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The influence of obesity and obstructive sleep apnea on metabolic hormones

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Abstract

Background

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 OSAS.

Methods

We 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 non-obese (n = 21) when it was lower than 27 kg/m2. Non-obese control subjects (n = 20) were non-snorers 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 radioimmunoassay.

Results

The 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 non-obese in both patient and control groups. In the case of ghrelin, differences between obese and non-obese subjects were only seen in patients. There were no significant differences in hormone levels between the obese controls and obese patients or between non-obese controls and non-obese patients. After 3 months of nCPAP treatment, adiponectin levels decreased significantly both in obese and non-obese patients, and leptin levels decreased in obese patients. Finally, nCPAP did not reduce ghrelin in either obese or non-obese patients.

Conclusions

The 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 non-obese patients with OSAS.

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Acknowledgments

This 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.

Competing interests

None declared.

Author information

Authors and Affiliations

  1. Respiratory Diseases Research Unit, Hospital Universitari Arnau de Vilanova, IRB Lleida, Rovira Roure, 80, 25198, Lleida, Spain

    Manuel Sánchez-de-la-Torre, Cristina Esquinas, Angelina Miro & Ferran Barbé

  2. Respiratory Services, Hospital Universitario de Guadalajara, Guadalajara, Spain

    Olga Mediano

  3. Clinic Analysis and Respiratory Services, Hospital Universitari Son Dureta, Palma de Mallorca, Spain

    Antonia Barceló, Javier Piérola & Monica de la Peña

  4. Sleep Disorders Unit, Hospital Txagorritxu, University of the Basque Country, Vitoria, Spain

    Joaquin Durán-Cantolla

  5. Thorax Institute, Hospital Clinic, Universitat de Barcelona, Barcelona, Spain

    Alvar G. Agustí

  6. Respiratory Service, Hospital Virgen del Rocío, Seville, Spain

    Francisco Capote

  7. Respiratory Division, Hospital Miguel Servet, Zaragoza, Spain

    Jose Maria Marin

  8. Servicio de Neumología, Hospital Clínic i Provincial, Barcelona, Spain

    Josep Maria Montserrat

  9. Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Madrid, Spain

    Manuel Sánchez-de-la-Torre, Antonia Barceló, Javier Piérola, Monica de la Peña, Cristina Esquinas, Angelina Miro, Joaquin Durán-Cantolla, Alvar G. Agustí, Jose Maria Marin, Josep Maria Montserrat & Ferran Barbé

  10. Respiratory Services, Hospital Universitario de La Paz, Madrid, Spain

    Francisco García-Río

Authors
  1. Manuel Sánchez-de-la-Torre
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  2. Olga Mediano
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  3. Antonia Barceló
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  8. Joaquin Durán-Cantolla
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  9. Alvar G. Agustí
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  10. Francisco Capote
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  11. Jose Maria Marin
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  12. Josep Maria Montserrat
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  13. Francisco García-Río
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  14. Ferran Barbé
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Corresponding author

Correspondence to Ferran Barbé.

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Sánchez-de-la-Torre, M., Mediano, O., Barceló, A. et al. The influence of obesity and obstructive sleep apnea on metabolic hormones. Sleep Breath 16, 649–656 (2012). https://doi.org/10.1007/s11325-011-0552-7

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  • DOI: https://doi.org/10.1007/s11325-011-0552-7

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