Diet and exercise improve chemoreflex sensitivity in patients with metabolic syndrome and obstructive sleep apnea

作者：Maki Nunes Cristiane; Toschi Dias Edgar; Cepeda Felipe X; Rondon Maria Urbana P B; Alves Maria Janieire N N; Fraga Raffael F; Braga Ana Maria F W; Aguilar Adriana M; Amaro Aline C; Drager Luciano F; Lorenzi Filho Geraldo; Negrao Carlos E; Trombetta Ivani C^*

来源：Obesity, 2015, 23(8): 1582-1590.

DOI：10.1002/oby.21126

ObjectiveChemoreflex hypersensitity was caused by obstructive sleep apnea (OSA) in patients with metabolic syndrome (MetS). This study tested the hypothesis that hypocaloric diet and exercise training (D+ET) would improve peripheral and central chemoreflex sensitivity in patients with MetS and OSA.
MethodsPatients were assigned to: (1) D+ET (n=16) and (2) no intervention control (C, n=8). Minute ventilation (VE, pre-calibrated pneumotachograph) and muscle sympathetic nerve activity (MSNA, microneurography) were evaluated during peripheral chemoreflex sensitivity by inhalation of 10% O-2 and 90% N-2 with CO2 titrated and central chemoreflex by 7% CO2 and 93% O-2 for 3 min at study entry and after 4 months.
ResultsPeak VO2 was increased by D+ET; body weight, waist circumference, glucose levels, systolic/diastolic blood pressure, and apnea-hypopnea index (AHI) (345.1 vs. 18 +/- 3.2 events/h, P=0.04) were reduced by D+ET. MSNA was reduced by D+ET at rest and in response to hypoxia (8.6 +/- 1.2 vs. 5.4 +/- 0.6 bursts/min, P=0.02), and VE in response to hypercapnia (14.8 +/- 3.9 vs. 9.1 +/- 1.2 l/min, P=0.02). No changes were found in the C group. A positive correlation was found between AHI and MSNA absolute changes (R=0.51, P=0.01) and body weight and AHI absolute changes (R=0.69, P<0.001).
ConclusionsSympathetic peripheral and ventilatory central chemoreflex sensitivity was improved by D+ET in MetS+OSA patients, which may be associated with improvement in sleep pattern.

• 出版日期2015-8