Beneficial Effects of a Multifaceted 1-Year Lifestyle Intervention on Metabolic Abnormalities in Obese Adolescents With and Without Sleep-Disordered Breathing

Abstract

Obesity is considered a chronic subinflammatory disease and is a risk factor for many diseases such as sleep-disordered breathing (SDB). Although the interaction between obesity and sleep has been explored, not much is known about SDB in the adolescent population. Thus, the aims of this study were, first, to verify the effect of 1 year of interdisciplinary therapy on inflammatory markers in SDB and without SDB and, second, to investigate the influence of SDB on the result of the therapy by comparing these groups. A total of 36 obese adolescents were enrolled; however, only 24 completed the therapy (SDB group, n=12; non-SDB obese group, n=12). Sleep, anthropometric, metabolic, and inflammatory profiles were evaluated at baseline and after the treatment. In both groups, the therapy was able to improve all anthropometric variables. Metabolic parameters such as insulin, homeostasis model assessment (HOMA), and quantitative insulin sensitivity check index (QUICKI) were significantly improved only in non-SDB group. In both groups, the inflammatory state was significantly improved by the reduction in the leptin/adiponectin ratio. After the intervention, both groups no longer presented the hyperleptinemic state, favoring not only the inflammatory state, but also neuroendocrine regulation. Regarding the sleep parameter, the SDB group improved significantly in all respiratory events, and after therapy only four patients remained with SDB. Furthermore, there was an increase in sleep time. The lifestyle intervention was able to improve anthropometric, metabolic, and inflammatory parameters in both groups; however, the presence of SDB impaired better results. The data supported that the inclusion of SDB in the metabolic syndrome because of the link shown between them.

Beneficial effects of a lifestyle intervention program on C-reactive protein: impact of cardiorespiratory fitness in obese adolescents with sleep disturbances

“…Overall, in accordance with other authors, the LIP induced positive changes regarding inflammation in our whole population, with decreased CRP and increased adiponectin levels (12,71). As expected, the decrease in leptin concentration was associated with FM lowering (44).…”

“…Unexpectedly, similar levels of leptin were observed in both groups. In our population, leptin levels were higher than those reported in previous studies (12,22), and it may be hypothesized that the morbid degree of obesity in our population outweighs the potential effects of Values are presented as means (SD). BMI, body mass index; CRP, C-reactive protein; FM, fat mass; HOMAIR, homeostasis model assessment of insulin resistance; N1, stage N1 sleep; N2, stage N2 sleep; N3, stage N3 sleep; OAHI, obstructive apnea-hypopnea index; ODI, oxygen desaturation index; OSA, obstructive sleep apnea; REM, rapid eye movement sleep; TST, total sleep time; V O2peak, absolute peak oxygen uptake (l/min); V O2peakBW, peak oxygen uptake expressed relative to body weight (ml•min Ϫ1 •kg Ϫ1 ); V O2peakFFM, peak oxygen uptake expressed relative to fat-free mass (ml•min Ϫ1 •kg Ϫ1 ); WC, waist circumference; ⌬, change in values between admission and postintervention.…”

Can low-level laser therapy (LLLT) associated with an aerobic plus resistance training change the cardiometabolic risk in obese women? A placebo-controlled clinical trial

“…Obesity is a complex disease and its pathogenesis is multifactorial, resulting mainly from sedentary behaviors coupled with inadequate eating habits [1,2]. It is strongly associated with subclinical inflammation, metabolic syndrome, type 2 diabetes and an elevated risk of cardiovascular diseases [3].…”

Nutrient intake is a predictor of lung function in obese asthmatic adolescents undergoing interdisciplinary therapy

“…Once in a week, a nutritional education session was delivered to groups with a maximum of twenty adolescents. Each session lasted 60 min and practical, playful and theoretical activities were developed, aimed at promoting healthy habits and nutritional education, with topics about food pyramid, food for weight loss, concepts of fat, sugars, healthy eating and eating disorders (43) .…”

“…In addition, practical lessons were taught in global postural re-education groups, stretching and postural guidance (27) . Psychologists worked with self-esteem, body image, behaviour, prejudice, eating disorders and family issues to assist teens with lifestyle and quality-of-life changes (43) . All adolescents were submitted to the same programme of physical exercises and assessed for physical activity level (45) .…”