Metabolic/inflammatory markers and sympatho-vagal balance in patients with metabolic syndrome and obstructive sleep apnea: effect of hypocaloric diet and exercise training

• Grant number: 16/16831-7
• Support Opportunities: Scholarships abroad - Research Internship - Doctorate
• Start date: January 16, 2017
• End date: January 15, 2018
• Field of knowledge: Biological Sciences - Physiology - General Physiology
• Principal Investigator: Ivani Credidio Trombetta
• Grantee: Felipe Xerez Cepêda Fonseca
• Supervisor: John Andrew Taylor
• 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
• Institution abroad: Harvard University, Boston, United States
• Associated to the scholarship: 15/03274-0 - Diet and exercise improves metabolic, inflammatory changes and sympathovagal balance in patients with metabolic syndrome and obstructive sleep apnea, BP.DR

Abstract

Background. Patients with metabolic syndrome (MetS) frequently have the co-morbid obstructive sleep apnea (OSA). Recent studies have shown that the prevalence of OSA in MetS patients is about 60%. In MetS, the overlap of OSA exacerbates muscle sympathetic nerve activity (MSNA) and impairs sympathovagal balance. However, the mechanisms and its integration are not completely understood. Metabolic and inflammatory alterations can be candidates to explain, at least in part, these impairments. Moreover, it is not known the effect of hypocaloric diet and exercise training (D+ET) on the inflammation markers, on MSNA and on sympathovagal balance in patients with MetS associated or not with OSA.Objectives. We will investigate: 1) Whether 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 D+ET on MetS risk factors, severity of OSA, and inflammatory and metabolic markers and these association with MSNA and sympathovagal balance in patients with MetS associated or not with OSA. Main Outcomes. In patients with MetS associated or without OSA: 1) Clarify the influence of metabolic and inflammatory alterations over the sympathovagal balance; and 2) The effect of D+TF in decreasing risk factors for MetS, severity of OSA, MSNA, sympathovagal balance, and their possible association with the improvement of metabolic and inflammatory markers, especially in patients with OSA.Proposal. Patients have been recruited and evaluated in Brazil. Up to now, Felipe had evaluated for pre and post intervention, about 80% of total sample size. In short, all data collected from the evaluations (microneurography, beat-by-beat heart rate and blood pressure) will be analyzed in association and under supervision and expertise of Dr. Taylor. (AU)

Scientific publications

(12)

(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)

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, MAY 21 2019. (15/03274-0, 16/16831-7, 11/17533-6, 13/15323-0, 13/07651-7)

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, 2021-04-16. (15/03274-0, 16/16831-7, 15/11738-6)

LOPES-VICENTE, WANDA R. P.; RODRIGUES, SARA; CEPEDA, FELIPE X.; JORDAO, CAMILA PAIXAO; COSTA-HONG, VALERIA; DUTRA-MARQUES, AKOTHIRENE C. B.; CARVALHO, JEFFERSON C.; ALVES, MARIA JANIEIRE N. N.; BORTOLOTTO, LUIZ A.; TROMBETTA, IVANI C.. Arterial stiffness and its association with clustering of metabolic syndrome risk factors. DIABETOLOGY & METABOLIC SYNDROME, v. 9, OCT 25 2017. (11/17533-6, 16/16831-7, 13/15323-0)

CEPEDA, FELIPE XEREZ; RODRIGUES, SARA; DUTRA-MARQUES, AKOTHIRENE C. B.; TOSCHI-DIAS, EDGAR; CARVALHO, JEFFERSON C.; CARVALHO, GLAUCE L.; RONDON, MARIA URBANA P. B.; ALVES, MARIA JANIEIRE N. N.; TROMBETTA, IVANI C.. Diet Associated with Exercise Training Improves Heart Rate Recovery and Autonomic Control in Metabolic Syndrome Subjects. FASEB JOURNAL, v. 32, n. 1, p. 2-pg., 2018-04-01. (11/17533-6, 16/16831-7)

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, 2020-08-28. (15/03274-0, 16/16831-7)

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, JUN 9 2021. (16/16831-7, 11/17533-6, 15/03274-0, 13/07651-7)

TOSCHI-DIAS, EDGAR; TROMBETTA, IVANI C.; SILVA, VALDO J. D.; MAKI-NUNES, CRISTIANE; CEPEDA, FELIPE X.; ALVES, MARIA JANIEIRE N. N.; CARVALHO, GLAUCE L.; DRAGER, LUCIANO F.; LORENZI-FILHO, GERALDO; NEGRAO, CARLOS E.; et al. Diet associated with exercise improves baroreflex control of sympathetic nerve activity in metabolic syndrome and sleep apnea patients. Sleep and Breathing, v. 23, n. 1, p. 143-151, MAR 2019. (08/03714-6, 12/02953-2, 16/16831-7, 13/07651-7, 11/17533-6, 10/50048-1)

CEPEDA, FELIPE X.; LAPOINTE, MATTHEW; TAN, CAN OZAN; TAYLOR, J. ANDREW. Inconsistent relation of nonlinear heart rate variability indices to increasing vagal tone in healthy humans. AUTONOMIC NEUROSCIENCE-BASIC & CLINICAL, v. 213, p. 1-7, SEP 2018. (16/16831-7)

ALMEIDA, GERMANA P. L.; TROMBETTA, IVANI C.; CEPEDA, FELIPE X.; HATANAKA, ELAINE; CURI, RUI; MOSTARDA, CRISTIANO; IRIGOYEN, MARIA C.; BARRETO-FILHO, JOSE A. S.; KRIEGER, EDUARDO M.; CONSOLIM-COLOMBO, FERNANDA M.. The Role of Acute Intermittent Hypoxia in Neutrophil-Generated Superoxide, Sympathovagal Balance, and Vascular Functionin Healthy Subjects. FRONTIERS IN PHYSIOLOGY, v. 8, JAN 23 2017. (10/02963-2, 16/16831-7)

BERGER, MATHIEU; KLINE, CHRISTOPHER E.; CEPEDA, FELIPE X.; RIZZI, CAMILA F.; CHAPELLE, CELINE; LAPORTE, SILVY; HUPIN, DAVID; RAFFIN, JEREMY; COSTES, FREDERIC; HARGENS, TRENT A.; et al. Does obstructive sleep apnea affect exercise capacity and the hemodynamic response to exercise? An individual patient data and aggregate meta-analysis. SLEEP MEDICINE REVIEWS, v. 45, p. 42-53, JUN 2019. (16/16831-7)

VIVODTZEV, ISABELLE; PICARD, GLEN; CEPEDA, FELIPE X.; TAYLOR, J. ANDREW. Acute Ventilatory Support During Whole-Body Hybrid Rowing in Patients With High-Level Spinal Cord Injury A Randomized Controlled Crossover Trial. CHEST, v. 157, n. 5, p. 1230-1240, MAY 2020. (16/16831-7)

CEPEDA, FELIPE X.; RODRIGUES, SARA; DUTRA-MARQUES, AKOTHIRENE C. B.; CARVALHO, JEFFERSON C.; TOSCHI-DIAS, EDGAR; RONDON, MARIA URBANA P. B.; ALVES, MARIA JANIEIRE N. N.; LORENZI-FILHO, GERALDO; TROMBETTA, IVANI C.. Diet and Exercise Training Improve Insulin-Glucose Metabolism and Sympathetic Hyperactivation in Obstructive Sleep Apnea and Metabolic Syndrome. FASEB JOURNAL, v. 31, p. 1-pg., 2017-04-01. (11/17533-6, 16/16831-7)