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29.05.2017 | Original Contributions | Ausgabe 12/2017

Obesity Surgery 12/2017

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

Zeitschrift:
Obesity Surgery > Ausgabe 12/2017
Autoren:
Audrey Auclair, Laurent Biertho, Simon Marceau, Frédéric-Simon Hould, Simon Biron, Stéfane Lebel, François Julien, Odette Lescelleur, Yves Lacasse, Marie-Eve Piché, Katherine Cianflone, Sebastian Demian Parlee, Kerry Goralski, Julie Martin, Marjorie Bastien, David H. St-Pierre, Paul Poirier
Wichtige Hinweise

Electronic supplementary material

The online version of this article (doi:10.​1007/​s11695-017-2737-z) contains supplementary material, which is available to authorized users.

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.

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ESM 1 (DOCX 29.8 kb)
11695_2017_2737_MOESM1_ESM.docx
Literatur
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