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Life sciences · Review
Indian Journal of Clinical Anatomy and Physiology · November 2, 2026
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Obesity represents a chronic state of low-grade inflammation and metabolic disturbance that predisposes to cardiovascular disease. Heart rate variability (HRV), a non-invasive measure of autonomic function, is diminished in obesity and linked to adverse outcomes. This narrative review synthesises evidence on the associations between HRV and the inflammatory cytokines interleukin-6 (IL-6) and tumour necrosis factor-α (TNF-α), as well as glycated hemoglobin (HbA1c), in individuals with obesity. A growing body of research suggests that obesity is characterized by reduced vagally mediated HRV, elevated circulating IL-6 and TNF-α, and impaired glycemic control. These components maybe mechanistically connected through the cholinergic anti-inflammatory pathway, insulin resistance, and sympathetic overactivity, forming a self-perpetuating loop that accelerates cardiometabolic risk. The review underscores the potential of HRV as a non-invasive biomarker for identifying early autonomic and inflammatory derangements in obesity and for monitoring responses to lifestyle interventions.