ArticleFrontiers in physiology2026
Association of body mass index and visceral fat with heart rate variability in university students: a BMI-stratified analysis.
Article in Frontiers in physiology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Objective: This study aims to investigate the relationship between obesity-related metrics and resting photoplethysmography (PPG)-derived pulse rate variability (PRV) parameters among university students, with a particular focus on variations across BMI categories, patterns of fat distribution, and sex differences. Methods: In this cross-sectional investigation, a total of 1, 556 students from Yan'an University were categorized into underweight, normal weight, overweight, and obese groups based on BMI criteria. Body composition was evaluated using multi-frequency bioelectrical impedance analysis, measuring parameters such as body fat percentage, skeletal muscle mass, waist-to-hip ratio (WHR), visceral fat index, and fatty liver risk index. Resting heart rate and pulse rate variability (PRV) metrics were recorded through a photoplethysmography-based device. Differences among groups were assessed using one-way ANOVA, while associations were explored using Pearson correlation and BMI-stratified multivariable linear regression models, supported by bootstrap validation with 5, 000 resamples. Results: Body composition parameters showed significant variation across BMI groups (all P< 0.001). Relative to underweight and normal-weight individuals, those in the overweight and obese categories demonstrated a less favorable resting autonomic pattern, primarily reflected by elevated resting heart rate and reduced Standard Deviation of Normal-to-Normal (SDNN). Among males, SDNN values were lower in the obese group compared to those with normal weight (48.63 ± 16.83 vs. 60.46 ± 15.00 ms). In females, obesity was linked to decreased SDNN (39.74 ± 12.52 vs. 55.06 ± 15.77 ms), increased resting heart rate (89.75 ± 8.71 vs. 80.82 ± 9.40 bpm), and a reduced PRV index (10.94 ± 3.72 vs. 14.84 ± 4.44). Certain normalized frequency-domain measures did not demonstrate consistent differences across stratified groups. Within the obese category, SDNN exhibited inverse correlations with WHR, visceral fat index, and fatty liver risk index. Additionally, across all BMI categories, resting heart rate showed an independent negative association with both SDNN and PRV index. Conclusion: In university students, overweight and obesity were linked to poorer resting autonomic function. Measures such as SDNN and PRV index appear to provide greater sensitivity than certain normalized frequency-domain parameters in detecting early obesity-related autonomic dysfunction in young adults.
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