Nutritional intervention for weight loss is one of the treatment options for obstructive sleep apnoea (OSA) in patients with overweight or obesity. However, the effects of moderate energy restriction on OSA severity are not yet known. The present study aimed to evaluate the effects of moderate energy restriction on OSA severity and CVD risk factors in obese patients with OSA. In this 16-week randomised clinical trial, twentyone obese subjects aged 20-55 years and presenting an apnoea/hypopnoea index (AHI) ≥ 5 events/h were randomised into two groups: the energy restriction group (ERG) and the control group (CG). The ERG was instructed to follow an energy-restricted diet −3347·2 kJ/d (−800 kcal/d) and the CG was advised not to change their food intake. At the beginning and at the end of the study, participants underwent evaluation of the following: OSA (Watch-PAT200 ® ), nutritional parameters, blood pressure, sympathetic activity, inflammatory biomarkers, metabolic profile and endothelial function. The ERG (n 11), compared with the CG (n 10), had a significantly greater reduction in body weight (Cohen's d = −1·19; P < 0·001), in AHI (Cohen's d = −0·95; P = 0·04) and in plasma concentrations of adrenaline (Cohen's d = −1·02; P = 0·04) as well as a significantly greater increase in minimum O 2 saturation (Cohen's d = 1·08; P = 0·03). Although energy restriction was not associated with significant improvements in CVD risk factors, medium-to-large effect sizes were observed, suggesting that the statistically non-significant difference between groups may be due to the small sample size. This study suggests that in obese patients with OSA, moderate energy restriction is able to reduce the parameters of OSA severity and sympathetic activity.

BackgroundObservational studies have highlighted an association between serum uric acid (SUA) levels and cardiovascular risk factors. Despite the growing body of evidences, several studies were conducted in older individuals or in carriers of diseases susceptible to affect SUA levels and cardiometabolic risk markers.ObjectiveTo evaluate the relationship of SUA with body adiposity, metabolic profile, oxidative stress, inflammatory biomarkers, blood pressure and endothelial function in healthy young and middle-aged adults.Methods149 Brazilian adults aged 20-55 years, both sexes, underwent evaluation of body adiposity, SUA, fasting glucose and insulin, lipid profile, malondialdehyde (MDA), high sensitivity C-reactive protein (hs-CRP), adiponectin, blood pressure and endothelial function. Endothelial function was assessed by the reactive hyperemia index (RHI) derived from peripheral arterial tonometry method. Participants were allocated in two groups according to SUA levels: control group (CG; n = 130; men ≤ 7 mg/dL, women ≤ 6 mg/dL) and hyperuricemia group (HG; n = 19; men > 7 mg/dL, women > 6 mg/dL). A P-value < 0.05 was considered statistically significant.ResultsAfter adjustment for confounders, participants in HG compared with those in CG displayed higher body mass index (BMI): 34.15(33.36-37.19) vs.31.80 (26.26-34.42) kg/m2,p = 0.008, higher MDA: 4.67(4.03-5.30) vs. 3.53(3.10-4.07) ng/mL, p < 0.0001 and lower RHI: 1.68 ± 0.30 vs. 2.05 ± 0.46, p = 0.03). In correlation analysis adjusted for confounders, SUA was positively associated (p < 0.05) with BMI, waist circumference, LDL-cholesterol, triglycerides and MDA, and negatively associated (p < 0.05) with HDL-cholesterol, adiponectin and RHI.ConclusionsThis study suggests that in healthy young and middle-aged adults higher SUA levels are associated with higher body adiposity, unfavorable lipid and inflammatory phenotype, higher oxidative stress and impaired endothelial function.

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Background: Obstructive sleep apnea (OSA) is considered an independent risk factor for cardiovascular disease. There is evidence that individuals with OSA may have increased levels of inflammatory mediators, altered metabolic profile and endothelial dysfunction. Objective: To evaluate the relation of OSA with endothelial function, anthropometric parameters, body composition, metabolic profile and blood pressure in obese individuals. Methods: Cross-sectional study involving 22 obese patients with body mass index >30 and < 40 kg/m 2 , aged between 24 and 54 years. The diagnosis of OSA was performed using the equipment Watch-PAT200 ® . Endothelial function by peripheral arterial tonometry method, using Endo-PAT 2000 ® . Results: After the evaluation of apnea hypopnea index (AHI), participants were allocated in two groups according to AHI: OSA group (OSAG; n=11; AHI = 18.4 ± 3.9) and control group (CG; n=11; AHI= 2.6 ± 0.3). The percentage of men in AOSG (82%, n = 9) was greater than in CG (36%, n = 4); p = 0.03. Both groups presented similar (p > 0.05) age (OSAG: 38.7 ± 1.9 vs. CG: 35.3 ± 3.3y), as well as body mass index (OSAG: 33.2 ± 0.8 vs. CG: 33.3 ± 0.7kg/m 2 ); % body fat (OSAG: 31.5 ± 1.15 vs. CG: 35.7 ± 0.7kg/m 2 ); and waist circumference (OSAG: 106.2 ± 2 vs. CG: 106.8 ± 2.9cm). Participants in OSAG presented higher values of neck circumference (42.3 ± 0.9 vs. 38.9 ± 1.2cm; P=0.03) and glucose (95.8 ± 3.5 vs. 82.5 ±3.1mg/dL; p=0.01). Subjects with and without OSA had similar levels (p>0,05) of total cholesterol (OSAG: 204.7 ± 10.5 vs. CG: 217.2 ± 13.3mg/dL), HDL-cholesterol (OSAG: 48.1 ± 5.3 vs. CG: 49.5 ± 2.9mg/dL), LDL-cholesterol (OSAG: 129.56± 9.5 vs. CG: 138,3 ± 12.1mg/dL), trigycerides (OSAG: 156.1 ± 24.5 vs. GC: 146.8 ± 19.5mg/dL) and diastolic BP (OSAG: 77.8 ± 2.5 vs. CG: 78.6 ± 2.1mmHg). Mean values of systolic BP presented a tendency to be higher in OSAG (127.4 ± 2.8 vs. 120.7±2mmHg; p=0.07). Endothelial function evaluated by reactive hyperemia index was similar in both groups (OSAG: 1.98 ± 0.14 vs. CG: 1.94 ± 0.14; p=0.86). Conclusions: The findings of the present study suggest that in obese subjects OSA occurs more frequently in men and is associated with higher values of neck circumference and of serum glucose.

Background: Obstructive sleep apnea (OSA) is considered an independent risk factor for cardiovascular disease and reported as the most common secondary cause of high blood pressure (BP) maintenance. Objective: To determine the prevalence of OSA and verify its association with endothelial function behavior and anthropometric parameters in patients with resistant hypertension (RHGroup) and BP controlled by medication (CHGroup). Methods: Cross-sectional study involving 40 hypertensive patients (20 in RHG and 20 in CHG), aged between 18 and 75 years. Endothelial function and OSA were assessed by peripheral arterial tonometry. BP was measured by oscillometric method on automatic device. Endothelial function was assessed by peripheral arterial tonometry (PAT) by EndoPAT2000 and the OSA diagnosis also through PAT, using the portable device WatchPAT200. Anthropometric evaluation was performed through measurements of waist (WaC), hip and neck circumference (NC), BMI, waist to height ratio (WHtR), and body composition assessed by BIA. Results: The prevalence of OSA in RHG was 85% (17 of 20)[apnea-hypopnea index = 12.39±1.89], and 80% (16 of 20) in CHG (AHI=20.74±4.69) and it was more frequent in men (93.7% [15 of 16] vs 75% [16 of 24]; p=0.0455, OR =3.86; 95% IC 0.99 to 5.09). Both groups presented similar anthropometric parameters values. Endothelial function evaluated by reactive hyperemia index was similar in both groups (RHG: 1.88±0.44 vs CHG: 2.03±0.43; p=0.47). Although we found differences in oxygen desaturation> 4% (RHG: 28.75 ± 5.08 vs CHG: 64.15 ± 16.97, p = 0.05), total sleep time (RHG: 307.2 ± 71.3 vs CHG: 323.3 ± 83.8 min) and minimum saturation (RHG: 87.8±3.8 vs CHG: 83.3±10.6%) was not different. In general, OSA was correlated with weight (r = 0.5135, p = 0.0007), BMI (r = 0.4146, p = 0.0078), WaC (r = 0, 4458, p = 0.005), NC (r = 0.3863, p = 0.01) and WHtR (r = 0.3907, p = 0.01) and independently associated with impairment of endothelial function (p = 0.0297, OR = 0.17, 95% CI 0.04 to 0.72). Conclusions: The findings of the present study show that the prevalence of OSA was similar in both groups and suggest that, in hypertensive subjects, OSA occurs more frequently in men, being associated with endothelial dysfunction and correlated positively with weight, BMI and WaC.

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