title: Among Metabolic Factors, Significance of Fasting and Postprandial Increases in Acyl and Desacyl Ghrelin and the Acyl/Desacyl Ratio in Obstructive Sleep Apnea before and after Treatment.
abstract: OBJECTIVE
  There are reports suggesting that obstructive sleep apnea (OSA) may itself cause weight gain. However, recent reports showed increases in body mass index (BMI) following continuous positive airway pressure (CPAP) treatments. When considering weight changes, changes in humoral factors that have significant effects on appetite such as acyl (AG) and desacyl ghrelin (DAG), leptin, insulin, and glucose and their interactions, examples of which are AG/DAG and AG/insulin, are important. The aim of this study was to test the hypothesis that some appetite-related factors had a specific profile before and after CPAP treatment.
  
  
  METHODS
  Metabolic parameters were measured cross-sectionally while fasting and 30, 60, 90, and 120 min following breakfast in no or mild OSA (apnea-hypopnea index < 15, n = 15) and moderate-to-severe OSA (apnea-hypopnea index ≥ 15, n = 39) participants in a single institute. There were no differences in age, sex, BMI, or visceral fat accumulation between the two groups. Twenty-one patients with moderate-to-severe OSA who received CPAP treatment also prospectively underwent the same testing following 3 months of CPAP treatment.
  
  
  RESULTS
  Although fasting and postprandial glucose, insulin, and leptin levels did not differ between no or mild OSA and moderate-to-severe OSA participants, AG and DAG, including AG/DAG and AG/insulin, under fasting and postprandial conditions were significantly increased in the moderate-to-severe OSA patients (p < 0.01). After 3 months of CPAP treatment in 21 of the moderate-to-severe OSA participants, AG/DAG did not change significantly, but other ghrelin-related parameters including AG/insulin significantly decreased compared with values before treatment but remained higher than in no or mild OSA.
  
  
  CONCLUSIONS
  Among several important metabolic factors, ghrelin-related factors had the strongest associations with moderate-to-severe OSA. These results indicate that continuous changes in ghrelin secretion in OSA patients existed at least within 3 months of CPAP treatment. Methods to prevent OSA as well as treatment in its early stage may be recommended.
authors.affiliation: Department of Respiratory Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan.
authors.forename: Yuichi
authors.initials: Y
authors.lastname: Chihara
authors.affiliation: The First Department of Medicine, Wakayama Medical University, Wakayama, Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Akamizu
authors.affiliation: Department of Respiratory Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan.
authors.forename: Masanori
authors.initials: M
authors.lastname: Azuma
authors.affiliation: Department of Respiratory Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan.
authors.forename: Kimihiko
authors.initials: K
authors.lastname: Murase
authors.affiliation: Department of Respiratory Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan.
authors.forename: Yuka
authors.initials: Y
authors.lastname: Harada
authors.affiliation: Departments of Respiratory Care and Sleep Control Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan.
authors.forename: Kiminobu
authors.initials: K
authors.lastname: Tanizawa
authors.affiliation: Department of Respiratory Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan.
authors.forename: Tomohiro
authors.initials: T
authors.lastname: Handa
authors.affiliation: Departments of Respiratory Care and Sleep Control Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan.
authors.forename: Toru
authors.initials: T
authors.lastname: Oga
authors.affiliation: Department of Respiratory Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan.
authors.forename: Michiaki
authors.initials: M
authors.lastname: Mishima
authors.affiliation: Departments of Respiratory Care and Sleep Control Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan.
authors.forename: Kazuo
authors.initials: K
authors.lastname: Chin
mesh_terms: D001066:Appetite; D045422:Continuous Positive Airway Pressure; D003430:Cross-Sectional Studies; D005215:Fasting / Q000097:blood*; D005260:Female; D005500:Follow-Up Studies; D054439:Ghrelin / Q000097:blood*; D005947:Glucose; D006801:Humans; D007328:Insulin / Q000097:blood; D020738:Leptin / Q000097:blood; D008297:Male; D008875:Middle Aged; D017286:Polysomnography; D019518:Postprandial Period; D011446:Prospective Studies; D012720:Severity of Illness Index; D020181:Sleep Apnea, Obstructive / Q000097:blood*
chemical_list: D054439:Ghrelin; D007328:Insulin; D020738:Leptin; C422650:ghrelin, des-n-octanoyl; D005947:Glucose
keywords: acyl ghrelin; continuous positive airway pressure; desacyl ghrelin; metabolic disorder; obesity; obstructive sleep apnea
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