovagal function and blood pressure response to tilt in normal subjects. Muscle Nerve. 1997. 20:1561–1568.
crossref
3.Sletten DM., Weigand SD., Low PA. Relationship of Q-sweat to quantitative sudomotor axon reflex test (QSART) volumes. Muscle Nerve. 2010. 41:240–246.
crossref
4.Chen SF., Chang YT., Lu CH., Huang CR., Tsai NW., Chang CC, et al. Sweat output measurement of the post-ganglion sudomotor response by Q-Sweat Test: a normative database of Chinese indi-viduals. BMC Neurosci. 2012. 13:62.
crossref
5.Goldstein IB., Shapiro D. The cardiovascular response to postural change as a function of race. Biol Psychol. 1995. 39:173–186.
crossref
6.Jeong H., Park KJ., Kang H., Choi NC., Kwon OY., Lim B. Effects of age, sex, and body mass index on sudomotor and cardiovagal functions in a healthy Korean population. Neurol Asia. 2016. 21:255–260.
7.Park KJ., Lee H., Kim HA., Kang SY., Kim BJ., Nam TS, et al. Guidelines for autonomic function test. J Pain Aut Disord. 2013. 2:55–65.
8.Novak P. Quantitative autonomic testing. J Vis Exp. 2011. (53):e2502.
crossref
9.Low PA., Caskey PE., Tuck RR., Fealey RD., Dyck PJ. Quantitative sudomotor axon reflex test in normal and neuropathic subjects. Ann Neurol. 1983. 14:573–580.
crossref
10.Low PA., Opfer-Gehrking TL., Proper CJ., Zimmerman I. The effect of aging on cardiac autonomic and postganglionic sudomotor function. Muscle Nerve. 1990. 13:152–157.
crossref
11.McCance RA., Purohit G. Ethnic differences in the response of the sweat glands to pilocarpine. Nature. 1969. 221:378–379.
crossref
12.Vinik AI., Smith AG., Singleton JR., Callaghan B., Freedman BI., Tu-omilehto J, et al. Normative values for electrochemical skin con-ductances and impact of ethnicity on quantitative assessment of sudomotor function. Diabetes Technol Ther. 2016. 18:391–398.
crossref
13.Ewing DJ., Martyn CN., Young RJ., Clarke BF. The value of cardiovascular autonomic function tests: 10 years experience in diabetes. Diabetes Care. 1985. 8:491–498.
crossref
14.Torsvik M., Häggblom A., Eide GE., Schmutzhard E., Vetvik K., Win-kler AS. Cardiovascular autonomic function tests in an African population. BMC Endocr Disord. 2008. 8:19.
crossref
15.Vita G., Princi P., Calabro R., Toscano A., Manna L., Messina C. Cardiovascular reflex tests. Assessment of age-adjusted normal range. J Neurol Sci. 1986. 75:263–274.
16.Thayer JF., Yamamoto SS., Brosschot JF. The relationship of autonomic imbalance, heart rate variability and cardiovascular disease risk factors. Int J Cardiol. 2010. 141:122–131.
crossref

Fig. 1.
Heart-rate response to deep breathing (HRdb) as a function of age for males (A) and females (B). The HRdb was negatively correlated with age and was lower in females than in males. Lines show 2.5th, 5th, 50th, 95th, and 97.5th percentiles. bpm, beats per minute.
acn-21-87f1.tif
Fig. 2.
Expiration:inspiration (E:I) ratio as a function of age for males (A) and females (B). The E:I ratio was negatively correlated with age and was lower in females than in males. Lines show 2.5th, 5th, 50th, 95th, and 97.5th percentiles.
acn-21-87f2.tif
Fig. 3.
Valsalva ratio (VR) as a function of age. The VR was negatively correlated with age. Lines show 2.5th, 5th, 50th, 95th, and 97.5th percentiles.
acn-21-87f3.tif
Table 1.
Demographic characteristics of the participants
Total (n = 297) Males (n = 135) Females (n = 162) p-value
Age (years) 41.6 ± 14.1 39.6 ± 13.5 43.3 ± 14.4 0.036
Age group (years)       0.093
20-29 80 45 35  
30-39 58 29 29  
40-49 57 24 33  
50-59 58 21 37  
60-69 44 16 28  
Height (cm) 165.5 ± 8.6 172.6 ± 5.8 159.6 ± 5.7 <0.001
Weight (kg) 63.6 ± 11.6 72.1 ± 9.7 56.6 ± 7.6 <0.001
Body mass index (kg/m2) 23.1 ± 3.0 24.2 ± 2.6 22.3 ± 3.0 <0.001

Values are presented as mean ± standard deviation or number.

Table 2.
Sweat volume in the four tested regions according to sex
Percentile Forearm Proximal leg Distal leg Foot
Male:female
2.5th 0.05:0.07 0.25:0.12 0.15:0.10 0.08:0.05
5th 0.08:0.09 0.36:0.17 0.17:0.11 0.08:0.05
10th 0.10:0.11 0.48:0.26 0.29:0.16 0.13:0.017
90th 1.85:1.14 2.90:1.41 2.54:1.25 1.07:0.56
95th 2.46:1.32 3.08:1.63 3.18:1.68 1.25:0.80
97.5th 2.77:1.57 3.24:2.69 3.94:2.37 1.34:0.91
Table 3.
Heart-rate response to deep breathing according to age group and sex
Percentile 20-29 years 30-39 years 40-49 years 50-59 years 60-69 years
Male:female
2.5th 11.99:12.90 10.20:7.27 9.83:9.37 7.46:6.16 6.84:4.19
5th 13.25:13.98 10.82:9.86 10.54:9.50 7.82:6.64 6.87:4.49
10th 14.29:14.79 12.18:12.88 11.08:9.79 7.98:8.98 7.02:5.48
90th 32.73:30.03 28.54:25.52 29.00:25.49 19.58:20.38 19.24:13.88
95th 34.05:32.36 31.20:25.96 31.92:25.87 21.96:21.58 21.44:14.81
97.5th 34.48:33.29 35.37:27.25 34.09:26.38 24.03:22.06 21.72:15.64
Table 4.
Expiration:inspiration ratio according to age group and sex
Percentile 20-29 years 30-39 years 40-49 years 50-59 years 60-69 years
Male:female
2.5th 1.17:1.17 1.18:1.11 1.11:1.10 1.10:1.08 1.10:1.07
5th 1.20:1.17 1.20:1.14 1.14:1.12 1.12:1.10 1.10:1.07
10th 1.22:1.19 1.22:1.18 1.15:1.13 1.12:1.13 1.11:1.08
90th 1.64:1.52 1.52:1.44 1.50:1.43 1.41:1.34 1.33:1.23
95th 1.66:1.61 1.61:1.47 1.61:1.44 1.44:1.37 1.37:1.25
97.5th 1.66:1.75 1.72:1.49 1.70:1.45 1.49:1.39 1.39:1.29
Table 5.
Valsalva ratio according to age group
Percentile 20-29 years 30-39 years 40-49 years 50-59 years 60-69 years
2.5th 1.37 1.34 1.42 1.32 1.25
5th 1.42 1.40 1.47 1.34 1.27
10th 1.54 1.45 1.52 1.40 1.31
90th 2.62 2.27 2.26 2.13 1.79
95th 2.73 2.47 2.34 2.15 1.89
97.5th 2.77 2.76 2.42 2.19 2.03
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