Diet and exercise improve chemoreflex sensitivity in patients with metabolic syndrome and obstructive sleep apnea

Author(s):Show less -

Maki-Nunes, Cristiane ^[1] ; Toschi-Dias, Edgar ^[1] ; Cepeda, Felipe X. ^[1] ; Rondon, Maria Urbana P. B. ^{[1, 2]} ; Alves, Maria-Janieire N. N. ^[1] ; Fraga, Raffael F. ^[1] ; Braga, Ana Maria F. W. ^[1] ; Aguilar, Adriana M. ^[1] ; Amaro, Aline C. ^[3] ; Drager, Luciano F. ^[4] ; Lorenzi-Filho, Geraldo ^[3] ; Negrao, Carlos E. ^{[1, 2]} ; Trombetta, Ivani C. ^{[1, 5]}

Affiliation

^[1] Univ Sao Paulo, Sch Med, Heart Inst InCor, Cardiovasc Rehabil & Exercise Physiol Unit, Sao Paulo - Brazil

^[2] Univ Sao Paulo, Sch Phys Educ & Sport, Biodinam, Sao Paulo - Brazil

^[3] Univ Sao Paulo, Sch Med, Heart Inst InCor, Sleep Lab, Pulm Div, Sao Paulo - Brazil

^[4] Univ Sao Paulo, Sch Med, Hypertens Unit, Heart Inst InCor, Sao Paulo - Brazil

^[5] Univ Nove De Julho UNINOVE, Programa Posgrad Med, Sao Paulo - Brazil

• Document type: Journal article
• Source: OBESITY; v. 23, n. 8, p. 1582-1590, AUG 2015.
• Web of Science Citations: 11

Abstract

ObjectiveChemoreflex hypersensitity was caused by obstructive sleep apnea (OSA) in patients with metabolic syndrome (MetS). This study tested the hypothesis that hypocaloric diet and exercise training (D+ET) would improve peripheral and central chemoreflex sensitivity in patients with MetS and OSA. MethodsPatients were assigned to: (1) D+ET (n=16) and (2) no intervention control (C, n=8). Minute ventilation (VE, pre-calibrated pneumotachograph) and muscle sympathetic nerve activity (MSNA, microneurography) were evaluated during peripheral chemoreflex sensitivity by inhalation of 10% O-2 and 90% N-2 with CO2 titrated and central chemoreflex by 7% CO2 and 93% O-2 for 3 min at study entry and after 4 months. ResultsPeak VO2 was increased by D+ET; body weight, waist circumference, glucose levels, systolic/diastolic blood pressure, and apnea-hypopnea index (AHI) (345.1 vs. 18 +/- 3.2 events/h, P=0.04) were reduced by D+ET. MSNA was reduced by D+ET at rest and in response to hypoxia (8.6 +/- 1.2 vs. 5.4 +/- 0.6 bursts/min, P=0.02), and VE in response to hypercapnia (14.8 +/- 3.9 vs. 9.1 +/- 1.2 l/min, P=0.02). No changes were found in the C group. A positive correlation was found between AHI and MSNA absolute changes (R=0.51, P=0.01) and body weight and AHI absolute changes (R=0.69, P<0.001). ConclusionsSympathetic peripheral and ventilatory central chemoreflex sensitivity was improved by D+ET in MetS+OSA patients, which may be associated with improvement in sleep pattern. (AU)

• FAPESP's process: 08/03714-6 - 3D body scan to diagnose obesity and assess cardiovascular risk
• Grantee: Ivani Credidio Trombetta
• Support Opportunities: Scholarships abroad - New Frontiers
• FAPESP's process: 11/17533-6 - Autonomic, metabolic and inflammatory aspects of metabolic syndrome associated with obstructive sleep apnea: effect of hypocaloric diet and physical training
• Grantee: Ivani Credidio Trombetta
• Support Opportunities: Regular Research Grants
• FAPESP's process: 12/02953-2 - Impact of obstructive sleep apnea and sleep duration on the progression of cardiovascular diseases
• Grantee: Luciano Ferreira Drager
• Support Opportunities: Research Grants - Young Investigators Grants
• FAPESP's process: 13/07651-7 - Prognostic value of the oscillatory pattern of muscle sympathetic nerve activity in patients with heart failure
• Grantee: Edgar Toschi Dias
• Support Opportunities: Scholarships in Brazil - Post-Doctoral