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. 2020 Jan 15;11(3):559–575. doi: 10.1093/advances/nmz136

TABLE 2.

Human studies examining the association between micronutrient concentrations and HRV parameters1

Study, year (reference) Study population Nutrient measured HRV measurement HRV indicators Findings
Vitamin D
 Cetin et al., 2014 (36) 71 hospitalized patients with chronic heart failure (36 with NIDCM and 35 with IDCM) (mean age of 60 y) Serum 25(OH)D and calcitriol concentrations 24-h Holter monitor SDNN, SDANN, RMSSD

  • No differences in HRV parameters between vitamin D–deficient and –sufficient subjects

  • In patients with NIDCM only, there was a significant positive correlation between vitamin D concentrations and the HRV parameters SDNN and SDANN
 Tak et al., 2014 (37) 103 healthy adults (mean age 55 y):

  • vitamin D deficient, 25(OH)D <15 ng/mL

  • vitamin D nondeficient, 25(OH)D ≥15 ng/mL

 Serum 25(OH)D 5-min ECG recording while sitting SDNN, RMSSD, TP, VLF, LF, HF, LF:HF

  • Vitamin D significantly positively correlated with SDNN and LF

  • SDNN significantly lower in vitamin D deficient compared with nondeficient
 Canpolat et al., 2015 (38) 24 healthy vitamin D–deficient adults (mean age: 38 y); 50 age-, gender-, and BMI-matched vitamin D–sufficient adults Serum 25(OH)D 24-h Holter monitor SDNN, SDANN, RMSSD, pNN50, HF, LF, LF:HF

  • SDNN, SDANN, RMSDD, pNN50, HF lower in vitamin D–deficient group

  • LF and LF:HF higher in vitamin D–deficient group
 Nalbant et al., 2017 (39) 54 patients with low vitamin D (mean age: 29 y); 51 healthy controls with sufficient vitamin D concentrations Serum 25(OH)D 1-h Holter monitor while sitting SDNN, SDANN, RMSSD, and pNN50

  • No differences in HRV parameters between the 2 groups
 Jung et al., 2015 (40) 163 patients with type 2 diabetes (mean age: 57 y):

  • vitamin D sufficient, ≥20 ng/mL

  • vitamin D insufficient, 11–19 ng/mL

  • vitamin D deficiency, <10 ng/mL

 Serum 25(OH)D ECG in supine and upright position over short time period (duration not specified) SDNN, RMSSD, VLF, LF, HF, LF:HF

  • SDNN in supine position significantly lower in vitamin D–deficient compared with –sufficient subjects

  • RMSSD in supine position significantly lower in vitamin D–deficient compared with –insufficient subjects

  • SDNN in upright position significantly lower in vitamin D–deficient compared with other groups

  • LF:HF in upright position significantly higher in vitamin D–deficient group compared with other groups

  • Vitamin D significantly positively correlated with SDNN in the supine position only
 Hansen et al., 2017 (41) 113 people with type 1 or type 2 diabetes (mean age: 56 y) Serum 25(OH)D 5-min supine, resting ECG RMSSD, SDNN, HF, LF, TP, LF:HF

  • Significant inverted U-shaped association between serum vitamin D and SDNN, RMSSD, and HF

  • HRV indices peaked at vitamin D concentrations of 92, 98, and 102 nmol/L for SDNN, RMSSD, and HF, respectively
Vitamin B-12
 Sozen et al., 1998 (31) 12 patients with pernicious anemia (mean age: 51 y); 12 age- and sex-matched healthy controls Serum B-12 and hemoglobin 24-h Holter monitor SDNN, SDANN, RMSSD, pNN50, TP, LF, HF

  • SDNN, SDANN, RMSSD, TP, LF, and HF significantly lower in patients with pernicious anemia
 Aytemir et al., 2000 (32) 17 adults with vitamin B-12 deficiency (mean age: 58 y); 15 age- and sex-matched healthy volunteers Serum B-12 and hemoglobin 5-min ECG recordings at rest LF, HF, LF:HF

  • Vitamin B-12–deficient patients had significantly lower LF, HF, and LF:HF than controls

  • All HRV parameters positively correlated with vitamin B-12 concentration and negatively with the duration of the illness
 Sucharita et al., 2012 (33) 29 healthy elderly adults with vitamin B-12 deficiency (mean age: 67 y); 18 matched volunteers with sufficient vitamin B-12 concentrations Serum B-12 10-min ECG measurements in supine position HF, LF, TP, LF:HF

  • LF lower in B-12–deficient compared with B-12–replete patients
 Sucharita et al., 2013 (34) 14 healthy young adults (mean age not specified) Plasma vitamin B-12 and MMA Resting ECG recordings TP, LF, HF

  • Plasma MMA negatively correlated with LF and TP

  • Plasma MMA positively correlated with HF

  • There was no correlation between vitamin B-12 and any HRV parameters
 Sucharita et al., 2014 (35) 79 children (mean age: 5 y); based on median vitamin B-12 concentration of mothers (114 pmol/L), children categorized into lower or higher vitamin B-12 status group Mother's vitamin B-12 status during first trimester 10-min ECG recording in supine position LF, HF, TP, LF:HF

  • LF significantly lower in low B-12 status children

  • Strong trends of lower HF and TP levels in low B-12 status children

  • LF, TP, and HF positively correlated with cord blood B-12 concentrations measured at birth
Iron
 Yokusoglu et al., 2007 (42) 43 community-based patients with iron deficiency anemia (mean age: 34 y); 39 age- and gender-matched healthy adults Iron-deficient anemia (serum ferritin <12 ng/mL; hemoglobin <12 g/dL in women and <13 g/dL in men) 24-h Holter monitor SDNN, SDANN, RMSSD, SNN50 count, pNN50

  • SDNN, SDANN, SNN50 count, and pNN50 lower in adults with iron deficiency
 Tuncer et al., 2009 (43) 23 hospitalized patients with iron deficiency anemia (mean age: 30 y); 10 age- and gender-matched healthy people Iron-deficient anemia (low serum ferritin, hemoglobin <11.7 g/dL for women and <13 g/dL for men) 24-h Holter monitor SDNN, MSRSD, HRVM, SDHRV, SDANN

  • No differences in any HRV parameters
Magnesium
 Kim et al., 2012 (44) 166 healthy women (mean age: 46 y) Serum calcium and magnesium 5 min at rest measured with photoplethysmogram sensor SDNN, RMSSD, TP, LF, HF, LF:HF

  • Magnesium: SDDN and TP higher in women with higher magnesium concentrations; SDNN positively correlated with magnesium concentrations

  • Calcium to magnesium ratio: SDNN and LF lower in women with higher ratios. SDNN, TP, and LF negatively associated with ratio
Zinc
 Spann et al., 2015 (45) Pregnant adolescent mothers aged 14–19 y, 34–36 wk of gestation 24-h dietary recall to estimate intake of zinc and folate 20-min fetal heart rate placed on mother's abdomen Mean difference in fetal heart rate between adjacent epochs

  • HRV lower in mothers consuming a zinc-deficient but not folate-deficient diet
1

ECG, electrocardiogram; HF, high-frequency power; HRV, heart rate variability; HRVM, mean of the SD in all 5-min intervals; IDCM, ischemic dilated cardiomyopathy; LF, low-frequency power; LF:HF, low-frequency to high-frequency power ratio; MMA, methylmalonic acid; MSRSD, mean square root of differences between adjacent normal-to-normal intervals; NIDSCM, nonischemic dilated cardiomyopathy; pNN50, percentage of the beats with consecutive RR interval difference of >50 ms; RMSSD, root mean square of differences of successive RR interval; SDANN, SD of the 5-min RR interval means; SDNN, SD of all the RR intervals; SDHRV, SD in all 5-min intervals; SNN50 count, number of R-R intervals >50 ms; TP, total power, VLF, very-low-frequency power; 25(OH)D, 25 hydroxyvitamin D.