title: Beneficial effects of a multifaceted 1-year lifestyle intervention on metabolic abnormalities in obese adolescents with and without sleep-disordered breathing.
abstract: Obesity is considered a chronic subinflammatory disease and is a risk factor for many diseases such as sleep-disordered breathing (SDB). Although the interaction between obesity and sleep has been explored, not much is known about SDB in the adolescent population. Thus, the aims of this study were, first, to verify the effect of 1 year of interdisciplinary therapy on inflammatory markers in SDB and without SDB and, second, to investigate the influence of SDB on the result of the therapy by comparing these groups. A total of 36 obese adolescents were enrolled; however, only 24 completed the therapy (SDB group, n=12; non-SDB obese group, n=12). Sleep, anthropometric, metabolic, and inflammatory profiles were evaluated at baseline and after the treatment. In both groups, the therapy was able to improve all anthropometric variables. Metabolic parameters such as insulin, homeostasis model assessment (HOMA), and quantitative insulin sensitivity check index (QUICKI) were significantly improved only in non-SDB group. In both groups, the inflammatory state was significantly improved by the reduction in the leptin/adiponectin ratio. After the intervention, both groups no longer presented the hyperleptinemic state, favoring not only the inflammatory state, but also neuroendocrine regulation. Regarding the sleep parameter, the SDB group improved significantly in all respiratory events, and after therapy only four patients remained with SDB. Furthermore, there was an increase in sleep time. The lifestyle intervention was able to improve anthropometric, metabolic, and inflammatory parameters in both groups; however, the presence of SDB impaired better results. The data supported that the inclusion of SDB in the metabolic syndrome because of the link shown between them.
authors.affiliation: 1 Escola Paulista de Medicina, Universidade Federal de São Paulo (UNIFESP) , São Paulo, Brazil .
authors.forename: Flávia Campos
authors.initials: FC
authors.lastname: Corgosinho
authors.forename: Carolina
authors.initials: C
authors.lastname: Ackel-D'Elia
authors.forename: Sergio
authors.initials: S
authors.lastname: Tufik
authors.forename: Ana Raimunda
authors.initials: AR
authors.lastname: Dâmaso
authors.forename: Aline
authors.initials: A
authors.lastname: de Piano
authors.forename: Priscila de Lima
authors.initials: Pde L
authors.lastname: Sanches
authors.forename: Raquel Munhoz da Silveira
authors.initials: RM
authors.lastname: Campos
authors.forename: Patrícia Leão
authors.initials: PL
authors.lastname: Silva
authors.forename: June
authors.initials: J
authors.lastname: Carnier
authors.forename: Lian
authors.initials: L
authors.lastname: Tock
authors.forename: Monica Levy
authors.initials: ML
authors.lastname: Andersen
authors.forename: Gustavo Antônio
authors.initials: GA
authors.lastname: Moreira
authors.forename: Marcia
authors.initials: M
authors.lastname: Pradella-Hallinan
authors.forename: Lila Missae
authors.initials: LM
authors.lastname: Oyama
authors.forename: Marco Túlio
authors.initials: MT
authors.lastname: de Mello
mesh_terms: D052242:Adiponectin / Q000097:blood; D050154:Adiposity; D000293:Adolescent; D000886:Anthropometry; D001823:Body Composition; D005081:Exercise Therapy; D005260:Female; D006801:Humans; D007249:Inflammation; D007333:Insulin Resistance; D050152:Intra-Abdominal Fat / Q000473:pathology; D008019:Life Style; D008297:Male; D009765:Obesity / Q000097:blood / Q000150:complications / Q000628:therapy*; D017286:Polysomnography; D011613:Psychotherapy; D012307:Risk Factors; D012890:Sleep; D012891:Sleep Apnea Syndromes / Q000150:complications / Q000628:therapy*
chemical_list: D052242:Adiponectin