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.

Obstructive Sleep Apnea and Cardiovascular Risk Markers (Fibrinogen & Gamma Glutamyl Transferase) in Obese Males

2021 ◽  
Vol 15 (12) ◽  
pp. 3312-3314
Author(s):  
Shagufta Khaliq ◽  
Mudassar Ali Roomi ◽  
Shaheena Naz ◽  
Komal Iqbal ◽  
Muhammad Imran Ashraf ◽  
...  
Keyword(s):  
Oxidative Stress ◽  
Blood Pressure ◽  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Gamma Glutamyl Transferase ◽  
Strong Positive Correlation ◽  
Positive Correlation ◽  
Gamma Glutamyl ◽  
Obstructive Sleep ◽  
Glutamyl Transferase

Aim: To determine and compare gamma glutamyl transferase (GGT) and fibrinogen among obese males with and without obstructive sleep apnea (OSA). Second objective was to investigate correlation between blood pressure and GGT. Methodology: Sixty-four obese males aged 20-45 years with BMI > 25kg/m2 were included by convenience sampling. The study was conducted, after obtaining ethical approval from IRB, at the Department of Physiology, Post Graduate Medical Institute, Lahore from August 2014 to May 2015. Participants having acute or chronic inflammatory conditions were excluded. Participants were screened for OSA by Berlin and STOP BANG questionnaires. Diagnosis of OSA was made by overnight portable pulse oximetry. The participants were divided into two groups. Group I had 32 obese males with OSA. Group II contained 32 obese males without OSA. After an overnight fasting of 10-12 hours blood samples were drawn. Serum fibrinogen and GGT were measured by spectrophotometer. The data was analyzed using SPSS-22. Quantitative variables were compared between the two groups by Mann-Whitney U test. Spearman correlation was used to correlate blood pressure and GGT among the participants. Results: Fibrinogen was significantly raised (p=0.015) in obese males with OSA. Systolic blood pressure (p=0.003), diastolic blood pressure (p=0.001) and mean arterial blood pressure (p<0.001) showed strong positive correlation with GGT in obese males with OSA. Conclusion: Proinflammatory, procoagulant and proatherogenic marker fibrinogen levels were significantly raised in obese otherwise healthy males with OSA. Oxidative stress marker GGT showed strong positive correlation with blood pressure in obese males with OSA. Keywords: Fibrinogen, gamma glutamyl transferase, inflammation, obstructive sleep apnea, oxidative stress

Obstructive sleep apnea is independently associated with inflammation and insulin resistance, but not with blood pressure, plasma catecholamines, and endothelial function in obese subjects

Nutrition ◽  
2015 ◽  
Vol 31 (11-12) ◽  
pp. 1351-1357 ◽  
Author(s):  
Luciene da Silva Araújo ◽  
Julia Freitas Rodrigues Fernandes ◽  
Márcia Regina Simas Torres Klein ◽  
Antonio Felipe Sanjuliani
Keyword(s):  
Insulin Resistance ◽  
Blood Pressure ◽  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Endothelial Function ◽  
Plasma Catecholamines ◽  
Pressure Plasma ◽  
Obstructive Sleep ◽  
Obese Subjects

Effects of intermittent hypoxia on oxidative stress-induced myocardial damage in mice

2007 ◽  
Vol 102 (5) ◽  
pp. 1806-1814 ◽  
Author(s):  
Ah-Mee Park ◽  
Yuichiro J. Suzuki
Keyword(s):  
Oxidative Stress ◽  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Intermittent Hypoxia ◽  
Myocardial Injury ◽  
Ischemia Reperfusion Injury ◽  
Ischemia Reperfusion ◽  
Cardiac Damage ◽  
Obstructive Sleep ◽  
Increased Risk

Obstructive sleep apnea is associated with increased risk for cardiovascular diseases. As obstructive sleep apnea is characterized by episodic cycles of hypoxia and normoxia during sleep, we investigated effects of intermittent hypoxia (IH) on ischemia-reperfusion-induced myocardial injury. C57BL/6 mice were subjected to IH (2 min 6% O2 and 2 min 21% O2) for 8 h/day for 1, 2, or 4 wk; isolated hearts were then subjected to ischemia-reperfusion. IH for 1 or 2 wk significantly enhanced ischemia-reperfusion-induced myocardial injury. However, enhanced cardiac damage was not seen in mice treated with 4 wk of IH, suggesting that the heart has adapted to chronic IH. Ischemia-reperfusion-induced lipid peroxidation and protein carbonylation were enhanced with 2 wk of IH, while, with 4 wk, oxidative stress was normalized to levels in animals without IH. H2O2 scavenging activity in adapted hearts was higher after ischemia-reperfusion, suggesting the increased antioxidant capacity. This might be due to the involvement of thioredoxin, as the expression level of this protein was increased, while levels of other antioxidant enzymes were unchanged. In the heart from mice treated with 2 wk of IH, ischemia-reperfusion was found to decrease thioredoxin. Ischemia-reperfusion injury can also be enhanced when thioredoxin reductase was inhibited in control hearts. These results demonstrate that IH changes the susceptibility of the heart to oxidative stress in part via alteration of thioredoxin.

Influence of obstructive sleep apnea on ischemia-modified albumin levels and carotid intima-media thickness

2016 ◽  
Vol 64 (5) ◽  
pp. 1035-1041 ◽  
Author(s):  
Harun Karamanli ◽  
Aysel Kiyici ◽  
Bilal Arik ◽  
Duran Efe ◽  
Recep Akgedik
Keyword(s):  
Oxidative Stress ◽  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Intima Media Thickness ◽  
Carotid Intima Media Thickness ◽  
Control Group ◽  
Ischemia Modified Albumin ◽  
Media Thickness ◽  
Obstructive Sleep ◽  
Increased Risk

Obstructive sleep apnea (OSA) is associated with an increased risk of atherosclerosis. Carotid intima-media thickness (CIMT) is strongly associated with the presence of significant risk factors for cardiovascular disturbances. A disturbance in the oxidative/antioxidative balance is involved in the pathogenesis of OSA and cardiovascular diseases. Ischemia-modified albumin (IMA) is suggested as a novel marker of oxidative stress; IMA can be defined as decreased binding of transitional metal ions to serum albumin in oxidative status. The purpose of this research was to evaluate the influence of OSA on IMA levels and CIMT. In total, 61 individuals with OSA with no comorbidities and 24 healthy controls with a similar body mass index and age were enrolled in this study. Serum levels of IMA, CIMT (estimated radiologically), and polysomnographic parameters, were determined and interpreted. Serum IMA levels were significantly higher in individuals with OSA compared with the control group (p=0.0003). CIMT was significantly higher in the OSA group compared with the control group (0.88± 0.26 mm vs 0.75±0.17 mm, p=0.005). The CIMT and serum IMA levels were positively correlated with the apnea-hypopnea index (r=0.35 and r=0.32, respectively), and with the oxygen desaturation index (r=0.34 and r=0.29, respectively) at baseline. Increased IMA levels and CIMT may be related to increased oxidative stress and risk of atherosclerosis in individuals with OSA.

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 Six Months of Inspiratory Muscle Training to Lower Blood Pressure and Improve Endothelial Function in Middle-Aged and Older Adults With Above-Normal Blood Pressure and Obstructive Sleep Apnea: Protocol for the CHART Clinical Trial

2021 ◽  
Vol 8 ◽  
Author(s):  
Dallin Tavoian ◽  
Lupita E. Ramos-Barrera ◽  
Daniel H. Craighead ◽  
Douglas R. Seals ◽  
Edward J. Bedrick ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Cardiovascular Disease ◽  
Older Adults ◽  
Clinical Trial ◽  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Endothelial Function ◽  
High Resistance ◽  
Middle Aged ◽  
Obstructive Sleep

Background: Cardiovascular disease is a major global health concern and prevalence is high in adults with obstructive sleep apnea (OSA). Lowering blood pressure (BP) can greatly reduce cardiovascular disease risk and physical activity is routinely prescribed to achieve this goal. Unfortunately, many adults with OSA suffer from fatigue, daytime sleepiness, and exercise intolerance—due to poor sleep quality and nocturnal hypoxemia—and have difficulty initiating and maintaining an exercise program. High-resistance inspiratory muscle strength training (IMST) is a simple, time-efficient breathing exercise consistently reported to reduce BP in small, selective groups of both healthy and at-risk adults. Herein we present the study protocol for a randomized clinical trial to determine the long-term efficacy of IMST performed regularly for 24 weeks in middle-aged and older adults with OSA. The primary outcome is casual systolic BP. Secondary outcomes are 24-h systolic BP and circulating plasma norepinephrine concentration. Other outcomes include vascular endothelial function (endothelial-dependent and -independent dilation), aortic stiffness, casual and 24-h diastolic BP, and the influence of circulating factors on endothelial cell nitric oxide and reactive oxygen species production. Overall, this trial will establish efficacy of high-resistance IMST for lowering BP and improving cardiovascular health in middle-aged and older adults with OSA.Methods: This is a single-site, double-blind, randomized clinical trial. A minimum of 92 and maximum of 122 male and female adults aged 50–80 years with OSA and above-normal BP will be enrolled. After completion of baseline assessments, subjects will be randomized in a 1:1 ratio to participate in either high-resistance or sham (low-resistance) control IMST, performed at home, 5 min/day, 5 days/week, for 24 weeks. Repeat assessments will be taken after the 24-week intervention, and after 4 and 12 weeks of free living.Discussion: This study is designed to assess the effects of 24 weeks of IMST on BP and vascular function. The results will characterize the extent to which IMST can reduce BP when performed over longer periods (i.e., 6 months) than have been assessed previously. Additionally, this study will help to determine underlying mechanisms driving IMST-induced BP reductions that have been reported previously.Clinical Trial Registration: This trial is registered with ClinicalTrials.gov (Registration Number: NCT04932447; Date of registration June 21, 2021).

Abstract MP63: Childhood-onset Obstructive Sleep Apnea Is Associated With Increased Risk Of Adolescent Hypertension

Circulation ◽  
2021 ◽  
Vol 143 (Suppl_1) ◽  
Author(s):  
Julio Fernandez-Mendoza ◽  
Fan He ◽  
Susan Calhoun ◽  
Alexandros Vgontzas ◽  
Duanping Liao ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Obstructive Sleep Apnea ◽  
Risk Factor ◽  
Sleep Apnea ◽  
Apnea Hypopnea Index ◽  
Childhood Onset ◽  
Obstructive Sleep ◽  
Increased Risk ◽  
Transition To Adolescence

Introduction: Obstructive sleep apnea (OSA) is an established risk factor for hypertension in adults. However, the association of childhood OSA with an increased risk of hypertension has remained elusive. Hypothesis: Childhood-onset OSA is longitudinally associated with hypertension in adolescence. Methods: We tested this hypothesis in a population-based sample of 421 children (5-12 years) from the Penn State Child Cohort who were followed-up 6-13 years later as adolescents (12-23 years). In-lab polysomnography, to ascertain the apnea/hypopnea index (AHI), and seated blood pressure were assessed at baseline and at follow-up. The presence of hypertension at follow-up was defined based on pediatric criteria dependent upon the subject’s age (below and above 13 years). Logistic regression analyses adjusted for sex, race/ethnicity, age, body mass index percentile and systolic blood pressure percentile at baseline. Results: Childhood OSA that persisted in the transition to adolescence was associated with 2.9-fold (95%CI=1.1-7.4) higher odds of adolescent hypertension. In contrast, childhood OSA that remitted in the transition to adolescence was not associated with increased odds of adolescent hypertension (OR=0.9, 95%CI=0.3-2.6). Adolescent-onset OSA was associated with 1.7-fold (95%CI=1.1-2.9) increased odds of adolescent hypertension. Conclusions: Childhood-onset persistent OSA is a risk factor for hypertension in adolescence. Remission of childhood OSA during this transitional period, which previous research has shown to be highly determined by weight loss, does not confer a significant risk of adolescent hypertension. Early life chronic adverse sleep exposures predict cardiovascular risk in adolescence, a critical developmental period.

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.

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