Abstract 461: Effects Of Energy Restriction On Sleep Apnea, Blood Pressure, Sympathetic Activity, Oxidative Stress, Inflammatory Biomarkers, Endothelial Function And Metabolic Profile In Obese Patients With Obstructive Sleep Apnea
Introduction: Weight loss is one of the treatment options for obstructive sleep apnea (OSA) in patients with excess body adiposity. However, the effects of moderate energy restriction on OSA are not known.
Objective: To evaluate the effects of moderate energy restriction on severity of OSA, blood pressure (BP), sympathetic activity, oxidative stress, inflammation, body adiposity, metabolic profile and endothelial function in obese patients with OSA.
Methods: A 16-week randomized clinical trial, involving 21 obese subjects aged 20-55y with apnea/hipopnea index (AHI) ≥ 5 events/h. Subjects were randomized in 2 groups: 11 in energy restriction group (ERG) and 10 in control group (CG). ERG was instructed to follow an energy-restricted diet (-800 kcal/day) and CG was advised not to change food intake. At the beginning and at the end of the study, participants underwent evaluation of: OSA with Watch- PAT200® including the determination of OSA severity parameters, body adiposity, BP, plasma catecholamines, c-reactive protein (CRP), adiponectin, malondialdehyde, metabolism of glucose, lipid profile and endothelial function (Endo PAT 2000®).
Results: ERG, compared to CG, presented significantly greater reduction in body weight (-5.6±1.8 vs. 0.4±1.2kg, p<0.001) and in all parameters of body adiposity; AHI (-7.2±2.8 vs. 0.1±1.9 events/h, p=0.04); number of O2 desaturation >4% (-33.7±15.6 vs. 1.8±7.9, p=0.04); plasma adrenaline (-12.7±3.0 vs. -1.3±3.9pg/mL, p=0.04); and significantly greater increase in minimum O2 saturation (4.6±1.6 vs. -0.6±1.4%, p=0.03). ERG showed greater decrease, however without statistical significance, in systolic BP (-4.2±1.9 vs. 2.3±1.4mmHg, p=0.05), insulin (-5.1±1.9 vs. -0.7±1.3μU/mL, p=0.07) and HOMA-IR (-1.2±0.5 vs. -0.08±0.3, p=0.09). During the study period, changes in body adiposity presented significant correlation with changes in parameters of OSA severity, BP, insulin, HOMA-IR, norepinephrine and adiponectin. Changes in parameters of OSA severity presented significant association with changes in CRP.
Conclusions: This study suggests that in obese patients with OSA moderate energy restriction is able to reduce body adiposity, parameters of OSA severity and sympathetic nervous system activity.
Author Disclosures: J.F.R. Fernandes: None. L.S. Araújo: None. M.G. Rodrigues: None. D.C.T. Valença: None. J.N. Neto: None. B.B.S. Gaspar: None. N.F. Gomes: None. H.G.D.L. Carvalho: None. M.R.S.T. Klein: None. A.F. Sanjuliani: None.
- © 2014 by American Heart Association, Inc.