title: Preliminary evidence that obese patients with obstructive sleep apnea/hypopnea syndrome are refractory to the acute beneficial metabolic effects of a very low calorie diet.
abstract: Since obesity seems to play a causal role in both obstructive sleep apnea/hypopnea syndrome (OSAHS) and type 2 diabetes, the question arises whether diet-induced weight loss is equally efficacious in type 2 diabetic patients with and without OSAHS. The present study was aimed to investigate the effect of 1 week very low calorie diet (VLCD) on oxygen desaturation index (ODI) and on glucose regulation in OSAHS versus non-OSAHS patients. Fourteen patients with type 2 diabetes mellitus and morbid obesity were enrolled. According to ODI, patients were divided into 2 groups (with and without OSAHS) and evaluated by a hyperglycemic clamp study, before and after a 7 day-VLCD. After a VLCD, a significant reduction of anthropometric parameters, in the overall group and in subgroups, was observed. M-value and acute insulin response increased significantly only in patients without obstructive sleep apnea (990.10 ± 170.19 vs. 1,205.22 ± 145.73 μmol min(-1) m(-2), p = 0.046; -1.05 ± 8.40 vs. 48.26 ± 11. 90 pmol/L, p = 0.028, respectively). The average 24-h heart rate (24-h HR) fell significantly (p = 0.05), primarily because of a decrease during daytime (p = 0.041), in the whole group. In conclusion, we observed that morbidly obese patients with type 2 diabetes and OSAHS are specifically resistant to the acute beneficial effects of VLCD on metabolic parameters. Our preliminary observation deserves further investigation to clarify the pathogenetic mechanisms involved.
authors.affiliation: Department of Medicina dei Sistemi, University of Rome Tor Vergata, Rome, Italy.
authors.forename: Ilaria
authors.initials: I
authors.lastname: Giordani
authors.forename: Ilaria
authors.initials: I
authors.lastname: Malandrucco
authors.forename: Fabiana
authors.initials: F
authors.lastname: Picconi
authors.forename: Susanna
authors.initials: S
authors.lastname: Longo
authors.forename: Alessandra
authors.initials: A
authors.lastname: Di Flaviani
authors.forename: Laura
authors.initials: L
authors.lastname: Chioma
authors.forename: Barbara
authors.initials: B
authors.lastname: Moscatelli
authors.forename: Silvia
authors.initials: S
authors.lastname: Donno
authors.forename: Simona
authors.initials: S
authors.lastname: Frontoni
mesh_terms: D031204:Caloric Restriction; D003924:Diabetes Mellitus, Type 2 / Q000178:diet therapy* / Q000378:metabolism; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000178:diet therapy* / Q000378:metabolism; D020181:Sleep Apnea, Obstructive / Q000178:diet therapy* / Q000378:metabolism