Bariatric Surgery-Induced Resolution of Hypertension and Obstructive Sleep Apnea: Impact of Modulation of Body Fat, Ectopic Fat, Autonomic Nervous Activity, Inflammatory and Adipokine Profiles
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...
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| Veröffentlicht in: | Obesity surgery 2017-12, Vol.27 (12), p.3156-3164 |
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| creator | Auclair, Audrey Biertho, Laurent Marceau, Simon Hould, Frédéric-Simon Biron, Simon Lebel, Stéfane Julien, François Lescelleur, Odette Lacasse, Yves Piché, Marie-Eve Cianflone, Katherine Parlee, Sebastian Demian Goralski, Kerry Martin, Julie Bastien, Marjorie St-Pierre, David H. Poirier, Paul |
| description | 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 cm
2
vs. −274.5 ± 29.0 cm
2
;
p
= 0.001) in contrast to a trend for lower abdominal subcutaneous adipose tissue reduction in patients with unresolved OSA (−247.7 ± 91.5 cm
2
vs. −390.5 ± 109.1 cm
2
;
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. |
| doi_str_mv | 10.1007/s11695-017-2737-z |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1903941594</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>1903941594</sourcerecordid><originalsourceid>FETCH-LOGICAL-c372t-bb3456e14721f6f67744306fe5d150357b836a85f39a6d793b913118f0e81ebd3</originalsourceid><addsrcrecordid>eNp1kc1u1TAUhC0EopfCA7BBltiwaMA_cZywu61aeqVCEYV15MTHyCWxg-1USp-OR8PpbRFCYmWN_M3MkQahl5S8pYTId5HSqhEFobJgksvi9hHaUEnqgpSsfow2pKlIUTeMH6BnMV4TwmjF2FN0wGohREnqDfp1rIJVKdgeX83hO4Sl2Dk996DxF4h-mJP1DnuDz5cJQgIXV62cxpddTGHuk70BfDUATHg7OVDv8W6cVJ9Wz0ev50E9JBx7veAzlY7waZ_8lBvvxHZO3vkxy08Qbvwc8XYNtWk5wjtnBjWOKvmw3JVutZ38D-sAfw7e2AHic_TEqCHCi_v3EH07O_16cl5cXH7YnWwvip5Lloqu46WogJaSUVOZSsqy5KQyIDQVhAvZ1bxStTC8UZWWDe8ayimtDYGaQqf5IXqzz52C_zlDTO1oYw_DoBzko1vaEN6UVDRlRl__g177Obh8XaYkYaQs2UrRPdUHH2MA007BjiosLSXtOm-7n7fN87brvO1t9ry6T567EfQfx8OeGWB7IOYvl-f8q_q_qb8BOhqycg</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1970204424</pqid></control><display><type>article</type><title>Bariatric Surgery-Induced Resolution of Hypertension and Obstructive Sleep Apnea: Impact of Modulation of Body Fat, Ectopic Fat, Autonomic Nervous Activity, Inflammatory and Adipokine Profiles</title><source>MEDLINE</source><source>SpringerNature Journals</source><creator>Auclair, Audrey ; Biertho, Laurent ; Marceau, Simon ; Hould, Frédéric-Simon ; Biron, Simon ; Lebel, Stéfane ; Julien, François ; Lescelleur, Odette ; Lacasse, Yves ; Piché, Marie-Eve ; Cianflone, Katherine ; Parlee, Sebastian Demian ; Goralski, Kerry ; Martin, Julie ; Bastien, Marjorie ; St-Pierre, David H. ; Poirier, Paul</creator><creatorcontrib>Auclair, Audrey ; Biertho, Laurent ; Marceau, Simon ; Hould, Frédéric-Simon ; Biron, Simon ; Lebel, Stéfane ; Julien, François ; Lescelleur, Odette ; Lacasse, Yves ; Piché, Marie-Eve ; Cianflone, Katherine ; Parlee, Sebastian Demian ; Goralski, Kerry ; Martin, Julie ; Bastien, Marjorie ; St-Pierre, David H. ; Poirier, Paul</creatorcontrib><description>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 cm
2
vs. −274.5 ± 29.0 cm
2
;
p
= 0.001) in contrast to a trend for lower abdominal subcutaneous adipose tissue reduction in patients with unresolved OSA (−247.7 ± 91.5 cm
2
vs. −390.5 ± 109.1 cm
2
;
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.</description><identifier>ISSN: 0960-8923</identifier><identifier>EISSN: 1708-0428</identifier><identifier>DOI: 10.1007/s11695-017-2737-z</identifier><identifier>PMID: 28555408</identifier><language>eng</language><publisher>New York: Springer US</publisher><subject>Adipokines - blood ; Adipose Tissue - metabolism ; Adipose Tissue - pathology ; Adipose Tissue - surgery ; Adiposity - physiology ; Adolescent ; Adult ; Aged ; Autonomic Nervous System - physiopathology ; Bariatric Surgery - methods ; Biliopancreatic Diversion ; Biomarkers - blood ; Female ; Follow-Up Studies ; Gastrointestinal surgery ; Humans ; Hypertension ; Hypertension - complications ; Hypertension - physiopathology ; Hypertension - surgery ; Inflammation Mediators - blood ; Intra-Abdominal Fat - metabolism ; Intra-Abdominal Fat - pathology ; Male ; Medicine ; Medicine & Public Health ; Metabolome ; Middle Aged ; Obesity ; Obesity, Morbid - complications ; Obesity, Morbid - metabolism ; Obesity, Morbid - physiopathology ; Obesity, Morbid - surgery ; Original Contributions ; Polysomnography ; Remission Induction ; Sleep apnea ; Sleep Apnea, Obstructive - complications ; Sleep Apnea, Obstructive - physiopathology ; Sleep Apnea, Obstructive - surgery ; Surgery ; Surgical outcomes ; Young Adult</subject><ispartof>Obesity surgery, 2017-12, Vol.27 (12), p.3156-3164</ispartof><rights>Springer Science+Business Media New York 2017</rights><rights>Obesity Surgery is a copyright of Springer, (2017). All Rights Reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c372t-bb3456e14721f6f67744306fe5d150357b836a85f39a6d793b913118f0e81ebd3</citedby><cites>FETCH-LOGICAL-c372t-bb3456e14721f6f67744306fe5d150357b836a85f39a6d793b913118f0e81ebd3</cites><orcidid>0000-0002-5395-3273</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s11695-017-2737-z$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s11695-017-2737-z$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>315,781,785,27929,27930,41493,42562,51324</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/28555408$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Auclair, Audrey</creatorcontrib><creatorcontrib>Biertho, Laurent</creatorcontrib><creatorcontrib>Marceau, Simon</creatorcontrib><creatorcontrib>Hould, Frédéric-Simon</creatorcontrib><creatorcontrib>Biron, Simon</creatorcontrib><creatorcontrib>Lebel, Stéfane</creatorcontrib><creatorcontrib>Julien, François</creatorcontrib><creatorcontrib>Lescelleur, Odette</creatorcontrib><creatorcontrib>Lacasse, Yves</creatorcontrib><creatorcontrib>Piché, Marie-Eve</creatorcontrib><creatorcontrib>Cianflone, Katherine</creatorcontrib><creatorcontrib>Parlee, Sebastian Demian</creatorcontrib><creatorcontrib>Goralski, Kerry</creatorcontrib><creatorcontrib>Martin, Julie</creatorcontrib><creatorcontrib>Bastien, Marjorie</creatorcontrib><creatorcontrib>St-Pierre, David H.</creatorcontrib><creatorcontrib>Poirier, Paul</creatorcontrib><title>Bariatric Surgery-Induced Resolution of Hypertension and Obstructive Sleep Apnea: Impact of Modulation of Body Fat, Ectopic Fat, Autonomic Nervous Activity, Inflammatory and Adipokine Profiles</title><title>Obesity surgery</title><addtitle>OBES SURG</addtitle><addtitle>Obes Surg</addtitle><description>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 cm
2
vs. −274.5 ± 29.0 cm
2
;
p
= 0.001) in contrast to a trend for lower abdominal subcutaneous adipose tissue reduction in patients with unresolved OSA (−247.7 ± 91.5 cm
2
vs. −390.5 ± 109.1 cm
2
;
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.</description><subject>Adipokines - blood</subject><subject>Adipose Tissue - metabolism</subject><subject>Adipose Tissue - pathology</subject><subject>Adipose Tissue - surgery</subject><subject>Adiposity - physiology</subject><subject>Adolescent</subject><subject>Adult</subject><subject>Aged</subject><subject>Autonomic Nervous System - physiopathology</subject><subject>Bariatric Surgery - methods</subject><subject>Biliopancreatic Diversion</subject><subject>Biomarkers - blood</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Gastrointestinal surgery</subject><subject>Humans</subject><subject>Hypertension</subject><subject>Hypertension - complications</subject><subject>Hypertension - physiopathology</subject><subject>Hypertension - surgery</subject><subject>Inflammation Mediators - blood</subject><subject>Intra-Abdominal Fat - metabolism</subject><subject>Intra-Abdominal Fat - pathology</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Metabolome</subject><subject>Middle Aged</subject><subject>Obesity</subject><subject>Obesity, Morbid - complications</subject><subject>Obesity, Morbid - metabolism</subject><subject>Obesity, Morbid - physiopathology</subject><subject>Obesity, Morbid - surgery</subject><subject>Original Contributions</subject><subject>Polysomnography</subject><subject>Remission Induction</subject><subject>Sleep apnea</subject><subject>Sleep Apnea, Obstructive - complications</subject><subject>Sleep Apnea, Obstructive - physiopathology</subject><subject>Sleep Apnea, Obstructive - surgery</subject><subject>Surgery</subject><subject>Surgical outcomes</subject><subject>Young Adult</subject><issn>0960-8923</issn><issn>1708-0428</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNp1kc1u1TAUhC0EopfCA7BBltiwaMA_cZywu61aeqVCEYV15MTHyCWxg-1USp-OR8PpbRFCYmWN_M3MkQahl5S8pYTId5HSqhEFobJgksvi9hHaUEnqgpSsfow2pKlIUTeMH6BnMV4TwmjF2FN0wGohREnqDfp1rIJVKdgeX83hO4Sl2Dk996DxF4h-mJP1DnuDz5cJQgIXV62cxpddTGHuk70BfDUATHg7OVDv8W6cVJ9Wz0ev50E9JBx7veAzlY7waZ_8lBvvxHZO3vkxy08Qbvwc8XYNtWk5wjtnBjWOKvmw3JVutZ38D-sAfw7e2AHic_TEqCHCi_v3EH07O_16cl5cXH7YnWwvip5Lloqu46WogJaSUVOZSsqy5KQyIDQVhAvZ1bxStTC8UZWWDe8ayimtDYGaQqf5IXqzz52C_zlDTO1oYw_DoBzko1vaEN6UVDRlRl__g177Obh8XaYkYaQs2UrRPdUHH2MA007BjiosLSXtOm-7n7fN87brvO1t9ry6T567EfQfx8OeGWB7IOYvl-f8q_q_qb8BOhqycg</recordid><startdate>20171201</startdate><enddate>20171201</enddate><creator>Auclair, Audrey</creator><creator>Biertho, Laurent</creator><creator>Marceau, Simon</creator><creator>Hould, Frédéric-Simon</creator><creator>Biron, Simon</creator><creator>Lebel, Stéfane</creator><creator>Julien, François</creator><creator>Lescelleur, Odette</creator><creator>Lacasse, Yves</creator><creator>Piché, Marie-Eve</creator><creator>Cianflone, Katherine</creator><creator>Parlee, Sebastian Demian</creator><creator>Goralski, Kerry</creator><creator>Martin, Julie</creator><creator>Bastien, Marjorie</creator><creator>St-Pierre, David H.</creator><creator>Poirier, Paul</creator><general>Springer US</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8C1</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-5395-3273</orcidid></search><sort><creationdate>20171201</creationdate><title>Bariatric Surgery-Induced Resolution of Hypertension and Obstructive Sleep Apnea: Impact of Modulation of Body Fat, Ectopic Fat, Autonomic Nervous Activity, Inflammatory and Adipokine Profiles</title><author>Auclair, Audrey ; Biertho, Laurent ; Marceau, Simon ; Hould, Frédéric-Simon ; Biron, Simon ; Lebel, Stéfane ; Julien, François ; Lescelleur, Odette ; Lacasse, Yves ; Piché, Marie-Eve ; Cianflone, Katherine ; Parlee, Sebastian Demian ; Goralski, Kerry ; Martin, Julie ; Bastien, Marjorie ; St-Pierre, David H. ; Poirier, Paul</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c372t-bb3456e14721f6f67744306fe5d150357b836a85f39a6d793b913118f0e81ebd3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><topic>Adipokines - blood</topic><topic>Adipose Tissue - metabolism</topic><topic>Adipose Tissue - pathology</topic><topic>Adipose Tissue - surgery</topic><topic>Adiposity - physiology</topic><topic>Adolescent</topic><topic>Adult</topic><topic>Aged</topic><topic>Autonomic Nervous System - physiopathology</topic><topic>Bariatric Surgery - methods</topic><topic>Biliopancreatic Diversion</topic><topic>Biomarkers - blood</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Gastrointestinal surgery</topic><topic>Humans</topic><topic>Hypertension</topic><topic>Hypertension - complications</topic><topic>Hypertension - physiopathology</topic><topic>Hypertension - surgery</topic><topic>Inflammation Mediators - blood</topic><topic>Intra-Abdominal Fat - metabolism</topic><topic>Intra-Abdominal Fat - pathology</topic><topic>Male</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Metabolome</topic><topic>Middle Aged</topic><topic>Obesity</topic><topic>Obesity, Morbid - complications</topic><topic>Obesity, Morbid - metabolism</topic><topic>Obesity, Morbid - physiopathology</topic><topic>Obesity, Morbid - surgery</topic><topic>Original Contributions</topic><topic>Polysomnography</topic><topic>Remission Induction</topic><topic>Sleep apnea</topic><topic>Sleep Apnea, Obstructive - complications</topic><topic>Sleep Apnea, Obstructive - physiopathology</topic><topic>Sleep Apnea, Obstructive - surgery</topic><topic>Surgery</topic><topic>Surgical outcomes</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Auclair, Audrey</creatorcontrib><creatorcontrib>Biertho, Laurent</creatorcontrib><creatorcontrib>Marceau, Simon</creatorcontrib><creatorcontrib>Hould, Frédéric-Simon</creatorcontrib><creatorcontrib>Biron, Simon</creatorcontrib><creatorcontrib>Lebel, Stéfane</creatorcontrib><creatorcontrib>Julien, François</creatorcontrib><creatorcontrib>Lescelleur, Odette</creatorcontrib><creatorcontrib>Lacasse, Yves</creatorcontrib><creatorcontrib>Piché, Marie-Eve</creatorcontrib><creatorcontrib>Cianflone, Katherine</creatorcontrib><creatorcontrib>Parlee, Sebastian Demian</creatorcontrib><creatorcontrib>Goralski, Kerry</creatorcontrib><creatorcontrib>Martin, Julie</creatorcontrib><creatorcontrib>Bastien, Marjorie</creatorcontrib><creatorcontrib>St-Pierre, David H.</creatorcontrib><creatorcontrib>Poirier, Paul</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Public Health Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><jtitle>Obesity surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Auclair, Audrey</au><au>Biertho, Laurent</au><au>Marceau, Simon</au><au>Hould, Frédéric-Simon</au><au>Biron, Simon</au><au>Lebel, Stéfane</au><au>Julien, François</au><au>Lescelleur, Odette</au><au>Lacasse, Yves</au><au>Piché, Marie-Eve</au><au>Cianflone, Katherine</au><au>Parlee, Sebastian Demian</au><au>Goralski, Kerry</au><au>Martin, Julie</au><au>Bastien, Marjorie</au><au>St-Pierre, David H.</au><au>Poirier, Paul</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Bariatric Surgery-Induced Resolution of Hypertension and Obstructive Sleep Apnea: Impact of Modulation of Body Fat, Ectopic Fat, Autonomic Nervous Activity, Inflammatory and Adipokine Profiles</atitle><jtitle>Obesity surgery</jtitle><stitle>OBES SURG</stitle><addtitle>Obes Surg</addtitle><date>2017-12-01</date><risdate>2017</risdate><volume>27</volume><issue>12</issue><spage>3156</spage><epage>3164</epage><pages>3156-3164</pages><issn>0960-8923</issn><eissn>1708-0428</eissn><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 cm
2
vs. −274.5 ± 29.0 cm
2
;
p
= 0.001) in contrast to a trend for lower abdominal subcutaneous adipose tissue reduction in patients with unresolved OSA (−247.7 ± 91.5 cm
2
vs. −390.5 ± 109.1 cm
2
;
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.</abstract><cop>New York</cop><pub>Springer US</pub><pmid>28555408</pmid><doi>10.1007/s11695-017-2737-z</doi><tpages>9</tpages><orcidid>https://orcid.org/0000-0002-5395-3273</orcidid></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0960-8923 |
| ispartof | Obesity surgery, 2017-12, Vol.27 (12), p.3156-3164 |
| issn | 0960-8923 1708-0428 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_1903941594 |
| source | MEDLINE; SpringerNature Journals |
| subjects | Adipokines - blood Adipose Tissue - metabolism Adipose Tissue - pathology Adipose Tissue - surgery Adiposity - physiology Adolescent Adult Aged Autonomic Nervous System - physiopathology Bariatric Surgery - methods Biliopancreatic Diversion Biomarkers - blood Female Follow-Up Studies Gastrointestinal surgery Humans Hypertension Hypertension - complications Hypertension - physiopathology Hypertension - surgery Inflammation Mediators - blood Intra-Abdominal Fat - metabolism Intra-Abdominal Fat - pathology Male Medicine Medicine & Public Health Metabolome Middle Aged Obesity Obesity, Morbid - complications Obesity, Morbid - metabolism Obesity, Morbid - physiopathology Obesity, Morbid - surgery Original Contributions Polysomnography Remission Induction Sleep apnea Sleep Apnea, Obstructive - complications Sleep Apnea, Obstructive - physiopathology Sleep Apnea, Obstructive - surgery Surgery Surgical outcomes Young Adult |
| title | Bariatric Surgery-Induced Resolution of Hypertension and Obstructive Sleep Apnea: Impact of Modulation of Body Fat, Ectopic Fat, Autonomic Nervous Activity, Inflammatory and Adipokine Profiles |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2024-12-12T21%3A40%3A19IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Bariatric%20Surgery-Induced%20Resolution%20of%20Hypertension%20and%20Obstructive%20Sleep%20Apnea:%20Impact%20of%20Modulation%20of%20Body%20Fat,%20Ectopic%20Fat,%20Autonomic%20Nervous%20Activity,%20Inflammatory%20and%20Adipokine%20Profiles&rft.jtitle=Obesity%20surgery&rft.au=Auclair,%20Audrey&rft.date=2017-12-01&rft.volume=27&rft.issue=12&rft.spage=3156&rft.epage=3164&rft.pages=3156-3164&rft.issn=0960-8923&rft.eissn=1708-0428&rft_id=info:doi/10.1007/s11695-017-2737-z&rft_dat=%3Cproquest_cross%3E1903941594%3C/proquest_cross%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=1970204424&rft_id=info:pmid/28555408&rfr_iscdi=true |