Abstract 461: Effects Of Energy Restriction On Sleep Apnea, Blood Pressure, Sympathetic Activity, Oxidative Stress, Inflammatory Biomarkers, Endothelial Function And Metabolic Profile In Obese Patients With Obstructive Sleep Apnea

Hypertension ◽  
2014 ◽  
Vol 64 (suppl_1) ◽  
Author(s):  
Julia F Fernandes ◽  
Luciene S Araújo ◽  
Maria de Lourdes G Rodrigues ◽  
Debora C Valença ◽  
José Firmino N Neto ◽  
...  
Keyword(s):  
Oxidative Stress ◽  
Sleep Apnea ◽  
Endothelial Function ◽  
Sympathetic Activity ◽  
Metabolic Profile ◽  
Energy Restriction ◽  
Obese Patients ◽  
Body Adiposity ◽  
Obstructive Sleep ◽  
Moderate Energy

Introduction: Weight loss is one of the treatment options for obstructive sleep apnea (OSA) in patients with excess body adiposity. However, the effects of moderate energy restriction on OSA are not known. Objective: To evaluate the effects of moderate energy restriction on severity of OSA, blood pressure (BP), sympathetic activity, oxidative stress, inflammation, body adiposity, metabolic profile and endothelial function in obese patients with OSA. Methods: A 16-week randomized clinical trial, involving 21 obese subjects aged 20-55y with apnea/hipopnea index (AHI) ≥ 5 events/h. Subjects were randomized in 2 groups: 11 in energy restriction group (ERG) and 10 in control group (CG). ERG was instructed to follow an energy-restricted diet (-800 kcal/day) and CG was advised not to change food intake. At the beginning and at the end of the study, participants underwent evaluation of: OSA with Watch- PAT200® including the determination of OSA severity parameters, body adiposity, BP, plasma catecholamines, c-reactive protein (CRP), adiponectin, malondialdehyde, metabolism of glucose, lipid profile and endothelial function (Endo PAT 2000®). Results: ERG, compared to CG, presented significantly greater reduction in body weight (-5.6±1.8 vs. 0.4±1.2kg, p<0.001) and in all parameters of body adiposity; AHI (-7.2±2.8 vs. 0.1±1.9 events/h, p=0.04); number of O2 desaturation >4% (-33.7±15.6 vs. 1.8±7.9, p=0.04); plasma adrenaline (-12.7±3.0 vs. -1.3±3.9pg/mL, p=0.04); and significantly greater increase in minimum O2 saturation (4.6±1.6 vs. -0.6±1.4%, p=0.03). ERG showed greater decrease, however without statistical significance, in systolic BP (-4.2±1.9 vs. 2.3±1.4mmHg, p=0.05), insulin (-5.1±1.9 vs. -0.7±1.3μU/mL, p=0.07) and HOMA-IR (-1.2±0.5 vs. -0.08±0.3, p=0.09). During the study period, changes in body adiposity presented significant correlation with changes in parameters of OSA severity, BP, insulin, HOMA-IR, norepinephrine and adiponectin. Changes in parameters of OSA severity presented significant association with changes in CRP. Conclusions: This study suggests that in obese patients with OSA moderate energy restriction is able to reduce body adiposity, parameters of OSA severity and sympathetic nervous system activity.

Abstract 466: Obstructive Sleep Apnea And Its Association With Endothelial Function, Oxidative Stress, Inflammation, Metabolic Profile, Blood Pressure And Sympathetic Activity In Obese Individuals

Hypertension ◽  
2014 ◽  
Vol 64 (suppl_1) ◽  
Author(s):  
Luciene S Araújo ◽  
Julia F Fernandes ◽  
Debora C Valença ◽  
Maria de Lourdes G Rodrigues ◽  
Nathalia F Gomes ◽  
...  
Keyword(s):  
Oxidative Stress ◽  
Blood Pressure ◽  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Endothelial Function ◽  
Metabolic Profile ◽  
Neck Circumference ◽  
Obstructive Sleep ◽  
Increased Risk ◽  
Hs Crp

Background: Obstructive sleep apnea (OSA) is associated with an increased risk of cardiovascular disease (CVD). Several of the proposed mechanisms for the development of CVD in OSA are similar to those proposed for the increased risk of CVD in obesity, being difficult to determine the influence of OSA on these pathogenic mechanisms in obese individuals. Objectives: The purpose of this study was to evaluate the relationship of OSA with endothelial function, oxidative stress, inflammatory biomarkers, metabolic profile, sympathetic nervous system activity and blood pressure (BP) in obese individuals. Methods: In this cross-sectional study, were included 53 obese adults (28 women). Sleep study was performed with Watch-PAT200® and the diagnosis of OSA was made when apnea-hipopnea index (AHI) ≥5 events/h (n=33). All participants underwent evaluation of: body adiposity, BP, plasma catecholamines, high sensitivity C-reactive protein (hs-CRP), adiponectin, malondialdehyde, glucose, insulin, lipid profile and endothelial function (Endo-PAT 2000®). Results: Mean age (39.6 ± 1.5 vs. 32.5 ± 2.1y) and percentage of male participants (61% vs. 25%) were significantly higher in participants with OSA than in those without OSA (p=0.01). In univariate analysis participants with OSA compared with those without OSA exhibited higher values of neck circumference (40.98 ± 0.63 vs. 38.65 ± 0.75 cm, p=0.02), glucose (92.54 ± 1.97 vs. 80.2 ± 1.92 mg/dL, p=0.0001), noradrenaline (0.16±0.02 vs. 0.12±0.03 ng/mL, p=0.02) and systolic BP (126.05 ± 1.61 vs. 118.16 ± 1.86 mmHg, p=0.003). After adjustment for confounders, only glucose and hs-CRP were significantly higher in OSA patients. In correlation analysis, after controlling for confounders, AHI was associated with neck circumference (r=0.31,p=0.03) and hs-CRP (r=0.30,p=0.04), while minimum O2 saturation was associated with neck circumference (r=-0.31,p=0.03), insulin (r=-0.29,p=0.04) and HOMA-IR (r=-0.30,p=0.04). Conclusion: The present study suggests that in obese individuals OSA is associated with inflammation and worse glycemia; higher AHI correlates with increased central adiposity and inflammation; and lower oxygen saturation is related with insulin resistance.

scholarly journals The effects of moderate energy restriction on apnoea severity and CVD risk factors in obese patients with obstructive sleep apnoea

2015 ◽  
Vol 114 (12) ◽  
pp. 2022-2031 ◽  
Author(s):  
Julia Freitas Rodrigues Fernandes ◽  
Luciene da Silva Araújo ◽  
Sergio Emanuel Kaiser ◽  
Antonio Felipe Sanjuliani ◽  
Márcia Regina Simas Torres Klein
Keyword(s):  
Risk Factors ◽  
Obstructive Sleep Apnoea ◽  
Sympathetic Activity ◽  
Sleep Apnoea ◽  
Energy Restriction ◽  
Obese Patients ◽  
Cvd Risk Factors ◽  
Cvd Risk ◽  
Obstructive Sleep ◽  
Moderate Energy

AbstractNutritional intervention for weight loss is one of the treatment options for obstructive sleep apnoea (OSA) in patients with overweight or obesity. However, the effects of moderate energy restriction on OSA severity are not yet known. The present study aimed to evaluate the effects of moderate energy restriction on OSA severity and CVD risk factors in obese patients with OSA. In this 16-week randomised clinical trial, twenty-one obese subjects aged 20–55 years and presenting an apnoea/hypopnoea index (AHI)≥5 events/h were randomised into two groups: the energy restriction group (ERG) and the control group (CG). The ERG was instructed to follow an energy-restricted diet −3347·2 kJ/d (−800 kcal/d) and the CG was advised not to change their food intake. At the beginning and at the end of the study, participants underwent evaluation of the following: OSA (Watch-PAT200®), nutritional parameters, blood pressure, sympathetic activity, inflammatory biomarkers, metabolic profile and endothelial function. The ERG (n11), compared with the CG (n10), had a significantly greater reduction in body weight (Cohen’sd=−1·19;P<0·001), in AHI (Cohen’sd=−0·95;P=0·04) and in plasma concentrations of adrenaline (Cohen’sd=−1·02;P=0·04) as well as a significantly greater increase in minimum O2saturation (Cohen’sd=1·08;P=0·03). Although energy restriction was not associated with significant improvements in CVD risk factors, medium-to-large effect sizes were observed, suggesting that the statistically non-significant difference between groups may be due to the small sample size. This study suggests that in obese patients with OSA, moderate energy restriction is able to reduce the parameters of OSA severity and sympathetic activity.

scholarly journals Evaluation of endothelial function and cardiovascular risk in non-obese patients with slight degree of obstructive sleep apnea syndrome

2017 ◽  
Vol 87 (3) ◽  
Author(s):  
Fiorella Devito ◽  
Annapaola Zito ◽  
Silvano Dragonieri ◽  
Pierluigi Carratù ◽  
Vitaliano N. Quaranta ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Cardiovascular Risk ◽  
Sleep Apnea ◽  
Endothelial Function ◽  
Obstructive Sleep Apnea Syndrome ◽  
Sleep Apnea Syndrome ◽  
Intima Media Thickness ◽  
Obese Patients ◽  
Obstructive Sleep ◽  
Apnea Syndrome

Recently, it has been clearly described an independent relationship between obstructive sleep apnea syndrome (OSAS) and cardiovascular risk, with underlying mechanisms also including endothelial dysfunction. We enrolled 32 consecutive non-obese patients (mean age of 39.5±11.5 years), of which 16 with mild OSAS and 16 snoring without OSAS. Mild OSAS is defined by an AHI index between 5 and 15. We have investigated if whether there was a relationship between mild OSAS, endothelial function and carotid intima-media thickness (C-IMT). The population was divided into two groups: Group 1 (16 simple snorer patients with an average age of 39.4±12.1 years) and Group 2 (16 subjects with mild OSAS with an average age of 39.6±11.2 years). Each group underwent cardiovascular investigation including measurement of flow-mediated dilation (FMD) of the brachial artery and C-IMT. Both groups comprised non-obese subjects. Patients with mild OSAS had serum total cholesterol values statistically significantly higher than simple snores patients (178.6±24.9 vs 159.2±25.3; p=0.038). OSAS patients had also a trend towards higher values of maximum C-IMT compared to simple snorer patients (0.70±0.15 vs 0.65±0.16), although below the level of significance. Between the two groups, no difference was found for FMD values. The present results on mild OSAS strengthen the importance of a diagnosis of OSAS as soon as possible, in order to encourage all primary prevention interventions to correct risk factors responsible for disease progression and the occurrence of cardiovascular diseases, not excluding the use of therapies of non-invasive ventilation even in the early stages of the disease.

scholarly journals Nitric Oxide Bioavailability in Obstructive Sleep Apnea: Interplay of Asymmetric Dimethylarginine and Free Radicals

2015 ◽  
Vol 2015 ◽  
pp. 1-10 ◽  
Author(s):  
Mohammad Badran ◽  
Saeid Golbidi ◽  
Najib Ayas ◽  
Ismail Laher
Keyword(s):  
Oxidative Stress ◽  
Nitric Oxide ◽  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Endothelial Function ◽  
Asymmetric Dimethylarginine ◽  
Critical Role ◽  
Middle Aged ◽  
Obstructive Sleep

Obstructive sleep apnea (OSA) occurs in 2% of middle-aged women and 4% of middle-aged men and is considered an independent risk factor for cerebrovascular and cardiovascular diseases. Nitric oxide (NO) is an important endothelium derived vasodilating substance that plays a critical role in maintaining vascular homeostasis. Low levels of NO are associated with impaired endothelial function. Asymmetric dimethylarginine (ADMA), an analogue of L-arginine, is a naturally occurring product of metabolism found in the human circulation. Elevated levels of ADMA inhibit NO synthesis while oxidative stress decreases its bioavailability, so impairing endothelial function and promoting atherosclerosis. Several clinical trials report increased oxidative stress and ADMA levels in patients with OSA. This review discusses the role of oxidative stress and increased ADMA levels in cardiovascular disease resulting from OSA.

scholarly journals Effects of Nasal Continuous Positive Airway Pressure Treatment on Oxidative Stress and Adiponectin Levels in Obese Patients with Obstructive Sleep Apnea

Respiration ◽  
2010 ◽  
Vol 79 (5) ◽  
pp. 370-376 ◽  
Author(s):  
Anna Myrna Jaguaribe de Lima ◽  
Clélia Maria Ribeiro Franco ◽  
Célia Maria Machado Barbosa de Castro ◽  
Alice de Andrade Bezerra ◽  
Luiz Ataíde, Jr. ◽  
...  
Keyword(s):  
Oxidative Stress ◽  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Continuous Positive Airway Pressure ◽  
Airway Pressure ◽  
Positive Airway Pressure ◽  
Pressure Treatment ◽  
Obese Patients ◽  
Obstructive Sleep

scholarly journals Sympathetic nervous system and serum leptin level in obese patients with and without obstructive sleep apnea

2006 ◽  
Vol 12 (3) ◽  
pp. 256-261
Author(s):  
N. E. Zvartau ◽  
Yu. V. Sviryaev ◽  
O. P. Rotari ◽  
I. V. Emelyanov ◽  
N. K. Merculova ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Nervous System ◽  
Sleep Apnea ◽  
Sympathetic Nervous System ◽  
Sympathetic Activity ◽  
Obese Patients ◽  
Serum Leptin ◽  
Nervous System Activity ◽  
Obstructive Sleep ◽  
Sympathetic Nervous

The aim of the present study was to investigate sympathetic nervous system activity and serum leptin level in obese patients with and without obstructive sleep apnea (OSA). We examined 75 OSA patients and 40 age, weight, BMI and blood pressure levels matched obese patients without OSA. As a result, patients with OSA had higher sympathetic activity associated not only with repetitive episodes of hypoxia/hypercapnia during sleep, but also with more marked central obesity and higher serum leptin level.

Endothelial function is well preserved in obese patients with mild obstructive sleep apnea

2013 ◽  
Vol 18 (1) ◽  
pp. 177-186 ◽  
Author(s):  
Henry Blomster ◽  
Tomi Laitinen ◽  
Tiina Lyyra-Laitinen ◽  
Esko Vanninen ◽  
Helena Gylling ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Endothelial Function ◽  
Obese Patients ◽  
Obstructive Sleep ◽  
Mild Obstructive Sleep Apnea
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