Leptin and the control of pharyngeal patency during sleep in severe obesity

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dc.contributor Sistema FMUSP-HC: Faculdade de Medicina da Universidade de São Paulo (FMUSP) e Hospital das Clínicas da FMUSP
dc.contributor.author SHAPIRO, Steven D.
CHIN, Chien-Hung
KIRKNESS, Jason P.
MCGINLEY, Brian M.
PATIL, Susheel P.
POLOTSKY, Vsevolod Y.
BISELLI, Paolo Jose Cesare FMUSP-HC
SMITH, Philip L.
SCHNEIDER, Hartmut
SCHWARTZ, Alan R.
dc.date.issued 2014
dc.identifier.citation JOURNAL OF APPLIED PHYSIOLOGY, v.116, n.10, p.1334-1341, 2014
dc.identifier.issn 8750-7587
dc.identifier.uri http://observatorio.fm.usp.br/handle/OPI/17309
dc.description.abstract Rationale: Obesity imposes mechanical loads on the upper airway, resulting in flow limitation and obstructive sleep apnea (OSA). In previous animal models, leptin has been considered to serve as a stimulant of ventilation and may prevent respiratory depression during sleep. We hypothesized that variations in leptin concentration among similarly obese individuals will predict differences in compensatory responses to upper airway obstruction during sleep. Methods: An observational study was conducted in 23 obese women [body mass index (BMI): 46 +/- 3 kg/m(2), age: 41 +/- 12 yr] and 3 obese men (BMI: 46 +/- 3 kg/m(2), age: 43 +/- 4 yr). Subjects who were candidates for bariatric surgery were recruited to determine upper airway collapsibility under hypotonic conditions [pharyngeal critical pressure (passive PCRIT)], active neuromuscular responses to upper airway obstruction during sleep, and overnight fasting serum leptin levels. Compensatory responses were defined as the differences in peak inspiratory airflow (Delta V(I)max), inspired minute ventilation (Delta V-I), and pharyngeal critical pressure (Delta P-CRIT) between the active and passive conditions. Results: Leptin concentration was not associated with sleep disordered breathing severity, passive P-CRIT, or baseline ventilation. In the women, increases in serum leptin concentrations were significantly associated with increases in Delta V(I)max (r(2) = 0.44, P < 0.001), Delta V-I (r(2) = 0.40, P < 0.001), and Delta P-CRIT (r(2) = 0.19, P < 0.04). These responses were independent of BMI, waist-to-hip ratio, neck circumference, or sagittal girth. Conclusion: Leptin may augment neural compensatory mechanisms in response to upper airway obstruction, minimizing upper airway collapse, and/or mitigating potential OSA severity. Variability in leptin concentration among similarly obese individuals may contribute to differences in OSA susceptibility.
dc.description.sponsorship · National Heart, Lung, and Blood Institute Grant [HL50381]
dc.language.iso eng
dc.publisher AMER PHYSIOLOGICAL SOC
dc.relation.ispartof Journal of Applied Physiology
dc.rights restrictedAccess
dc.subject leptin; obesity; obstructive sleep apnea; upper airway control
dc.subject.other upper airway collapsibility; respiratory depression; gene-expression; lung-volume; apnea; pressure; weight; individuals; metabolism; mechanisms
dc.title Leptin and the control of pharyngeal patency during sleep in severe obesity
dc.type article
dc.rights.holder Copyright AMER PHYSIOLOGICAL SOC
dc.identifier.doi 10.1152/japplphysiol.00958.2013
dc.identifier.pmid 24557793
dc.type.category original article
dc.type.version publishedVersion
hcfmusp.author BISELLI, Paolo Jose Cesare:HU:DVCLME-62
hcfmusp.author.external · SHAPIRO, Steven D.:Johns Hopkins Sch Med, Div Pulm & Crit Care Med, Johns Hopkins Sleep Disorders Ctr, Baltimore, MD USA
· CHIN, Chien-Hung:Johns Hopkins Sch Med, Div Pulm & Crit Care Med, Johns Hopkins Sleep Disorders Ctr, Baltimore, MD USA; Chang Gung Univ, Kaohsiung Chang Gung Mem Hosp, Dept Internal Med, Div Pulm & Crit Care Med,Coll Med, Kaohsiung, Taiwan
· KIRKNESS, Jason P.:Johns Hopkins Sch Med, Div Pulm & Crit Care Med, Johns Hopkins Sleep Disorders Ctr, Baltimore, MD USA
· MCGINLEY, Brian M.:Johns Hopkins Sch Med, Div Pulm & Crit Care Med, Johns Hopkins Sleep Disorders Ctr, Baltimore, MD USA
· PATIL, Susheel P.:Johns Hopkins Sch Med, Div Pulm & Crit Care Med, Johns Hopkins Sleep Disorders Ctr, Baltimore, MD USA
· POLOTSKY, Vsevolod Y.:Johns Hopkins Sch Med, Div Pulm & Crit Care Med, Johns Hopkins Sleep Disorders Ctr, Baltimore, MD USA
· SMITH, Philip L.:Johns Hopkins Sch Med, Div Pulm & Crit Care Med, Johns Hopkins Sleep Disorders Ctr, Baltimore, MD USA
· SCHNEIDER, Hartmut:Johns Hopkins Sch Med, Div Pulm & Crit Care Med, Johns Hopkins Sleep Disorders Ctr, Baltimore, MD USA
· SCHWARTZ, Alan R.:Johns Hopkins Sch Med, Div Pulm & Crit Care Med, Johns Hopkins Sleep Disorders Ctr, Baltimore, MD USA
hcfmusp.origem.id WOS:000339167900010
hcfmusp.origem.id 2-s2.0-84901192929
hcfmusp.publisher.city BETHESDA
hcfmusp.publisher.country USA
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dc.description.index MEDLINE
dc.identifier.eissn 1522-1601
hcfmusp.citation.scopus 21
hcfmusp.citation.wos 18
hcfmusp.affiliation.country Brasil
hcfmusp.affiliation.country Taiwan
hcfmusp.affiliation.country Estados Unidos


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