Beneficial effects of a lifestyle intervention program on C-reactive protein: impact of cardiorespiratory fitness in obese adolescents with sleep disturbances

Abstract

The objectives of this study were to assess the relationship between inflammation and obstructive sleep apnea (OSA) and determine whether the lifestyle program’s effects on inflammatory markers are associated with changes in anthropometric parameters, cardiorespiratory fitness, sleep duration, and OSA severity in severely obese adolescents. Participants were aged 14.6 (SD 1.2) yr, with a body mass index (BMI) of 40.2 (SD 6.5) kg/m2. Sleep, anthropometric parameters, glucose metabolism, inflammatory profile, and cardiorespiratory fitness [V̇o2peakrelative to body weight (V̇o2peakBW) and fat-free mass (V̇o2peakFFM)] were assessed at admission and at the end of a 9-mo lifestyle intervention program (LIP). Associations between C-reactive protein (CRP) concentrations and BMI, sex, oxygen desaturation index (ODI), sleep fragmentation, total sleep time (TST), and V̇o2peakwere assessed via ANCOVA. Twenty-three subjects completed the study. OSA subjects ( n = 13) exhibited higher CRP concentrations and a trend for higher BMI than non-OSA subjects ( P = 0.09) at admission. After intervention, OSA was normalized in six subjects, and CRP significantly decreased in the OSA group and in the whole population. In both groups, leptin levels significantly decreased, whereas adiponectin concentrations increased. At admission, BMI adjusted for sex, arousal index, ODI, TST, and V̇o2peakBWwas associated with CRP levels (adjusted r2 = 0.32, P < 0.05). The decrease in CRP concentrations postintervention was associated with enhanced V̇o2peakFFMadjusted for sex, weight loss, and changed sleep parameters (adjusted r2 = 0.75, P < 0.05). Despite higher amounts of CRP in OSA subjects, obesity severity outweighs the proinflammatory effects of OSA, short sleep duration, and low cardiorespiratory fitness. However, enhanced cardiorespiratory fitness is associated with the decrease of inflammation after controlling for the same parameters.

Inflammatory Mediators and Type 2 Diabetes Risk Factors before and in Response to Lifestyle Intervention among Latino Adolescents with Obesity

“…Quasi-experimental lifestyle intervention studies have demonstrated significant increases in adiponectin [32][33][34]71,72], reductions in IL-6 [73], no changes in IL-10 [74,75], and conflicting results on TNF-α [62,74,75]. Two RCTs failed to support treatment effects on total adiponectin in response to lifestyle intervention compared to control groups, despite significant reductions in weight, adiposity, and C-reactive protein (established marker of systemic inflammation) and increases in insulin sensitivity [76,77].…”

Comparison between type A and type B early adiposity rebound in predicting overweight and obesity in children: a longitudinal study

“…The prevalence of paediatric overweight and obesity remains alarming worldwide (15) , accompanied by early metabolic (24) , sleep (25,26) and functional (27) impairments, amongst others, calling for effective preventive and treatment strategies.…”

Appetite Control Might not Be Improved after Weight Loss in Adolescents with Obesity, Despite Non-Persistent Metabolic Syndrome

“…The present work also certainly lacks the evaluation of some physiological factors that are implicated in the control of appetite. Indeed, it would have been interesting to also evaluate the evolution of the ghrelin and leptin levels, for instance, particularly since their respectively increase [ 28 ] and decrease [ 29 ] in response to similar weight loss interventions in adolescents with obesity could partly explain our results.…”