Diet associated with exercise improves baroreflex control of sympathetic nerve activity in metabolic syndrome and sleep apnea patients

Author(s):Show less -

Toschi-Dias, Edgar ^[1] ; Trombetta, Ivani C. ^[2] ; Silva, Valdo J. D. ^[3] ; Maki-Nunes, Cristiane ^[1] ; Cepeda, Felipe X. ^[1] ; Alves, Maria Janieire N. N. ^[1] ; Carvalho, Glauce L. ^[1] ; Drager, Luciano F. ^[1] ; Lorenzi-Filho, Geraldo ^[1] ; Negrao, Carlos E. ^{[4, 1]} ; Rondon, Maria Urbana P. B. ^[4]

Affiliation

^[1] Univ Sao Paulo, Med Sch, Heart Inst InCor, Sao Paulo, SP - Brazil

^[2] Univ Nove Julho, Sao Paulo, SP - Brazil

^[3] Triangulo Mineiro Fed Univ, Biol Sci Inst, Uberaba, MG - Brazil

^[4] Univ Sao Paulo, Sch Phys Educ & Sport, Sao Paulo, SP - Brazil

• Document type: Journal article
• Source: Sleep and Breathing; v. 23, n. 1, p. 143-151, MAR 2019.
• Web of Science Citations: 2

Abstract

PurposeWe tested the hypothesis that (i) diet associated with exercise would improve arterial baroreflex (ABR) control in metabolic syndrome (MetS) patients with and without obstructive sleep apnea (OSA) and (ii) the effects of this intervention would be more pronounced in patients with OSA.MethodsForty-six MetS patients without (noOSA) and with OSA (apnea-hypopnea index, AHI >15events/h) were allocated to no treatment (control, C) or hypocaloric diet (-500kcal/day) associated with exercise (40min, bicycle exercise, 3 times/week) for 4months (treatment, T), resulting in four groups: noOSA-C (n=10), OSA-C (n=12), noOSA-T (n=13), and OSA-T (n=11). Muscle sympathetic nerve activity (MSNA), beat-to-beat BP, and spontaneous arterial baroreflex function of MSNA (ABR(MSNA), gain and time delay) were assessed at study entry and end.ResultsNo significant changes occurred in C groups. In contrast, treatment in both patients with and without OSA led to a significant decrease in weight (P<0.05) and the number of MetS factors (P=0.03). AHI declined only in the OSA-T group (315 to 17 +/- 4events/h, P<0.05). Systolic BP decreased in both treatment groups, and diastolic BP decreased significantly only in the noOSA-T group. Treatment decreased MSNA in both groups. Compared with baseline, ABR(MSNA) gain increased in both OSA-T (13 +/- 1 vs. 24 +/- 2a.u./mmHg, P=0.01) and noOSA-T (27 +/- 3 vs. 37 +/- 3a.u./mmHg, P=0.03) groups. The time delay of ABR(MSNA) was reduced only in the OSA-T group (4.1 +/- 0.2s vs. 2.8 +/- 0.3s, P=0.04).Conclusionsp id=ParDiet associated with exercise improves baroreflex control of sympathetic nerve activity and MetS components in patients with MetS regardless of OSA. (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: 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: 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
• Grantee: Felipe Xerez Cepêda Fonseca
• Support Opportunities: Scholarships abroad - Research Internship - Doctorate
• 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
• 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: 10/50048-1 - Cellular and functional bases of exercise in cardiovascular diseases
• Grantee: Carlos Eduardo Negrão
• Support Opportunities: Research Projects - Thematic Grants