Month: February 2015

CoTASS 2 Sub-study: Heart Rate Variability

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Introduction

The Colombo Twin and Singleton Follow up study (CoTaSS 2) is a collaboration between Institute for Research and Development and Kings College London, U K which is being conducted in Colombo CoTaSS 2 is the largest twin Study being conducted in South Asia to examine the overlap of depression and metabolic syndrome (MetS).

Multicomponent study, questionnaires, clinical investigations, blood pressure, anthropometric measurements, actigraphy and heart rate variability data. Heart rate variability (HRV) component will examine the relationship of the autonomic function with depression and Mets.

Participants

12 male twin pairs from CoTaSS 2 were selected for this component. Sample selection and Size
calculation was done using power analyses.

Background

  • Normal resting heart rate is variable and not monotonously regular.
  • HRV refers to the beat-to-beat fluctuations in heart rate.
  • HRV measures neurocardiac regulation: sympathetic and parasympathetic
    influences on the modulations of heart rate (
  • Cardiovascular mortality is linked to an imbalanced autonornic nervous system
  • High HRV means that the heart and nervous system are flexible and better suited
    to cope with stress.
  • Lowered HRV has a high association with the risk for sudden cardiac death,
    arrhythmic complications, and all-cause mortality.
  • HRV decreases with age. an inactive lifestyle and is also related to physical and
    mental health conditions.
  • It can be measured using variation in duration between the R peaks on the
    QRS complexes Of an FCG.

Methodology

  • Ethical clearance was obtained from the ethics review committees of University of
    Sri Jayewardenepura and Kings College London. U K.
  • pairs from 2 were for this component, Sample selection and size
    calculation were done using analyses.
  • Female twins were excluded due to IOW participation during a feasibility Study
  • Depression is measured using the Beck Depression Inventory and WHO Composite International
    Diagnostic Interview questionnaires in the main CoTaSS 2 study.
  • Mets is diagnosed using clinical and anthropometric data collected from CoTaSS 2.
  • ECG recordings are done in a quiet environment free of distractions after participants have rested
    in thc supine position for five minutes,
  • 13 minute ECG recordings are done using the Schiller Medilog AR12 plus holter recorder using
    a sampling frequency Of 1
  • Collected data is processed, and digital data extracted using the Schiller Medilog Darwin software,
  • Power spectrum analysis is done using CARSPAN (Cardiovascular Experiments Analysis
    Environment) software.
  • Power spectrum analyses will be done to obtain frequency values correlating to the sympathetic
    and parasympathetic divisions of the autonomic nervous system.
  • Twin Modelling will allow estimation of the influence of genetics and environmental factors
    on HRV and its associations with depression and Mets,

Conclusion

  • This is a timely study as the prevalence of obesity and diabetes is rising at a staggering rate
  • Results and conclusions obtained can be used at policy level to prevent and reduce cardiac
    mortality linked with depression and Mc•tS by addressing and treating the ANS dysfunction
    among patients.

CoTASS 2 Sub-study: The Sleep study

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Introduction

The Sleep sub-study was conducted within the Colombo Twin and Singleton Follow-up Study and determined the contribution of sleep and activity to the prevalence of metabolic syndrome and depression in Sri Lanka. It also aimed help to understand the potential for estimating the degree to which phenotypic correlations in sleep parameter are due to shared genetic or environmental factors as well.

It is the first study conducted in a South Asian country to determine population based estimates of sleep parameters with a fixed 12 hour photo-period.

Sleep duration and physical activity data were collected using actiwatches. Sleep diary and questionnaires helped to validate the collected data. The actiwatches were worn by participants for a period of 7 days.

The collected data was analyzed and generated the journal article titled “Agreement between subjective and objective measures of sleep duration in a low-middle income country setting” .

Participants

  • 3750 Participants

Aim

To assess the association between reported sleep quality and depression in a population
based sample in Colombo.

Methodology

  • Data from 3750 participants over the age of 18 years from the Colombo Twin and Singleton
    Follow-up Study (2016) were used.
  • Ethical approval obtained from ethics review committees in Sri Lanka, IJK, and Australia.
    A nested-case-control study design was used for data analysis.
  • Subjective sleep quality for past month was measured using Pittsburgh Sleep Quality Index
    (score >5 indicated poor sleep quality).
  • Beck Depression Inventory 11 measured depression (score equal to or >14 indicated mild to
    severe depressive symptoms).

Results

  • 9% had mild to severe depression symptoms
  • (MSDs) (95% Cl 8% to 10%).
  • 65% had self reported poor quality sleep
  • (95% to 67%).
  • Depression symptoms were strongly
  • assodated with PSQ (p0001 ).
  • Participants with PSQ were 3x more likely
  • to have MSDs. OR 3.22, 95% Cl 284-4 45
  • (adjusted for age, and education)
  • Females with PSQ had higher odds of
  • developing MSDs.
  • (OR 3.92. 95% Cl 265-6.03, p<.0001)
  • Older participants had higher odds of developing MSDs with PSQ:
    • 35-54 years (OR 5.01, 95% Cl 2.84-8.84, p<.0001)
    • 55+ years (OR 6.0, 95% 235-15.09,

Conclusion

  • People with poor sleep quality are more likely to have mild to severe depression symptoms.
  • These results warrant the need to address sleep quality in people presenting with symptoms of depression.
  • Further research into causality, socio-cultural factors and omics research needs to be conducted.