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Diet and Exercise Training Improve Insulin‐Glucose Metabolism and Sympathetic Hyperactivation in Obstructive Sleep Apnea and Metabolic Syndrome
Author(s) -
Cepeda Felipe X.,
Rodrigues Sara,
DutraMarques Akothirene C.B.,
Carvalho Jefferson C.,
ToschiDias Edgar,
Rondon Maria Urbana P.B.,
Alves Maria Janieire N.N.,
LorenziFilho Geraldo,
Trombetta Ivani C.
Publication year - 2017
Publication title -
the faseb journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.709
H-Index - 277
eISSN - 1530-6860
pISSN - 0892-6638
DOI - 10.1096/fasebj.31.1_supplement.1039.4
Subject(s) - medicine , endocrinology , insulin , carbohydrate metabolism , obstructive sleep apnea , polysomnography , blood pressure , metabolic syndrome , context (archaeology) , apnea , diabetes mellitus , biology , paleontology
Obstructive sleep apnea (OSA) impairs insulin‐glucose metabolism and muscle sympathetic nervous activity (MSNA). Metabolic syndrome (MetS) frequently is common in OSA patients, exacerbating these alterations. In this context, the effect of hypocaloric diet and exercise training (D+ET) in patients with OSA+MetS is not clear. We tested the hypotheses that: 1) D+ET would improve insulin‐glucose metabolism and MSNA; and 2) The reduction in MSNA is associated with the improvement insulin‐glucose metabolism. Never treated OSA patients (apnea‐hypopnea index‐AHI>15 events/h by polysomnography, PSG) and MetS (ATP‐III), were divided into: Control (C, n=10, 46±2y) and D+ET (n=11, 55±3y). D (−500kcal/day) and ET (40min, 3times/week of cycle exercise for 4‐months). We evaluated MSNA (microneurography) and HOMA‐IR and QUICK by fasting insulin/glucose. Both groups were similar in MetS risk factors, PSG parameters, MSNA and fasting insulin/glucose at pre‐intervention. Compared with C, D+ET improved VO 2 peak, body weight, waist circumference, systolic and diastolic blood pressure, AHI (P<0,05). D+ET decreased MSNA (31±2 vs. 25±2 bursts/min, P=0.01), fasting insulin (13±1.3 vs. 9±1.0 μUI/mL, P=0.02), HOMA‐IR (3.4±0.4 vs. 2.2±0.3, P=0.03) and increased QUICK (0.32±0.01 vs. 0.35±0.01, P=0.02). No changes were found in C group. Further analysis showed a significant association between change in fasting insulin (R=0.49, P=0.03), in HOMA‐IR (R=0.54, P=0.02) and in QUICK (R=−0.55, P=0.02) with the change in MSNA. D+ET improved insulin‐glucose metabolism and MSNA in patients with OSA+MetS. The effect of D+ET in insulin‐glucose metabolism, can be a candidate to explain, at least in part, the improvement in sympathetic activity. Support or Funding Information Fundação de Amparo a Pesquisa do Estado de São Paulo (FAPESP) #2011/17533‐6, #2015/17533‐6 and #2016/16831‐7