Audrey Auclair1,2, Laurent Biertho1,3, Simon Marceau1,3, Frédéric-Simon Hould1,3, Simon Biron1,3, Stéfane Lebel1,3, François Julien1,3, Odette Lescelleur1,3, Yves Lacasse1, Marie-Eve Piché1,3, Katherine Cianflone1, Sebastian Demian Parlee4, Kerry Goralski5,6, Julie Martin1,2, Marjorie Bastien1,2, David H St-Pierre7, Paul Poirier8,9. 1. Institut Universitaire de Cardiologie et de Pneumologie de Québec, Québec, Canada. 2. Faculty of Pharmacy, Laval University, Québec, Canada. 3. Faculty of Medicine, Laval University, Québec, Canada. 4. Department of Molecular & Integrative Physiology, University of Michigan School of Medicine, Detroit, USA. 5. College of Pharmacy, Dalhousie University, Halifax, Canada. 6. Department of Pharmacology, Dalhousie University, Halifax, Canada. 7. Department of Exercise Sciences, Université du Québec à Montréal, Québec, Canada. 8. Institut Universitaire de Cardiologie et de Pneumologie de Québec, Québec, Canada. paul.poirier@criucpq.ulaval.ca. 9. Faculty of Pharmacy, Laval University, Québec, Canada. paul.poirier@criucpq.ulaval.ca.
Abstract
BACKGROUND: Obesity-associated systemic hypertension (HTN) and obstructive sleep apnea (OSA) have multiple pathophysiological pathways including ectopic fat deposition, inflammation, altered adipokine profile, and increased sympathetic nervous activity. We characterized these potential mechanisms in severely obese patients with or without HTN and OSA. We also compared changes of these mechanisms at 12 months following biliopancreatic diversion with duodenal switch (BPD-DS) surgery according to HTN and OSA resolution. METHODS: Sixty-two severely obese patients were evaluated at baseline and 12 months; 40 patients underwent BPD-DS. Blood samples, bioelectrical impedance analysis, computed tomography scan, and 24-h heart rate monitoring were performed. OSA have been determined with polysomnography and HTN with blood pressure measurement and medical file. RESULTS: Patients with HTN (n = 35) and OSA (n = 32) were older men with higher ectopic fat deposition and lower parasympathetic nervous activity without difference in adipokines and inflammatory markers. Lower reduction in weight was observed in patients with unresolved HTN (-40.9 ± 3.3 kg vs. -55.6 ± 3.8 kg; p = 0.001) and OSA (-41.4 ± 10.7 kg vs. -51.0 ± 15.2 kg; p = 0.006). Visceral adipose tissue reduction was lower in patients with unresolved HTN (-171.0 ± 25.7 cm2 vs. -274.5 ± 29.0 cm2; p = 0.001) in contrast to a trend for lower abdominal subcutaneous adipose tissue reduction in patients with unresolved OSA (-247.7 ± 91.5 cm2 vs. -390.5 ± 109.1 cm2; p = 0.08). At 12 months, parasympathetic activity was lowest in unresolved HTN and OSA patients, without difference in adipokines and inflammatory biomarkers. CONCLUSION: Lower ectopic fat mobilization, lower level of parasympathetic nervous activity, and lower subcutaneous adiposity mobilization may play a role in the pathophysiology of unresolved HTN and OSA following BPD-DS surgery.
BACKGROUND: Obesity-associated systemic hypertension (HTN) and obstructive sleep apnea (OSA) have multiple pathophysiological pathways including ectopic fat deposition, inflammation, altered adipokine profile, and increased sympathetic nervous activity. We characterized these potential mechanisms in severely obesepatients with or without HTN and OSA. We also compared changes of these mechanisms at 12 months following biliopancreatic diversion with duodenal switch (BPD-DS) surgery according to HTN and OSA resolution. METHODS: Sixty-two severely obesepatients were evaluated at baseline and 12 months; 40 patients underwent BPD-DS. Blood samples, bioelectrical impedance analysis, computed tomography scan, and 24-h heart rate monitoring were performed. OSA have been determined with polysomnography and HTN with blood pressure measurement and medical file. RESULTS:Patients with HTN (n = 35) and OSA (n = 32) were older men with higher ectopic fat deposition and lower parasympathetic nervous activity without difference in adipokines and inflammatory markers. Lower reduction in weight was observed in patients with unresolved HTN (-40.9 ± 3.3 kg vs. -55.6 ± 3.8 kg; p = 0.001) and OSA (-41.4 ± 10.7 kg vs. -51.0 ± 15.2 kg; p = 0.006). Visceral adipose tissue reduction was lower in patients with unresolved HTN (-171.0 ± 25.7 cm2 vs. -274.5 ± 29.0 cm2; p = 0.001) in contrast to a trend for lower abdominal subcutaneous adipose tissue reduction in patients with unresolved OSA (-247.7 ± 91.5 cm2 vs. -390.5 ± 109.1 cm2; p = 0.08). At 12 months, parasympathetic activity was lowest in unresolved HTN and OSA patients, without difference in adipokines and inflammatory biomarkers. CONCLUSION: Lower ectopic fat mobilization, lower level of parasympathetic nervous activity, and lower subcutaneous adiposity mobilization may play a role in the pathophysiology of unresolved HTN and OSA following BPD-DS surgery.
Entities:
Keywords:
Bariatric surgery; Body fat distribution; Obstructive sleep apnea; Severe obesity; Systemic hypertension
Authors: P Arner; J Bäckdahl; P Hemmingsson; P Stenvinkel; D Eriksson-Hogling; E Näslund; A Thorell; D P Andersson; K Caidahl; M Rydén Journal: Int J Obes (Lond) Date: 2014-07-08 Impact factor: 5.095
Authors: Ida J Hatoum; Robin Blackstone; Tina D Hunter; Diane M Francis; Michael Steinbuch; Jason L Harris; Lee M Kaplan Journal: JAMA Surg Date: 2016-02 Impact factor: 14.766
Authors: Mehmet Ali Kobat; Ahmet Celik; Mehmet Balin; Yakup Altas; Adil Baydas; Musa Bulut; Suleyman Aydin; Necati Dagli; Mustafa Ferzeyn Yavuzkir; Selcuk Ilhan Journal: J Clin Med Res Date: 2012-03-23
Authors: Hind A Beydoun; Sharmin Hossain; May A Beydoun; Jordan Weiss; Alan B Zonderman; Shaker M Eid Journal: J Periodontol Date: 2019-11-14 Impact factor: 4.494
Authors: Nara Nóbrega Crispim Carvalho; Francisco Antônio de Oliveira Junior; Gitana da Silva; Vinícius José Baccin Martins; Valdir de Andrade Braga; João Henrique da Costa-Silva; Flávia Cristina Fernandes Pimenta; José Luiz de Brito Alves Journal: Diabetes Metab Syndr Obes Date: 2019-08-21 Impact factor: 3.168