Association of Obstructive Sleep Apnea Severity with Exercise Capacity and Health-related Quality of Life.

BACKGROUND: Current research is inconclusive as to whether obstructive sleep apnea severity directly limits exercise capacity and lowers health-related quality of life (HRQoL). AIMS: The aim of this study was to evaluate the association of obstructive sleep apnea severity with determinants of exercise capacity and HRQoL. SUBJECTS AND METHODS: Subjects were evaluated by home somnography and classified as no obstructive sleep apnea (n = 43) or as having mild (n = 27), moderate or severe obstructive sleep apnea (n = 21). Exercise capacity was assessed by a ramping cycle ergometer test, and HRQoL was assessed with the SF-36 questionnaire. RESULTS: Greater obstructive sleep apnea severity was associated with older age, higher body weight, higher body mass index, lower peak aerobic capacity, a higher percentage of peak aerobic capacity at a submaximal exercise intensity of 55 watts, and lower physical component summary score from the SF-36. None of these variables were statistically different among obstructive sleep apnea severity groups after controlling for age and body weight. Obstructive sleep apnea severity was not associated with any cardiorespiratory fitness or HRQoL parameter. CONCLUSIONS: Obstructive sleep apnea severity has no independent association with exercise capacity or HRQoL.

Association between sleep disorders, obesity, and exercise: a review.

Decreased sleep duration and quality is associated with an increase in body weight and adiposity. Insomnia, obstructive sleep apnea, and restless legs syndrome are three of the most prevalent types of sleep disorder that lead to an increased risk for numerous chronic health conditions. Various studies have examined the impact of these sleep disorders on obesity, and are an important link in understanding the relationship between sleep disorders and chronic disease. Physical activity and exercise are important prognostic tools in obesity and chronic disease, and numerous studies have explored the relationship between obesity, sleep disorders, and exercise. As such, this review will examine the relationship between sleep disorders and obesity. In addition, how sleep disorders may impact the exercise response and how exercise may impact patient outcomes with regard to sleep disorders will also be reviewed.

Fat and muscle indices assessed by pQCT: relationships with physical activity and type 2 diabetes risk.

The aim of this study was to compare and determine the repeatability of foreleg and forearm muscle and fat indices evaluated by the peripheral quantitative computed tomography (pQCT). Effects of habitual physical activity and associated health risk of type 2 diabetes were examined within the interrelations of intermuscular adipose tissue (IMAT) and muscle density. Eighty-two premenopausal women (mean age ± standard deviation: 38.6 ± 4.7 yr) underwent dual-energy X-ray absorptiometry scans and pQCT of foreleg and forearm scans to assess muscle and fat parameters. Physical activity status was based on 4-d self-reported log and pedometer step counts. Fat and muscle distribution between the foreleg and forearm were similar and highly correlated to total body adiposity. The pQCT device reliably measured muscle density in the foreleg and forearm; coefficients of variation were 0.8% and 2.1%, which was therefore used to reflect IMAT status. Muscle density was positively related to physical activity and negatively associated with markers of fat distribution and risk for type 2 diabetes. The pQCT is a novel, noninvasive tool to assess IMAT and muscle density in the foreleg and forearm. Additional research is necessary to understand the biology of IMAT and its relations with physical activity and potentially, with risks for cardiometabolic disease.

A review of weight loss following Roux-en-Y gastric bypass vs restrictive bariatric surgery: impact on adiponectin and insulin.

BACKGROUND: Bariatric surgery is a common procedure often used to ameliorate comorbidities associated with obesity, including type 2 diabetes. Substantial weight loss leads to alterations in inflammation and insulin sensitivity as well as numerous metabolic and physiologic pathways. Several inflammatory markers have been evaluated, yet adiponectin, an anti-inflammatory adipokine, has not been fully investigated. Adiponectin may play a key role as a mediator between obesity and inflammation, as lower blood levels are more commonly associated with obesity and type 2 diabetes and because adiponectin lessens insulin resistance. This review evaluates outcome variables from patients who underwent Roux-en-Y gastric bypass (RYGB) or restrictive bariatric surgery to compare and contrast any differential surgical impacts on weight loss, adiponectin, and insulin. METHODS: A systematic literature review was conducted using a PubMed search. Published studies from 1999 to 2009 that measured blood levels of adiponectin and insulin in bariatric surgery patients prior to and at least 6 months after surgery were included. RESULTS: Eighteen studies met inclusion criteria for evaluation. RYGB surgery compared to restrictive surgery led to significantly greater weight loss and improvements in adiponectin and insulin sensitivity. Despite significant weight loss, many patients did not achieve "healthy" body mass index or normalization of inflammatory markers. CONCLUSIONS: While RYGB surgery appears to more favorably influence body weight and inflammatory markers, data are insufficient to fully understand the impact of bariatric surgery on changes in adiponectin and insulin and related health implications. Long-term research is needed to more thoroughly evaluate inflammatory outcomes following these two bariatric surgery procedures.