The Effect of Obstructive Sleep Apnea and Continuous Positive Airway Pressure Therapy on Skeletal Muscle Lipid Content in Obese and Nonobese Men.

Koenig, Alexander M; Koehler, Ulrich; Hildebrandt, Olaf; Schwarzbach, Hans; Hannemann, Lena; Boneberg, Raphael; Heverhagen, Johannes; Mahnken, Andreas H; Keller, Malte; Kann, Peter H; Deigner, Hans-Peter; Laur, Nico; Kinscherf, Ralf; Hildebrandt, Wulf (2021). The Effect of Obstructive Sleep Apnea and Continuous Positive Airway Pressure Therapy on Skeletal Muscle Lipid Content in Obese and Nonobese Men. Journal of the Endocrine Society, 5(8), bvab082. Oxford University Press 10.1210/jendso/bvab082

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Obstructive sleep apnea (OSA), independently of obesity (OBS), predisposes to insulin resistance (IR) for largely unknown reasons. Because OSA-related intermittent hypoxia triggers lipolysis, overnight increases in circulating free fatty acids (FFAs) including palmitic acid (PA) may lead to ectopic intramuscular lipid accumulation potentially contributing to IR. Using 3-T-1H-magnetic resonance spectroscopy, we therefore compared intramyocellular and extramyocellular lipid (IMCL and EMCL) in the vastus lateralis muscle at approximately 7 am between 26 male patients with moderate-to-severe OSA (17 obese, 9 nonobese) and 23 healthy male controls (12 obese, 11 nonobese). Fiber type composition was evaluated by muscle biopsies. Moreover, we measured fasted FFAs including PA, glycated hemoglobin A1c, thigh subcutaneous fat volume (ScFAT, 1.5-T magnetic resonance tomography), and maximal oxygen uptake (VO2max). Fourteen patients were reassessed after continuous positive airway pressure (CPAP) therapy. Total FFAs and PA were significantly (by 178% and 166%) higher in OSA patients vs controls and correlated with the apnea-hypopnea index (AHI) (r ≥ 0.45, P < .01). Moreover, IMCL and EMCL were 55% (P < .05) and 40% (P < .05) higher in OSA patients, that is, 114% and 103% in nonobese, 24.4% and 8.4% in obese participants (with higher control levels). Overall, PA, FFAs (minus PA), and ScFAT significantly contributed to IMCL (multiple r = 0.568, P = .002). CPAP significantly decreased EMCL (-26%) and, by trend only, IMCL, total FFAs, and PA. Muscle fiber composition was unaffected by OSA or CPAP. Increases in IMCL and EMCL are detectable at approximately 7 am in OSA patients and are partly attributable to overnight FFA excesses and high ScFAT or body mass index. CPAP decreases FFAs and IMCL by trend but significantly reduces EMCL.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Radiology, Neuroradiology and Nuclear Medicine (DRNN) > Institute of Diagnostic, Interventional and Paediatric Radiology

UniBE Contributor:

Heverhagen, Johannes

Subjects:

600 Technology > 610 Medicine & health

ISSN:

2472-1972

Publisher:

Oxford University Press

Language:

English

Submitter:

Maria de Fatima Henriques Bernardo

Date Deposited:

29 Jul 2021 16:05

Last Modified:

05 Dec 2022 15:52

Publisher DOI:

10.1210/jendso/bvab082

PubMed ID:

34268461

Uncontrolled Keywords:

aerobic capacity diabetes ectopic fat intermittent hypoxia obesity

BORIS DOI:

10.48350/157761

URI:

https://boris.unibe.ch/id/eprint/157761

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