Increased central adiposity in morbidly obese patients with obstructive sleep apnoea

Soriano-Co, Maria; Vanhecke, Thomas E.; Franklin, Barry A.; Sangal, R. Bart; Hakmeh, Basil; McCullough, Peter A.

doi:10.1111/j.1445-5994.2010.02283.x

Cited by 12 publications

(11 citation statements)

References 27 publications

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“…We used CT to assess the repartition of abdominal adipose tissue, which in contrast to anthropometric indices [26,27] or dual energy X-ray absorptiometry [28], can provide a quite accurate measure of specific abdominal fat compartments. Only one previous study has used CT, and it concluded that apnoeic females had a higher amount of visceral fat than controls [5].…”

Section: Sleep-related Disorders I Kritikou Et Almentioning

confidence: 99%

Sleep apnoea and visceral adiposity in middle-aged male and female subjects

et al. 2012

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In obese male subjects, visceral adiposity has been associated with obstructive sleep apnoea (OSA), while studies in overweight males and females are limited. Our goal was to examine the association between OSA and visceral fat in a relatively nonobese population and assess the effects of 2 months placebo-controlled continuous positive airway pressure (CPAP) use on abdominal fat.81 subjects, 22 middle-aged males and 20 post-menopausal females with OSA, and 19 male and 20 female controls were studied in the sleep laboratory for four nights. Abdominal (visceral (VAT) and subcutaneous (SAT) adipose tissue) and liver fat were assessed with computed tomography. OSA patients were re-assessed post-CPAP and post sham-CPAP.Apnoeic males had significantly higher VAT than controls, while apnoeic females had higher SAT than controls. In both sexes, OSA was associated with increased liver fat. In males, apnoea was associated with VAT whereas in females it was associated with subcutaneous, visceral and total fat. CPAP did not affect abdominal and liver fat.In overweight males, visceral adiposity is associated with OSA whereas in females it is associated with global adiposity. In overweight males, our therapeutic goal should be the reduction of visceral adiposity and its metabolic correlates, whereas, in females, weight loss may be sufficient. Shortterm CPAP treatment does not affect general, abdominal or intra-hepatic adiposity.

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Section: Sleep-related Disorders I Kritikou Et Almentioning

confidence: 99%

Sleep apnoea and visceral adiposity in middle-aged male and female subjects

et al. 2012

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“…Female sex hormones increase genioglossus contractility and prevent upper airway collapsibility during sleep [16,17]. Furthermore, the distinctive distribution of adipose tissue among the two genders (with central obesity being more strongly associated with OSA) [18], as well as the higher pharyngeal resistance in men [19], explain why OSA is more prevalent among male patients. Despite the evident predominance of the male sex in our study group, our male/female ratio is slightly lower than in previous studies (2.55:1 vs. 3:1-5:1) [20].…”

Section: Discussionmentioning

confidence: 99%

CPAP Effect on Cardiopulmonary Exercise Testing Performance in Patients with Moderate-Severe OSA and Cardiometabolic Comorbidities

et al. 2020

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Background and Objectives: Obstructive sleep apnea (OSA) is associated with daytime somnolence, cognitive impairment and high cardiovascular morbidity and mortality. Obesity, associated cardiovascular comorbidities, accelerated erythropoiesis and muscular mitochondrial energetic dysfunctions negatively influence exercise tolerance in moderate-severe OSA patients. The cardiopulmonary exercise testing (CPET) offers an integrated assessment of the individual's aerobic capacity and helps distinguish the main causes of exercise limitation. The purpose of this study is to evaluate the aerobic capacity of OSA patients, before and after short-term continuous positive airway pressure (CPAP). Materials and Methods: Our prospective study included 64 patients with newly diagnosed moderate-severe OSA (apnea hypopnea index (AHI) 39.96 ± 19.04 events/h) who underwent CPET before and after CPAP. Thirteen patients were unable to tolerate CPAP or were lost during follow-up. Results: 49.29% of our patients exhibited a moderate or severe decrease in functional capacity (Weber C or D). CPET performance was influenced by gender but not by apnea severity. Eight weeks of CPAP induced significant improvements in maximal exercise load (∆ = 14.23 W, p = 0.0004), maximum oxygen uptake (∆ = 203.87 mL/min, p = 0.004), anaerobic threshold (∆ = 316.4 mL/min, p = 0.001), minute ventilation (∆ = 5.1 L/min, p = 0.01) and peak oxygen pulse (∆ = 2.46, p = 0.007) as well as a decrease in basal metabolic rate (BMR) (∆ = −8.3 kCal/24 h, p = 0.04) and average Epworth score (∆ = −4.58 points, p < 0.000001). Conclusions: Patients with moderate-severe OSA have mediocre functional capacity. Apnea severity (AHI) was correlated with basal metabolic rate, resting heart rate and percent predicted maximum effort but not with anaerobic threshold or maximum oxygen uptake. Although CPET performance was similar in the two apnea severity subgroups, short-term CPAP therapy significantly improved most CPET parameters, suggesting that OSA per se has a negative influence on effort capacity.

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“…6,39 Hora e seus colaboradores, 40 em 2007, realizaram um estudo onde relataram que homens de meia idade com IMC elevado estão especialmente predispostos a desenvolver AS. Em estudos realizados na última dé-cada, pode se observar que, tanto a relação cintura/ A AS é uma condição crônica definida pela perda do padrão normal da respiração durante o sono, com consequências diversas que influenciam negativamente na qualidade de vida dos indivíduos afetados.…”

Section: Pas Pressão Arterial Sistólica; Pad Pressãounclassified

“…Dentre alguns fatores, que podem agravar a AS destacam-se a idade, 2 o sexo masculino, 3 o tabagismo, 4 o etilismo, 5 a obesidade, 6 a circunferência do pescoço, 3 o sedentarismo, 7 a genética, a raça negra, 4 dimorfismos craniofaciais. 8 Os efeitos e consequências da AS incluem ronco, 9 sonolência excessiva diurna, aumento da pressão arterial, 10 alterações cognitivas, 11 alterações…”

Section: Introductionunclassified