The effect of surgical and non-surgical weight loss on N-terminal pro-B-type natriuretic peptide and its relation to obstructive sleep apnea and pulmonary functionReportar como inadecuado

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BMC Research Notes

, 9:440



BackgroundObesity is a major risk factor for obstructive sleep apnea, impaired pulmonary function and heart failure, but obesity is also associated with paradoxically low levels of serum N-terminal pro-B-type natriuretic peptide NT-proBNP. In subjects with severe obesity undergoing weight loss treatment, we assessed the associations between changes in severity of obstructive sleep apnea, pulmonary function and serum NT-proBNP levels.

MethodsOne-year non-randomized controlled clinical trial. Participants, 69.6 % women, mean SD age 44.6 10.8 years and body mass index BMI 45.1 5.6 kg-m, underwent gastric bypass surgery n = 76 or intensive lifestyle intervention n = 63, resulting in 30 8 % and 8 9 % weight loss, respectively. The reference group included 30 normal weight, healthy, gender and age matched controls. Sleep recordings, arterial blood gases, pulmonary function and blood tests were assessed before and 1 year after the interventions.

ResultsNT-proBNP concentrations increased significantly more after surgery than after lifestyle intervention. The post intervention values in both groups were significantly higher than in a normal weight healthy reference group. In the whole study population changes ∆ in NT-proBNP correlated significantly with changes in both BMI r = −0.213 and apnea hypopnea index AHI, r = −0.354. ∆NT-proBNP was, independent of age, gender and ∆BMI, associated with ∆AHI beta −0.216, p = 0.021. ∆AHI was, independent of ∆BMI, significantly associated with changes in pO2 beta −0.204, pCO2 beta 0.199, forced vital capacity beta −0.168 and forced expiratory volume first second beta −0.160.

ConclusionsGastric bypass surgery was associated with a greater increase in NT-proBNP concentrations than non-surgical weight loss treatment. Reduced AHI was, independent of weight loss, associated with increased NT-proBNP levels and improved dynamic lung volumes and daytime blood gases.

Clinical Trial Registration NCT00273104, retrospectively registered Jan 5, 2006 study start Dec 2005

KeywordsObesity Natriuretic peptides Sleep apnea Respiration AbbreviationsBMIbody mass index

NT-proBNPN-terminal peptide

OSAobstructive sleep apnea

AHIapnea hypopnea index

CPAPcontinuous positive airway pressure

FEV1forced expiratory volume in one second

FVCforced vital capacity

DLCOdiffusing capacity for carbon monoxide

DLCO-VAdiffusing capacity for carbon monoxide-alveolar volume

TLCtotal lung capacity

ICinspiratory capacity

VCvital capacity

FRCfunctional residual capacity

ERVexpiratory reserve volume

RVresidual volume

Electronic supplementary materialThe online version of this article doi:10.1186-s13104-016-2241-x contains supplementary material, which is available to authorized users.

Autor: Anne-Marie Gabrielsen - Torbjørn Omland - Mette Brokner - Jan Magnus Fredheim - Jens Jordan - Sverre Lehmann - May Brit 


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