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Erschienen in: Obesity Surgery 9/2011

01.09.2011 | Clinical Research

Sleep Apnea Determines Soluble TNF-α Receptor 2 Response to Massive Weight Loss

verfasst von: Maria Pallayova, Kimberley E. Steele, Thomas H. Magnuson, Michael A. Schweitzer, Philip L. Smith, Susheel P. Patil, Shannon Bevans-Fonti, Vsevolod Y. Polotsky, Alan R. Schwartz

Erschienen in: Obesity Surgery | Ausgabe 9/2011

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Abstract

Background

The effects of surgical weight loss (WL) on inflammatory biomarkers associated with sleep apnea remain unknown. We sought to determine if any biomarkers can predict amelioration of sleep apnea achieved by bariatric surgery. We hypothesized that surgical WL would substantially reduce severity of sleep apnea and levels of proinflammatory cytokines.

Methods

Twenty-three morbidly obese adults underwent anthropometric measurements, polysomnography, and serum biomarker profiling prior to and 1 year following bariatric surgery. We examined the effect of WL and amelioration of sleep apnea on metabolic and inflammatory markers.

Results

Surgical WL resulted in significant decreases in BMI (16.7 ± 5.97 kg/m2/median 365 days), apnea–hypopnea index (AHI), CRP, IL-6, sTNFαR1, sTNFαR2, and leptin levels, while ghrelin, adiponectin, and soluble leptin receptor concentrations increased significantly. Utilizing an AHI cutoff of 15 events/h, we found significantly elevated levels of baseline sTNFαR2 and greater post-WL sTNFαR2 decreases in subjects with baseline AHI ≥15 events/h compared to those with AHI <15 events/h despite no significant differences in baseline BMI, age, and ΔBMI. In a multivariable linear regression model adjusting for sex, age, impaired glucose metabolism, ΔBMI, and follow-up period, the post-WL decreases in AHI were an independent predictor of the decreases in sTNFαR2 and altogether accounted for 46% of the variance of ΔsTNFαR2 (P = 0.011) in the entire cohort.

Conclusions

Of all the biomarkers, the decrease in sTNFαR2 was independently determined by the amelioration of sleep apnea achieved by bariatric surgery. The results suggest that sTNFαR2 may be a specific sleep apnea biomarker across a wide range of body weight.
Literatur
1.
Zurück zum Zitat McGinley BM, Schwartz AR, Schneider H, et al. Upper airway neuromuscular compensation during sleep is defective in obstructive sleep apnea. J Appl Physiol. 2008;105:197–205.PubMedCrossRef McGinley BM, Schwartz AR, Schneider H, et al. Upper airway neuromuscular compensation during sleep is defective in obstructive sleep apnea. J Appl Physiol. 2008;105:197–205.PubMedCrossRef
2.
Zurück zum Zitat Foster GE, Poulin MJ, Hanly PJ. Intermittent hypoxia and vascular function: implications for obstructive sleep apnoea. Exp Physiol. 2007;92:51–65.PubMedCrossRef Foster GE, Poulin MJ, Hanly PJ. Intermittent hypoxia and vascular function: implications for obstructive sleep apnoea. Exp Physiol. 2007;92:51–65.PubMedCrossRef
3.
Zurück zum Zitat Minoguchi K, Tazaki T, Yokoe T, et al. Elevated production of tumor necrosis factor-α by monocytes in patients with obstructive sleep apnea syndrome. Chest. 2004;126:1473–9.PubMedCrossRef Minoguchi K, Tazaki T, Yokoe T, et al. Elevated production of tumor necrosis factor-α by monocytes in patients with obstructive sleep apnea syndrome. Chest. 2004;126:1473–9.PubMedCrossRef
4.
Zurück zum Zitat Ciftci TU, Korturk O, Bukan N, et al. The relationship between serum cytokine levels with obesity and obstructive sleep apnea syndrome. Cytokine. 2004;28:87–91.PubMedCrossRef Ciftci TU, Korturk O, Bukan N, et al. The relationship between serum cytokine levels with obesity and obstructive sleep apnea syndrome. Cytokine. 2004;28:87–91.PubMedCrossRef
5.
Zurück zum Zitat Vgontzas AN, Papanicolaou DA, Bixler EO, et al. Elevation of plasma cytokines in disorders of excessive daytime sleepiness: role of sleep disturbance and obesity. J Clin Endocrinol Metab. 1997;82:1313–6.PubMedCrossRef Vgontzas AN, Papanicolaou DA, Bixler EO, et al. Elevation of plasma cytokines in disorders of excessive daytime sleepiness: role of sleep disturbance and obesity. J Clin Endocrinol Metab. 1997;82:1313–6.PubMedCrossRef
6.
Zurück zum Zitat Imagawa S, Yamaguchi Y, Ogawa K, et al. Interleukin-6 and tumor necrosis factor-alpha in patients with obstructive sleep apnea-hypopnea syndrome. Respiration. 2004;71:24–9.PubMedCrossRef Imagawa S, Yamaguchi Y, Ogawa K, et al. Interleukin-6 and tumor necrosis factor-alpha in patients with obstructive sleep apnea-hypopnea syndrome. Respiration. 2004;71:24–9.PubMedCrossRef
7.
Zurück zum Zitat Vgontzas AN, Zoumakis E, Bixler EO, et al. Selective effects of CPAP on sleep apnoea-associated manifestations. Eur J Clin Invest. 2008;38:585–95.PubMedCrossRef Vgontzas AN, Zoumakis E, Bixler EO, et al. Selective effects of CPAP on sleep apnoea-associated manifestations. Eur J Clin Invest. 2008;38:585–95.PubMedCrossRef
8.
Zurück zum Zitat Kohler M, Ayers L, Pepperell JC, et al. Effects of continuous positive airway pressure on systemic inflammation in patients with moderate to severe obstructive sleep apnoea: a randomised controlled trial. Thorax. 2009;64:67–73.PubMedCrossRef Kohler M, Ayers L, Pepperell JC, et al. Effects of continuous positive airway pressure on systemic inflammation in patients with moderate to severe obstructive sleep apnoea: a randomised controlled trial. Thorax. 2009;64:67–73.PubMedCrossRef
9.
Zurück zum Zitat Schiza SE, Mermigkis C, Panagiotis P, et al. C-reactive protein evolution in obstructive sleep apnoea patients under CPAP therapy. Eur J Clin Invest. 2010;40:968–75.PubMedCrossRef Schiza SE, Mermigkis C, Panagiotis P, et al. C-reactive protein evolution in obstructive sleep apnoea patients under CPAP therapy. Eur J Clin Invest. 2010;40:968–75.PubMedCrossRef
10.
Zurück zum Zitat Arias MA, Garcia-Rio F, Alonso-Fernandez A, et al. CPAP decreases plasma levels of soluble tumor necrosis factor-alpha receptor 1 in obstructive sleep apnoea. Eur Respir J. 2008;32:1009–15.PubMedCrossRef Arias MA, Garcia-Rio F, Alonso-Fernandez A, et al. CPAP decreases plasma levels of soluble tumor necrosis factor-alpha receptor 1 in obstructive sleep apnoea. Eur Respir J. 2008;32:1009–15.PubMedCrossRef
11.
Zurück zum Zitat Buchwald H, Avidor Y, Braunwald E, et al. Bariatric surgery: a systematic review and meta-analysis. JAMA. 2004;292:1724–37.PubMedCrossRef Buchwald H, Avidor Y, Braunwald E, et al. Bariatric surgery: a systematic review and meta-analysis. JAMA. 2004;292:1724–37.PubMedCrossRef
12.
Zurück zum Zitat Greenburg DL, Lettieri CJ, Eliasson AH. Effects of surgical weight loss on measures of obstructive sleep apnea: a meta-analysis. Am J Med. 2009;122:535–42.PubMedCrossRef Greenburg DL, Lettieri CJ, Eliasson AH. Effects of surgical weight loss on measures of obstructive sleep apnea: a meta-analysis. Am J Med. 2009;122:535–42.PubMedCrossRef
14.
Zurück zum Zitat Iber C, Ancoli-Israel S, Chesson A, et al for the American Academy of Sleep Medicine. The AASM Manual for the Scoring of Sleep and Associated Events: Rules, Terminology and Technical Specification. 1st ed.: Westchester, Illinois: American Academy of Sleep Medicine, 2007. Iber C, Ancoli-Israel S, Chesson A, et al for the American Academy of Sleep Medicine. The AASM Manual for the Scoring of Sleep and Associated Events: Rules, Terminology and Technical Specification. 1st ed.: Westchester, Illinois: American Academy of Sleep Medicine, 2007.
15.
Zurück zum Zitat American Academy of Sleep Medicine Task Force. Sleep-related breathing disorders in adults: recommendations for syndrome definition and measurement techniques in clinical research. The Report of an American Academy of Sleep Medicine Task Force. Sleep. 1999;22:667–89. American Academy of Sleep Medicine Task Force. Sleep-related breathing disorders in adults: recommendations for syndrome definition and measurement techniques in clinical research. The Report of an American Academy of Sleep Medicine Task Force. Sleep. 1999;22:667–89.
16.
Zurück zum Zitat American Sleep Disorders Association. Practice parameters for the indications for polysomnography and related procedures: polysomnography task force, American Sleep Disorders Association Standards of Practice Committee. Sleep. 1997;20:406–22. American Sleep Disorders Association. Practice parameters for the indications for polysomnography and related procedures: polysomnography task force, American Sleep Disorders Association Standards of Practice Committee. Sleep. 1997;20:406–22.
17.
Zurück zum Zitat The Expert Committee on the Diagnosis and Classification of Diabetes Mellitus. Follow-up report on the diagnosis of diabetes mellitus. Diab Care. 2003;26:3160–7.CrossRef The Expert Committee on the Diagnosis and Classification of Diabetes Mellitus. Follow-up report on the diagnosis of diabetes mellitus. Diab Care. 2003;26:3160–7.CrossRef
18.
Zurück zum Zitat Hohmann H-P, Brockhaus M, Bauerle PA, et al. Expression of the type A and B tumor necrosis factor (TNF) receptor is independently regulated, and both receptors mediate activation of the transcription factor NF-kB. J Biol Chem. 1990;265:22409–17.PubMed Hohmann H-P, Brockhaus M, Bauerle PA, et al. Expression of the type A and B tumor necrosis factor (TNF) receptor is independently regulated, and both receptors mediate activation of the transcription factor NF-kB. J Biol Chem. 1990;265:22409–17.PubMed
19.
Zurück zum Zitat Engelmann H, Novick D, Wallach D. Two tumor necrosis factor-binding proteins purified from human urine. Evidence for immunological cross-reactivity with cell surface tumor necrosis factor receptors. J Biol Chem. 1990;265:1531–6.PubMed Engelmann H, Novick D, Wallach D. Two tumor necrosis factor-binding proteins purified from human urine. Evidence for immunological cross-reactivity with cell surface tumor necrosis factor receptors. J Biol Chem. 1990;265:1531–6.PubMed
20.
Zurück zum Zitat Yue HJ, Mills PJ, Ancoli-Israel S, et al. The roles of TNF-alpha and the soluble TNF receptor I on sleep architecture in OSA. Sleep Breath. 2009;13:263–9.PubMedCrossRef Yue HJ, Mills PJ, Ancoli-Israel S, et al. The roles of TNF-alpha and the soluble TNF receptor I on sleep architecture in OSA. Sleep Breath. 2009;13:263–9.PubMedCrossRef
21.
Zurück zum Zitat Ronnemaa T, Pulkki K, Kaprio J. Serum soluble tumor necrosis factor-alpha receptor 2 is elevated in obesity but is not related to insulin sensitivity: a study in identical twins discordant for obesity. J Clin Endocrinol Metab. 2000;85:2728–32.PubMedCrossRef Ronnemaa T, Pulkki K, Kaprio J. Serum soluble tumor necrosis factor-alpha receptor 2 is elevated in obesity but is not related to insulin sensitivity: a study in identical twins discordant for obesity. J Clin Endocrinol Metab. 2000;85:2728–32.PubMedCrossRef
22.
Zurück zum Zitat Benjafield AV, Wang XL, Morris BJ. Tumor necrosis factor receptor 2 gene (TNFRSF1B) in genetic basis of coronary artery disease. J Mol Med. 2001;79:109–15.PubMedCrossRef Benjafield AV, Wang XL, Morris BJ. Tumor necrosis factor receptor 2 gene (TNFRSF1B) in genetic basis of coronary artery disease. J Mol Med. 2001;79:109–15.PubMedCrossRef
23.
Zurück zum Zitat Bulló M, Garcia-Lorda P, Salas-Salvadó J. Plasma soluble tumor necrosis factor alpha receptors and leptin levels in normal-weight and obese women: effect of adiposity and diabetes. Eur J Endocrinol. 2002;146:325–31.PubMedCrossRef Bulló M, Garcia-Lorda P, Salas-Salvadó J. Plasma soluble tumor necrosis factor alpha receptors and leptin levels in normal-weight and obese women: effect of adiposity and diabetes. Eur J Endocrinol. 2002;146:325–31.PubMedCrossRef
24.
Zurück zum Zitat Vanden Berghe W, Vermeulen L, De Wilde G, et al. Signal transduction by tumor necrosis factor and gene regulation of the inflammatory cytokine interleukin-6. Biochem Pharmacol. 2000;60:1185–95.CrossRef Vanden Berghe W, Vermeulen L, De Wilde G, et al. Signal transduction by tumor necrosis factor and gene regulation of the inflammatory cytokine interleukin-6. Biochem Pharmacol. 2000;60:1185–95.CrossRef
25.
Zurück zum Zitat Ammit AJ, Lazaar AL, Irani C, et al. Tumor necrosis factor-alpha-induced secretion of RANTES and interleukin-6 from human airway smooth muscle cells: modulation by glucocorticoids and beta-agonists. Am J Respir Cell Mol Biol. 2002;26:465–74.PubMed Ammit AJ, Lazaar AL, Irani C, et al. Tumor necrosis factor-alpha-induced secretion of RANTES and interleukin-6 from human airway smooth muscle cells: modulation by glucocorticoids and beta-agonists. Am J Respir Cell Mol Biol. 2002;26:465–74.PubMed
26.
Zurück zum Zitat Bruun JM, Pedersen SB, Kristensen K, et al. Opposite regulation of interleukin-8 and tumor necrosis factor-alpha by weight loss. Obes Res. 2002;10:499–506.PubMedCrossRef Bruun JM, Pedersen SB, Kristensen K, et al. Opposite regulation of interleukin-8 and tumor necrosis factor-alpha by weight loss. Obes Res. 2002;10:499–506.PubMedCrossRef
27.
Zurück zum Zitat Baggiolini M, Loetscher P, Moser B. Interleukin-8 and the chemokine family. Int J Immunopharmacol. 1995;17:103–8.PubMedCrossRef Baggiolini M, Loetscher P, Moser B. Interleukin-8 and the chemokine family. Int J Immunopharmacol. 1995;17:103–8.PubMedCrossRef
28.
Zurück zum Zitat Willi SM, Oexmann MJ, Wright NM, et al. The effects of a high-protein, low-fat, ketogenic diet on adolescents with morbid obesity: body composition, blood chemistries, and sleep abnormalities. Pediatrics. 1998;101:61–7.PubMedCrossRef Willi SM, Oexmann MJ, Wright NM, et al. The effects of a high-protein, low-fat, ketogenic diet on adolescents with morbid obesity: body composition, blood chemistries, and sleep abnormalities. Pediatrics. 1998;101:61–7.PubMedCrossRef
29.
Zurück zum Zitat Sinton CM, Fitch T, Gershenfeld HK. The effect of leptin on REM sleep and slow wave delta in rats are reversed by food deprivation. J Sleep Res. 1999;8:197–203.PubMedCrossRef Sinton CM, Fitch T, Gershenfeld HK. The effect of leptin on REM sleep and slow wave delta in rats are reversed by food deprivation. J Sleep Res. 1999;8:197–203.PubMedCrossRef
Metadaten
Titel
Sleep Apnea Determines Soluble TNF-α Receptor 2 Response to Massive Weight Loss
verfasst von
Maria Pallayova
Kimberley E. Steele
Thomas H. Magnuson
Michael A. Schweitzer
Philip L. Smith
Susheel P. Patil
Shannon Bevans-Fonti
Vsevolod Y. Polotsky
Alan R. Schwartz
Publikationsdatum
01.09.2011
Verlag
Springer-Verlag
Erschienen in
Obesity Surgery / Ausgabe 9/2011
Print ISSN: 0960-8923
Elektronische ISSN: 1708-0428
DOI
https://doi.org/10.1007/s11695-011-0359-4

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