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A multidisciplinary weight loss intervention in obese adolescents with and without sleep-disordered breathing improves cardiometabolic health, whether SDB was normalized or not.

Authors
  • Roche, Johanna1
  • Corgosinho, Flavia Campos2
  • Isacco, Laurie3
  • Scheuermaier, Karine4
  • Pereira, Bruno5
  • Gillet, Valérie6
  • Moreira, Gustavo A7
  • Pradella-Hallinan, Marcia7
  • Tufik, Sergio8
  • de Mello, Marco Túlio9
  • Mougin, Fabienne3
  • Dâmaso, Ana R10
  • Thivel, David11
  • 1 EA3920, Exercise Performance Health Innovation Platform, University of Bourgogne Franche-Comte, CHRU Jean Minjoz, Boulevard Fleming, 25000 Besançon, France; Sleep and Health Medicine Center Ellipse, Besançon, France; Laboratory of the Metabolic Adaptations to Exercise Under Physiological and Pathological Conditions (AME2P), EA3533, Clermont Auvergne University, Clermont-Ferrand, France; Wits Sleep Laboratory, Brain Function Research Group, School of Physiology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa. Electronic address: [email protected] , (France)
  • 2 Universidade Federal de Goiás, Faculdade de Nutrição - Programa de Pos-Graduação em Nutrição, São Paulo, Brazil. , (Brazil)
  • 3 EA3920, Exercise Performance Health Innovation Platform, University of Bourgogne Franche-Comte, CHRU Jean Minjoz, Boulevard Fleming, 25000 Besançon, France. , (France)
  • 4 Wits Sleep Laboratory, Brain Function Research Group, School of Physiology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa. , (South Africa)
  • 5 Clermont-Ferrand University Hospital, Biostatistics Unit (DRCI), Clermont-Ferrand, France. , (France)
  • 6 Sleep and Health Medicine Center Ellipse, Besançon, France. , (France)
  • 7 Universidade Federal de São Paulo, Escola Paulista de Medicina, Programa de Pos-Graduação em Nutrição, São Paulo, Brazil; Universidade Federal de São Paulo, Escola Paulista de Medicina, Departameno de Psicobiologia, São Paulo, Brazil. , (Brazil)
  • 8 Universidade Federal de São Paulo, Escola Paulista de Medicina, Departameno de Psicobiologia, São Paulo, Brazil. , (Brazil)
  • 9 Universidade Federal de Minas Gerais, Programa de Pós-Graduação em Educação Física, Minas Gerais, Brazil. , (Brazil)
  • 10 Universidade Federal de São Paulo, Escola Paulista de Medicina, Programa de Pos-Graduação em Nutrição, São Paulo, Brazil. , (Brazil)
  • 11 Laboratory of the Metabolic Adaptations to Exercise Under Physiological and Pathological Conditions (AME2P), EA3533, Clermont Auvergne University, Clermont-Ferrand, France; Auvergne Research Center for Human Nutrition (CRNH), 58 Rue Montalembert, 63009 Clermont-Ferrand, France. , (France)
Type
Published Article
Journal
Sleep medicine
Publication Date
Jun 30, 2020
Volume
75
Pages
225–235
Identifiers
DOI: 10.1016/j.sleep.2020.06.030
PMID: 32861060
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

Pediatric obesity and sleep-disordered breathing (SDB) are strongly associated, and both promote metabolic impairments. However, the effects of a lifestyle intervention on the overall metabolic syndrome (MetS) are unknown. The objectives were i) to evaluate the effects of a lifestyle intervention on cardiometabolic risk (CMR), assessed with a dichotomous (MetS) and a continuous (MetScoreFM) instrument, in obese adolescents with and without SDB and ii) to compare the post-intervention cardiometabolic responses between adolescents with persistent (apnea-hypopnea index; AHI≥2) or normalized-SDB (AHI<2). Seventy-six adolescents with obesity recruited from two specialized institutions underwent a 9-12month diet and exercise intervention. Sleep and SDB (AHI≥2) were studied by polysomnography. Anthropometric parameters, fat mass (FM), glucose, insulin, lipid and leptin profiles, blood pressure (BP), MetScoreFM and MetS were assessed pre- and post-intervention. We performed comparisons between Non-SDB and SDB groups and between Normalized-SDB and Persistent-SDB subgroups. Fifty participants completed the study. Pre-intervention, twenty youth had SDB (40%) with higher insulin concentrations and systolic BP than Non-SDB participants (p < 0.01), for a similar degree of obesity. Post-intervention, MetScoreFM (p < 0.001) and MetS prevalence (p < 0.05) were decreased in both groups. Eleven participants (55%) normalized SDB along with a decrease in insulin concentrations and BP (p < 0.05). Triglycerides, total cholesterol and LDL-cholesterol concentrations (p < 0.01) improved equally in the Normalized and Persistent-SDB subgroups. SDB was associated with lower insulin sensitivity and higher BP but did not affect the lipid profile. A diet and exercise lifestyle intervention is effective in decreasing the CMR whether or not SDB was normalized in obese adolescents. Copyright © 2020 Elsevier B.V. All rights reserved.

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