Evaluation of autophagic flow in response to cellular stress of musculoskeletal and adipose tissues in obese patients with obstructive sleep apnea

Abstract

Introduction: Obstructive sleep apnea (OSA) is a sleep-disordered breathing whose main risk factor isthe obesity. Changes in metabolic and inflammatory profile induced by OSA and obesity has beenpointed as responsible by increase of comorbidities, such as insulin resistance and type 2 diabetesmellitus. Thus, the skeletal muscle and adipose tissues are key components in metabolic regulation andinsulin sensibility, producing and releasing factors that act of autocrine, paracrine and endocrine mannerto adaptation of energy system in cellular stress moment. The autophagy contributes with this processand can be altered in obese subjects and potentiated in apneic patients, since OSA potentiate the proinflammatoryprofile induced by obesity, exposes the subjects to intermittent hypoxia during sleep andincrease the sympathetic tone activity, generating high rest metabolic rate.Aim: to evaluate metabolic regulation factors and autophagy from visceral adipose and skeletal muscleof obese individuals with OSA, in a stress cellular condition induced by fasting.Methods: Obese individuals who will undergo to bariatric and metabolic surgery (BMIe40 or e35 withassociated comorbidities). The volunteers will be distributed in six groups, non-apneic, mild apneic,moderate apneic and severe apneic. There will also be a non-apneic and apneic eutrophic control groupscomposed of patients who will be referred for cholecystectomy. The subjects will be evaluate toinflammatory profile, body mass, rest metabolic rate, autophagic flux from skeletal muscle and adiposesample collected in fast condition, during intraoperative moment.