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Metabolic/inflammatory markers and sympatho-vagal balance in patients with metabolic syndrome and obstructive sleep apnea: effect of hypocaloric diet and exercise training

Grant number: 16/16831-7
Support Opportunities:Scholarships abroad - Research Internship - Doctorate
Effective date (Start): January 16, 2017
Effective date (End): January 15, 2018
Field of knowledge:Biological Sciences - Physiology - General Physiology
Principal Investigator:Ivani Credidio Trombetta
Grantee:Felipe Xerez Cepêda Fonseca
Supervisor: John Andrew Taylor
Host Institution: Instituto do Coração Professor Euryclides de Jesus Zerbini (INCOR). Hospital das Clínicas da Faculdade de Medicina da USP (HCFMUSP). Secretaria da Saúde (São Paulo - Estado). São Paulo , SP, Brazil
Research place: Harvard University, Boston, United States  
Associated to the scholarship:15/03274-0 - Diet and exercise improves metabolic, inflammatory changes and sympathovagal balance in patients with metabolic syndrome and obstructive sleep apnea, BP.DR

Abstract

Background. Patients with metabolic syndrome (MetS) frequently have the co-morbid obstructive sleep apnea (OSA). Recent studies have shown that the prevalence of OSA in MetS patients is about 60%. In MetS, the overlap of OSA exacerbates muscle sympathetic nerve activity (MSNA) and impairs sympathovagal balance. However, the mechanisms and its integration are not completely understood. Metabolic and inflammatory alterations can be candidates to explain, at least in part, these impairments. Moreover, it is not known the effect of hypocaloric diet and exercise training (D+ET) on the inflammation markers, on MSNA and on sympathovagal balance in patients with MetS associated or not with OSA.Objectives. We will investigate: 1) Whether the overlap of OSA in MetS has an additive effect on metabolic and inflammatory alterations; 2) The association among these alterations and sympathovagal balance; and 3) The effect of D+ET on MetS risk factors, severity of OSA, and inflammatory and metabolic markers and these association with MSNA and sympathovagal balance in patients with MetS associated or not with OSA. Main Outcomes. In patients with MetS associated or without OSA: 1) Clarify the influence of metabolic and inflammatory alterations over the sympathovagal balance; and 2) The effect of D+TF in decreasing risk factors for MetS, severity of OSA, MSNA, sympathovagal balance, and their possible association with the improvement of metabolic and inflammatory markers, especially in patients with OSA.Proposal. Patients have been recruited and evaluated in Brazil. Up to now, Felipe had evaluated for pre and post intervention, about 80% of total sample size. In short, all data collected from the evaluations (microneurography, beat-by-beat heart rate and blood pressure) will be analyzed in association and under supervision and expertise of Dr. Taylor. (AU)

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Scientific publications (12)
(References retrieved automatically from Web of Science and SciELO through information on FAPESP grants and their corresponding numbers as mentioned in the publications by the authors)
IVANI CREDIDIO TROMBETTA; JOSÉ ROBERTO DEMOURA; CLEBER RENE ALVES; RENATO CARBONARI-BRITO; FELIPE XEREZ CEPEDA; JOSÉ RIBEIRO LEMOS JR. Níveis Séricos do BDNF na Proteção Cardiovascular e em Resposta ao Exercício. Arquivos Brasileiros de Cardiologia, v. 115, n. 2, p. 263-269, . (15/03274-0, 16/16831-7)
BERGER, MATHIEU; KLINE, CHRISTOPHER E.; CEPEDA, FELIPE X.; RIZZI, CAMILA F.; CHAPELLE, CELINE; LAPORTE, SILVY; HUPIN, DAVID; RAFFIN, JEREMY; COSTES, FREDERIC; HARGENS, TRENT A.; et al. Does obstructive sleep apnea affect exercise capacity and the hemodynamic response to exercise? An individual patient data and aggregate meta-analysis. SLEEP MEDICINE REVIEWS, v. 45, p. 42-53, . (16/16831-7)
DUTRA-MARQUES, AKOTHIRENE C.; RODRIGUES, SARA; CEPEDA, FELIPE X.; TOSCHI-DIAS, EDGAR; RONDON, EDUARDO; CARVALHO, JEFFERSON C.; ALVES, MARIA JANIEIRE N. N.; BRAGA, ANA MARIA F. W.; RONDON, MARIA URBANA P. B.; TROMBETTA, IVANI C.. Exaggerated Exercise Blood Pressure as a Marker of Baroreflex Dysfunction in Normotensive Metabolic Syndrome Patients. FRONTIERS IN NEUROSCIENCE, v. 15, . (16/16831-7, 11/17533-6, 15/03274-0, 13/07651-7)
VIVODTZEV, ISABELLE; PICARD, GLEN; CEPEDA, FELIPE X.; TAYLOR, J. ANDREW. Acute Ventilatory Support During Whole-Body Hybrid Rowing in Patients With High-Level Spinal Cord Injury A Randomized Controlled Crossover Trial. CHEST, v. 157, n. 5, p. 1230-1240, . (16/16831-7)
ALMEIDA, GERMANA P. L.; TROMBETTA, IVANI C.; CEPEDA, FELIPE X.; HATANAKA, ELAINE; CURI, RUI; MOSTARDA, CRISTIANO; IRIGOYEN, MARIA C.; BARRETO-FILHO, JOSE A. S.; KRIEGER, EDUARDO M.; CONSOLIM-COLOMBO, FERNANDA M.. The Role of Acute Intermittent Hypoxia in Neutrophil-Generated Superoxide, Sympathovagal Balance, and Vascular Functionin Healthy Subjects. FRONTIERS IN PHYSIOLOGY, v. 8, . (10/02963-2, 16/16831-7)
CEPEDA, FELIPE X.; LAPOINTE, MATTHEW; TAN, CAN OZAN; TAYLOR, J. ANDREW. Inconsistent relation of nonlinear heart rate variability indices to increasing vagal tone in healthy humans. AUTONOMIC NEUROSCIENCE-BASIC & CLINICAL, v. 213, p. 1-7, . (16/16831-7)
TOSCHI-DIAS, EDGAR; TROMBETTA, IVANI C.; SILVA, VALDO J. D.; MAKI-NUNES, CRISTIANE; CEPEDA, FELIPE X.; ALVES, MARIA JANIEIRE N. N.; CARVALHO, GLAUCE L.; DRAGER, LUCIANO F.; LORENZI-FILHO, GERALDO; NEGRAO, CARLOS E.; et al. Diet associated with exercise improves baroreflex control of sympathetic nerve activity in metabolic syndrome and sleep apnea patients. Sleep and Breathing, v. 23, n. 1, p. 143-151, . (08/03714-6, 12/02953-2, 16/16831-7, 13/07651-7, 11/17533-6, 10/50048-1)
CEPEDA, FELIPE X.; RODRIGUES, SARA; DUTRA-MARQUES, AKOTHIRENE C. B.; CARVALHO, JEFFERSON C.; TOSCHI-DIAS, EDGAR; RONDON, MARIA URBANA P. B.; ALVES, MARIA JANIEIRE N. N.; LORENZI-FILHO, GERALDO; TROMBETTA, IVANI C.. Diet and Exercise Training Improve Insulin-Glucose Metabolism and Sympathetic Hyperactivation in Obstructive Sleep Apnea and Metabolic Syndrome. FASEB JOURNAL, v. 31, p. 1-pg., . (11/17533-6, 16/16831-7)
CEPEDA, FELIPE XEREZ; RODRIGUES, SARA; DUTRA-MARQUES, AKOTHIRENE C. B.; TOSCHI-DIAS, EDGAR; CARVALHO, JEFFERSON C.; CARVALHO, GLAUCE L.; RONDON, MARIA URBANA P. B.; ALVES, MARIA JANIEIRE N. N.; TROMBETTA, IVANI C.. Diet Associated with Exercise Training Improves Heart Rate Recovery and Autonomic Control in Metabolic Syndrome Subjects. FASEB JOURNAL, v. 32, n. 1, p. 2-pg., . (11/17533-6, 16/16831-7)
CEPEDA, FELIPE X.; VIRMONDES, LESLIE; RODRIGUES, SARA; DUTRA-MARQUES, AKOTHIRENE C. B.; TOSCHI-DIAS, EDGAR; FERREIRA-CAMARGO, FERNANDA C.; HUSSID, MARIA FERNANDA; RONDON, MARIA URBANA P. B.; ALVES, MARIA JANIEIRE N. N.; TROMBETTA, IVANI C.. Identifying the risk of obstructive sleep apnea in metabolic syndrome patients: Diagnostic accuracy of the Berlin Questionnaire. PLoS One, v. 14, n. 5, . (15/03274-0, 16/16831-7, 11/17533-6, 13/15323-0, 13/07651-7)
MARIA FERNANDA HUSSID; FELIPE XEREZ CEPEDA; CAMILA P. JORDÃO; RAFAELA R. P. LOPES-VICENTE; LESLIE VIRMONDES; KEYLA Y. KATAYAMA; EZEQUIEL F. DE OLIVEIRA; LUIS V. F. OLIVEIRA; FERNANDA MARCIANO CONSOLIM-COLOMBO; IVANI CREDIDIO TROMBETTA. Obesidade Visceral e Hipertensão Sistólica como Substratos da Disfunção Endotelial em Adolescentes Obesos. Arquivos Brasileiros de Cardiologia, v. 116, n. 4, p. 795-803, . (15/03274-0, 16/16831-7, 15/11738-6)
LOPES-VICENTE, WANDA R. P.; RODRIGUES, SARA; CEPEDA, FELIPE X.; JORDAO, CAMILA PAIXAO; COSTA-HONG, VALERIA; DUTRA-MARQUES, AKOTHIRENE C. B.; CARVALHO, JEFFERSON C.; ALVES, MARIA JANIEIRE N. N.; BORTOLOTTO, LUIZ A.; TROMBETTA, IVANI C.. Arterial stiffness and its association with clustering of metabolic syndrome risk factors. DIABETOLOGY & METABOLIC SYNDROME, v. 9, . (11/17533-6, 16/16831-7, 13/15323-0)

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