Cardiac autonomic modulation in obese and eutrophic children: systematic review and meta-analysis

Abstract

This study aimed to verify the influence of childhood obesity on the regulation of cardiac autonomic modulation through the heart rate variability of obese and eutrophic children. The study consisted of a systematic review and meta-analysis in five PubMed, Scielo, Cochrane Library, BVS/Lilacs and Medline databases. Of the 60 articles found, 15 met the pre-established criteria. These studies were submitted to evaluation of methodological quality and risk of bias, and the Joanna Briggs Institute Critical Appraisal Checklist for Prevalence Studies (JBI) was applied. Meta-analysis was performed with the Review Manager 5.3 software for variables related to the alteration of cardiac autonomic modulation. Fifteen studies were used for meta-analysis, all were classified with high methodological quality (7 to 9 points), 13 presented results showing alteration of autonomic cardiac modulation in obese children in comparison with eutrophic children, and only two presented indicatives that refute this hypothesis. The present study identified reduction in the parasympathetic activity of the obese group in relation to the eutrophic group through the variables studied. The use of RMSSD, pNN50 and SDNN variables is recommended in future studies, as their results were significant for this meta-analysis.