title: Endothelial function is well preserved in obese patients with mild obstructive sleep apnea.
abstract: OBJECTIVE
  Endothelial dysfunction is one of the early markers of cardiovascular complications in obstructive sleep apnea (OSA). The aim of our study was to evaluate whether overweight patients with mild OSA displayed endothelial dysfunction, and to assess the effect of 1-year lifestyle intervention with an early very low calorie diet in endothelial function.
  
  
  METHODS
  At baseline, the study population consisted of 83 overweight patients with mild OSA and 46 weight-matched non-OSA subjects. OSA patients were further randomized into a 1-year supervised lifestyle intervention group or control group which received routine lifestyle counselling. Endothelial function measured by brachial artery flow-mediated dilatation (FMD), apnea-hypopnea index (AHI), body mass index (BMI), and metabolic parameters were assessed at baseline and 12 months.
  
  
  RESULTS
  No correlations between endothelial function and mild OSA were detected. However, patients with impaired endothelial function had lower mean saturation and impaired endothelial function correlated significantly with glucose intolerance and dyslipidemia. After the lifestyle intervention and successful weight reduction, AHI, BMI, serum triglycerides and insulin improved significantly; however, no improvement in FMD was detected.
  
  
  CONCLUSIONS
  Mild OSA was not observed to be associated with endothelial dysfunction. Although in mild OSA endothelial function is still preserved, lifestyle intervention with weight reduction did achieve an improvement in other obesity-related risk factors for cardiovascular diseases, thus highlighting the importance of early intervention.
authors.affiliation: Institute of Clinical Medicine, Department of Otorhinolaryngology, Kuopio University Hospital, and University of Eastern Finland, P.O. Box 1777, 70211, Kuopio, Finland, henry.blomster@kuh.fi.
authors.forename: Henry
authors.initials: H
authors.lastname: Blomster
authors.forename: Tomi
authors.initials: T
authors.lastname: Laitinen
authors.forename: Tiina
authors.initials: T
authors.lastname: Lyyra-Laitinen
authors.forename: Esko
authors.initials: E
authors.lastname: Vanninen
authors.forename: Helena
authors.initials: H
authors.lastname: Gylling
authors.forename: Markku
authors.initials: M
authors.lastname: Peltonen
authors.forename: Tarja
authors.initials: T
authors.lastname: Martikainen
authors.forename: Johanna
authors.initials: J
authors.lastname: Sahlman
authors.forename: Jouko
authors.initials: J
authors.lastname: Kokkarinen
authors.forename: Jukka
authors.initials: J
authors.lastname: Randell
authors.forename: Grigori
authors.initials: G
authors.lastname: Smirnov
authors.forename: Juha
authors.initials: J
authors.lastname: Seppä
authors.forename: Henri
authors.initials: H
authors.lastname: Tuomilehto
mesh_terms: D000328:Adult; D000368:Aged; D015992:Body Mass Index; D002318:Cardiovascular Diseases / Q000175:diagnosis / Q000503:physiopathology* / Q000628:therapy; D003131:Combined Modality Therapy; D003430:Cross-Sectional Studies; D004038:Diet, Reducing; D004730:Endothelium, Vascular / Q000503:physiopathology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008019:Life Style; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000175:diagnosis / Q000503:physiopathology* / Q000628:therapy; D017286:Polysomnography; D012307:Risk Factors; D020181:Sleep Apnea, Obstructive / Q000175:diagnosis / Q000503:physiopathology* / Q000628:therapy; D014664:Vasodilation / Q000502:physiology; D015431:Weight Loss