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Diet and exercise improves metabolic, inflammatory changes and sympathovagal balance in patients with metabolic syndrome and obstructive sleep apnea

Grant number: 15/03274-0
Support type:Scholarships in Brazil - Doctorate
Effective date (Start): June 01, 2015
Effective date (End): February 28, 2019
Field of knowledge:Biological Sciences - Physiology - General Physiology
Cooperation agreement: Coordination of Improvement of Higher Education Personnel (CAPES)
Principal researcher:Ivani Credidio Trombetta
Grantee:Felipe Xerez Cepêda Fonseca
Home 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
Associated scholarship(s):16/16831-7 - Metabolic/inflammatory markers and sympatho-vagal balance in patients with metabolic syndrome and obstructive sleep apnea: effect of hypocaloric diet and exercise training, BE.EP.DR


Background. The association of metabolic syndrome (MetS) and obstructive sleep apnea (OSA) impairs sympathovagal balance. However, the mechanisms are not completely understood. Metabolic and inflammatory alterations can be candidates to explain, at least in part, this impairment. Objectives. We will investigate: 1) The overlap of OSA in MetS has an additive effect on metabolic and inflammatory alterations; 2) The association among these alterations and sympathovagal balance; and 3) The effect of hypocaloric diet and exercise training (D+ET) in MetS risk factors, severity of OSA, sympathovagal balance and inflammatory and metabolic markers in patients with MetS. Methods. MetS patients (ATP-III) will be divided into MetS+OSA and MetS-OSA and randomized in to: D+ET (D, a decrease of 500 kcal/day, and ET, 3session/week, 50-70% VO2peak) or control period (no intervention) during 4 months. We will evaluate OSA (polysomnography), functional capacity (cardiopulmonary exercise test), sympathovagal balance (heart rate variability), muscle sympathetic nerve activity (microneurography), insulin resistance (oral glucose/insulin test tolerance and HOMA), leptin and adiponectin levels, TNF-±, protein C-reactive, IL-1B and IL-6. Main Outcomes. 1) Clarify the influence of metabolic and inflammatory alterations over the sympathovagal control; and 2) The effect of D+TF in decreasing risk factors for MetS, severity of OSA, sympathovagal balance, and their possible association with the improvement of metabolic and inflammatory markers, especially in patients with OSA. (AU)

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Scientific publications (5)
(References retrieved automatically from Web of Science and SciELO through information on FAPESP grants and their corresponding numbers as mentioned in the publications by the authors)
DUTRA-MARQUES, AKOTHIRENE C.; RODRIGUES, SARA; CEPEDA, FELIPE X.; TOSCHI-DIAS, EDGAR; RONDON, EDUARDO; CARVALHO, JEFFERSON C.; ALVES, MARIA JANIEIRE N. N.; BRAGA, ANA MARIA F. W.; RONDON, MARIA URBANA P. B.; TROMBETTA, IVANI C.. Exaggerated Exercise Blood Pressure as a Marker of Baroreflex Dysfunction in Normotensive Metabolic Syndrome Patients. FRONTIERS IN NEUROSCIENCE, v. 15, . (16/16831-7, 11/17533-6, 15/03274-0, 13/07651-7)
IVANI CREDIDIO TROMBETTA; JOSÉ ROBERTO DEMOURA; CLEBER RENE ALVES; RENATO CARBONARI-BRITO; FELIPE XEREZ CEPEDA; JOSÉ RIBEIRO LEMOS JR. Níveis Séricos do BDNF na Proteção Cardiovascular e em Resposta ao Exercício. Arquivos Brasileiros de Cardiologia, v. 115, n. 2, p. 263-269, . (16/16831-7, 15/03274-0)
CEPEDA, FELIPE X.; VIRMONDES, LESLIE; RODRIGUES, SARA; DUTRA-MARQUES, AKOTHIRENE C. B.; TOSCHI-DIAS, EDGAR; FERREIRA-CAMARGO, FERNANDA C.; HUSSID, MARIA FERNANDA; RONDON, MARIA URBANA P. B.; ALVES, MARIA JANIEIRE N. N.; TROMBETTA, IVANI C.. Identifying the risk of obstructive sleep apnea in metabolic syndrome patients: Diagnostic accuracy of the Berlin Questionnaire. PLoS One, v. 14, n. 5, . (15/03274-0, 16/16831-7, 11/17533-6, 13/15323-0, 13/07651-7)
RODRIGUES, SARA; CEPEDA, FELIPE X.; TOSCHI-DIAS, EDGAR; DUTRA-MARQUES, AKOTHIRENE C. B.; CARVALHO, JEFFERSON C.; COSTA-HONG, VALERIA; ALVES, MARIA JANIEIRE N. N.; RONDON, MARIA URBANA P. B.; BORTOLOTTO, LUIZ A.; TROMBETTA, IVANI C.. The role of increased glucose on neurovascular dysfunction in patients with the metabolic syndrome. JOURNAL OF CLINICAL HYPERTENSION, v. 19, n. 9, p. 840-847, . (15/03274-0, 13/15323-0, 13/07651-7, 11/17533-6)
MARIA FERNANDA HUSSID; FELIPE XEREZ CEPEDA; CAMILA P. JORDÃO; RAFAELA R. P. LOPES-VICENTE; LESLIE VIRMONDES; KEYLA Y. KATAYAMA; EZEQUIEL F. DE OLIVEIRA; LUIS V. F. OLIVEIRA; FERNANDA MARCIANO CONSOLIM-COLOMBO; IVANI CREDIDIO TROMBETTA. Obesidade Visceral e Hipertensão Sistólica como Substratos da Disfunção Endotelial em Adolescentes Obesos. Arquivos Brasileiros de Cardiologia, v. 116, n. 4, p. 795-803, . (16/16831-7, 15/11738-6, 15/03274-0)
Academic Publications
(References retrieved automatically from State of São Paulo Research Institutions)
FONSECA, Felipe Xerez Cepêda. Metabolic / inflammatory markers and simpathovagal balance in patients with metabolic syndrome and obstructive sleep apnea: effect of hypocaloric diet and physical training. 2019. Doctoral Thesis - Universidade de São Paulo (USP). Faculdade de Medicina (FM/SBD) São Paulo.

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