The influence of obesity and obstructive sleep apn

Authors: Manuel SánchezdelaTorre Olga Mediano Antonia Barceló Javier Piérola Monica de la Peña Cristina Esquinas Angelina Miro Joaquin DuránCantolla Alvar G Agustí Francisco Capote Jose Maria Marin Josep Maria Montserrat Francisco GarcíaRío Ferran Barbé

Publish Date: 2011/09/13

Volume: 16, Issue: 3, Pages: 649-656

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Abstract

Obstructive sleep apnea syndrome OSAS is a common disorder characterized by excessive daytime sleepiness and repetitive upper airway obstruction episodes during sleep Clinically obesity is a major risk factor for developing OSAS However OSAS has been associated with hormonal and metabolic alterations that could predispose patients to obesity The aim of this study was to investigate the independent role of apneas and obesity on plasma levels of metabolic hormones adiponectin ghrelin and leptin in patients with OSASWe have studied patients with OSAS and controls with and without obesity All patients were male had an apnea–hypopnea index of 20/h or greater and were eligible for nasal continuous positive airway pressure nCPAP treatment Patients were considered obese n = 28 when their BMI was higher than 30 kg/m2 and nonobese n = 21 when it was lower than 27 kg/m2 Nonobese control subjects n = 20 were nonsnorers with a normal cardiorespiratory sleep study while obese control subjects n = 10 were recruited from those obese subjects who were visited in our sleep unit and for whom OSAS was excluded by full polysomnography A single blood sample was obtained from an antecubital vein in all participants after the completion of the nocturnal sleep laboratory recording Plasma leptin adiponectin and ghrelin levels were determined by radioimmunoassayThe adiponectin ghrelin and leptin plasma levels were similar in both patients and controls There were differences in leptin and adiponectin plasma levels between the obese and nonobese in both patient and control groups In the case of ghrelin differences between obese and nonobese subjects were only seen in patients There were no significant differences in hormone levels between the obese controls and obese patients or between nonobese controls and nonobese patients After 3 months of nCPAP treatment adiponectin levels decreased significantly both in obese and nonobese patients and leptin levels decreased in obese patients Finally nCPAP did not reduce ghrelin in either obese or nonobese patientsThe basal levels of leptin adiponectin and ghrelin were mostly associated with obesity We found that sleep apnea was not a determinant factor in leptin adiponectin and ghrelin hormonal levels Interestingly nCPAP treatment diminishes leptin in obese OSA patients and adiponectin levels in obese and nonobese patients with OSASThis work was supported by Societat Catalana de Hipertensió Arterial SCHTA Fondo de Investigación Sanitaria PI070585 and Sociedad Española de Neumología y Cirugía Torácica SEPAR We would like to thank the patients who participated in this study for their collaboration

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