| Grant number: | 11/17533-6 |
| Support Opportunities: | Regular Research Grants |
| Start date: | February 01, 2012 |
| End date: | January 31, 2014 |
| Field of knowledge: | Health Sciences - Medicine - Medical Clinics |
| Principal Investigator: | Ivani Credidio Trombetta |
| Grantee: | Ivani Credidio Trombetta |
| Host Institution: | Instituto do Coração Professor Euryclides de Jesus Zerbini (INCOR). Hospital das Clínicas da Faculdade de Medicina da USP (HCFMUSP). Secretaria da Saúde (São Paulo - Estado). São Paulo , SP, Brazil |
| City of the host institution: | São Paulo |
| Associated researchers: | Ana Maria Fonseca Wanderley Braga ; Carlos Eduardo Negrão ; Glauce Lamoglie de Carvalho ; Maria Janieire de Nazaré Nunes Alves ; Maria Urbana Pinto Brandão Rondon |
Abstract
Context. Metabolic syndrome (MetS) is strongly associated with obstructive sleep apnea (OSA). MetS and OSA cause sympathetic hyperactivation, which mechanisms are not completely known. Metabolic, inflammatory and baro/chemoreflex control alterations may could explain, at least in part, the sympathetic hyperactivation. Objectives. In this study we intend to investigate whether OSA has an additive effect on hemodynamic and autonomic control and on metabolic and inflammatory markers and if there is association between sympathetic nerve hyperactivity with metabolic and inflammatory markers. In addition, we will investigate the effect of hypocaloric diet associated with exercise training (D+ET) on the severity of OSA, on the hemodynamic and autonomic control and on the metabolic/inflammatory controlin these MetS patients. Design, participants and intervertions. Prospective randomized clinical trial, blind. The MetS patients (according ATP-III) will be divided into MetS+OSA and MetS-OSA and all will be randomized for interventions by D (decrease of 500 kcal/day) and ET (3x/week, 50-70% VO2peak) or control period for 4 months. A normal control group will be also enrolled in this study. Methods. We will evaluate: OSA (polysomnography - measurer blind), physical fitness (ergospirometry), baroreflex sensitivity (spontaneous fluctuations of BP and HR), peripheral chemoreflex control (inhalation of hypoxic gas mixture with 10%O2 and 90% N2 for 3 min) and central (hypercapnic inhalation of 7%CO2 and 93%O2 for 3 min), insulin resistance (HOMA and OGTT) leptin and adiponectin and inflammatory markers, sympathetic nerve activity (microneurography), muscle blood flow (plethysmography), blood pressure (oscillometric); heart rate (ECG), oxygen saturation (oximetry), end-tidal CO2 (capnography), respiratory rate (piezoeletric), pulmonary ventilation (pneumotachograph) and pulse wave velocity.Main outcome measures. Absolute change from pre to post D+ET on hemodynamic, autonomic, metabolic and inflammatory control in MetS patients. (AU)
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