Interações entre sono e marcadores de padrões desfavoráveis de composição corporal

Detalhes bibliográficos
Autor(a) principal: Piovezan, Ronaldo Delmonte [UNIFESP]
Data de Publicação: 2018
Tipo de documento: Tese
Idioma: por
Título da fonte: Repositório Institucional da UNIFESP
Texto Completo: https://sucupira.capes.gov.br/sucupira/public/consultas/coleta/trabalhoConclusao/viewTrabalhoConclusao.jsf?popup=true&id_trabalho=6329206
https://repositorio.unifesp.br/handle/11600/52886
Resumo: Background: Evidence suggests that patterns of body composition such as obesity, sarcopenia and sarcopenic obesity (SO) are associated with sleep changes beginning in middle age. Circadian hormonal oscillations also undergo significant transformations along aging and may affect body composition. However, investigations into the associations between sleep and body composition are still scarce. Objectives: To investigate, using three studies, the interactions between sleep and its disturbances with unfavorable patterns of body composition in adults. First, we evaluated the effects of a pharmacological agent on sleep and the hormonal axes involved in body metabolism in older men. Second, we analyzed the association between sleep and serum levels of 25-hydroxyvitamin D (25(OH)D), a possible mediator of muscle and lipid metabolism, in a sample from a clinical setting. Finally, we investigated associations of poor sleep markers and sleep disturbances with adverse body composition patterns in a population-based sample. Methods: In study 1, a double-blind, randomized, placebo-controlled, crossover clinical trial tested the effects of gabapentin 300mg on serum hormone levels and sleep parameters in healthy older men (>60 years). Nocturnal growth hormone (GH), testosterone, and cortisol serum measures were collected every 20 minutes. Polysomnography (PSG) measured the effects of the intervention on sleep structure and respiratory parameters. In study 2, PSG data and serum quantification of 25 (OH)D were analyzed in adults from a clinically evaluated sample. Logistic regression models assessed the cross-sectional associations between the risk of 25 (OH) D deficiency (<30 ng / mL) and indicators of poor sleep and sleep disorders. In study 3, in a population-based adult sample, sleep was evaluated by several methods, and electrical bioimpedance (BIA) evaluated body composition. Appendicular skeletal muscle mass (ASMM) adjusted for body mass index (BMI) morphologically defined sarcopenia (men <0.789; women <0.512). Total body fat defined obesity (men> 30%, women> 40%) and SO was defined by the overlap between the two conditions. The cross-sectional associations between sleep and body composition were analyzed using multinomial logistic regression models. Results: In 8 older men, gabapentin 300mg did not increase the percentage of sleep stage 3 (N3) and total nocturnal GH secretion (median: 1.63 ng/mL, p = 0.21) did not differ from placebo (median 1.08 ng/mL). The apnea and hypopnea index (AHI) and the oxygen esaturation index (ODI) increased in the comparisons between placebo and gabapentin (median AHI: 6.90 vs. 21.4, p = 0.01; ODI: 6.45 vs. 15.2, p = 0.01). In the 657 participants in study 2, the risk of 25(OH)D deficiency was associated with obstructive sleep apnea (OSA) (OR: 1.89, 95%CI: 1.29-2.77), nocturnal hypoxemia (OR: 2.62, 95%CI 95 %: 1.56-4.32) and short duration of sleep (< 6hs) (OR: 1.56, 95%CI: 1.11-2.21). In the 707 participants in study 3, severe OSA (AHI>30) was associated with OS (OR: 3.23, 95%CI: 1.10-9.53) and nocturnal hypoxemia was associated with obesity (OR: 2.48, 95%CI: 1.45-4.25) and OS (OR = 2.12, 95%CI: 1.10-4.10). Conclusions: Taken together, our findings derived from different studies suggest an intricate pathophysiologic relationship between sleep disorders, especially OSA, and adverse body composition patterns, which may go beyond fat deposition and involve muscle metabolism. Likewise, vitamin D may play a modulatory role in the associations between sleep and body composition and, in older men, not only the increase in adipose tissue but also the morphofunctional muscle decline may be a risk factor for OSA.
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spelling Interações entre sono e marcadores de padrões desfavoráveis de composição corporalInteractions between sleep and markers of unfavorable body compositionSleepBody compositionSleep disordersObstructive sleep apneaSarcopeniaSarcopenic obesitySonoComposição corporalDistúrbios do sonoApneia obstrutiva do sonoSarcopeniaObesidade sarcopênicaBackground: Evidence suggests that patterns of body composition such as obesity, sarcopenia and sarcopenic obesity (SO) are associated with sleep changes beginning in middle age. Circadian hormonal oscillations also undergo significant transformations along aging and may affect body composition. However, investigations into the associations between sleep and body composition are still scarce. Objectives: To investigate, using three studies, the interactions between sleep and its disturbances with unfavorable patterns of body composition in adults. First, we evaluated the effects of a pharmacological agent on sleep and the hormonal axes involved in body metabolism in older men. Second, we analyzed the association between sleep and serum levels of 25-hydroxyvitamin D (25(OH)D), a possible mediator of muscle and lipid metabolism, in a sample from a clinical setting. Finally, we investigated associations of poor sleep markers and sleep disturbances with adverse body composition patterns in a population-based sample. Methods: In study 1, a double-blind, randomized, placebo-controlled, crossover clinical trial tested the effects of gabapentin 300mg on serum hormone levels and sleep parameters in healthy older men (>60 years). Nocturnal growth hormone (GH), testosterone, and cortisol serum measures were collected every 20 minutes. Polysomnography (PSG) measured the effects of the intervention on sleep structure and respiratory parameters. In study 2, PSG data and serum quantification of 25 (OH)D were analyzed in adults from a clinically evaluated sample. Logistic regression models assessed the cross-sectional associations between the risk of 25 (OH) D deficiency (<30 ng / mL) and indicators of poor sleep and sleep disorders. In study 3, in a population-based adult sample, sleep was evaluated by several methods, and electrical bioimpedance (BIA) evaluated body composition. Appendicular skeletal muscle mass (ASMM) adjusted for body mass index (BMI) morphologically defined sarcopenia (men <0.789; women <0.512). Total body fat defined obesity (men> 30%, women> 40%) and SO was defined by the overlap between the two conditions. The cross-sectional associations between sleep and body composition were analyzed using multinomial logistic regression models. Results: In 8 older men, gabapentin 300mg did not increase the percentage of sleep stage 3 (N3) and total nocturnal GH secretion (median: 1.63 ng/mL, p = 0.21) did not differ from placebo (median 1.08 ng/mL). The apnea and hypopnea index (AHI) and the oxygen esaturation index (ODI) increased in the comparisons between placebo and gabapentin (median AHI: 6.90 vs. 21.4, p = 0.01; ODI: 6.45 vs. 15.2, p = 0.01). In the 657 participants in study 2, the risk of 25(OH)D deficiency was associated with obstructive sleep apnea (OSA) (OR: 1.89, 95%CI: 1.29-2.77), nocturnal hypoxemia (OR: 2.62, 95%CI 95 %: 1.56-4.32) and short duration of sleep (< 6hs) (OR: 1.56, 95%CI: 1.11-2.21). In the 707 participants in study 3, severe OSA (AHI>30) was associated with OS (OR: 3.23, 95%CI: 1.10-9.53) and nocturnal hypoxemia was associated with obesity (OR: 2.48, 95%CI: 1.45-4.25) and OS (OR = 2.12, 95%CI: 1.10-4.10). Conclusions: Taken together, our findings derived from different studies suggest an intricate pathophysiologic relationship between sleep disorders, especially OSA, and adverse body composition patterns, which may go beyond fat deposition and involve muscle metabolism. Likewise, vitamin D may play a modulatory role in the associations between sleep and body composition and, in older men, not only the increase in adipose tissue but also the morphofunctional muscle decline may be a risk factor for OSA.Introdução: Evidências sugerem que padrões de composição corporal, como obesidade, sarcopenia e obesidade sarcopênica (OS), estão associados a mudanças na qualidade e na duração do sono que se iniciam na meia idade. Variações hormonais circadianas também sofrem transformações marcantes ao longo do envelhecimento e podem afetar a composição corporal. Entretanto, investigações sobre as associações entre sono e composição corporal são ainda escassas. Objetivos: Investigar por meio de 3 experimentos as interações entre sono e seus distúrbios com padrões desfavoráveis de composição corporal em adultos. Primeiramente, avaliamos os efeitos de um agente farmacológico sobre o sono e os eixos hormonais envolvidos no metabolismo corporal em homens idosos. Em segundo, analisamos a associação entre sono e o nível sérico de 25- hidroxivitamina D (25(OH)D), um possível mediador do metabolismo muscular e lipídico, em uma amostra de origem clínica. Por fim, investigamos as associações de marcadores de sono ruim e de distúrbios do sono com padrões adversos de composição corporal em uma amostra populacional. Métodos: No estudo 1, um ensaio clínico cruzado, duplo-cego, randomizado, controlado por placebo, testou os efeitos de uma dose de gabapentina 300mg sobre níveis séricos hormonais e parâmetros do sono em homens idosos (>60 anos) saudáveis. Medidas séricas noturnas de hormônio do crescimento (GH), testosterona e cortisol foram coletadas a cada 20 minutos. A polissonografia (PSG) mediu os efeitos da intervenção na estrutura e nos parâmetros respiratórios do sono. No estudo 2, dados de PSG e quantificação sérica de 25(OH)D foram analisados em adultos de uma amostra avaliada clinicamente. Modelos de regressão logística avaliaram a associação transversal entre o risco de deficiência de 25(OH)D (<30 ng/mL) e os indicadores de sono ruim e seus distúrbios. No estudo 3, em uma amostra de base populacional, o sono foi avaliado por diversos instrumentos e a bioimpedância elétrica (BIA) avaliou a composição corporal. A massa muscular esquelética apendicular (MMEA) ajustada para o índice de massa corporal (IMC) definiu morfologicamente a sarcopenia (homens <0,789; mulheres <0,512). A gordura corporal total definiu a obesidade (homens >30%, mulheres >40%) e a OS foi definida pela sobreposição entre as duas condições. As associações transversais entre sono e composição corporal foram analisadas por meio de regressões logísticas multinomiais. Resultados: Em 8 homens idosos, gabapentina 300mg não aumentou o percentual do estágio 3 do sono (N3) e a secreção total noturna de GH após a intervenção (mediana: 1,63 ng/mL, p=0,21) não diferiu do placebo (mediana: 1,08 ng/mL). O índice de apneia e hipopneia (IAH) e o índice de dessaturação de oxigênio (IDO) se elevaram nas comparações entre placebo e gabapentina (medianas IAH: 6,90 vs. 21,4, p=0,01; e IDO: IDO: 6,45 vs. 15,2, p=0,01). Nos 657 participantes do estudo 2, o risco de deficiência de 25(OH)D foi associado a apneia obstrutiva do sono (AOS) (OR: 1,89, IC95%:1,29-2,77), hipoxemia noturna (OR: 2,62, IC95%: 1,56-4,32) e curta duração do sono (< 6hs) (OR: 1,56, IC95%: 1,11-2,21). Nos 707 participantes do estudo 3, a AOS grave (IAH>30) foi associada à OS (OR: 3,23, IC95%: 1,10-9,53) e a hipoxemia noturna foi associada a obesidade (OR: 2,48, IC 95%: 1,45-4,25) e OS (OR = 2,12, IC 95%: 1,10-4,10). Conclusões: Em conjunto, nossos achados obtidos em estudos diversos sugerem uma relação fisiopatológica complexa entre os distúrbios do sono, principalmente a AOS, e os padrões adversos de composição corporal, que pode ir além da deposição de gordura e envolver o metabolismo muscular. Nesse sentido, a vitamina D pode desempenhar um papel modulador nas associações entre sono e composição corporal e, em idosos, não somente o aumento do tecido adiposo, mas também o declínio morfofuncional muscular pode ser um fator de risco para a AOS.Dados abertos - Sucupira - Teses e dissertações (2018)Associação Fundo de Incentivo à Pesquisa (AFIP)Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)Universidade Federal de São Paulo (UNIFESP)Poyares, Dalva Lucia Rollemberg [UNIFESP]Universidade Federal de São Paulo (UNIFESP)Piovezan, Ronaldo Delmonte [UNIFESP]2020-03-25T12:10:39Z2020-03-25T12:10:39Z2018-06-28info:eu-repo/semantics/doctoralThesisinfo:eu-repo/semantics/publishedVersion190 f.application/pdfhttps://sucupira.capes.gov.br/sucupira/public/consultas/coleta/trabalhoConclusao/viewTrabalhoConclusao.jsf?popup=true&id_trabalho=6329206PIOVEZAN, Ronaldo Delmonte. Interações entre sono e marcadores de padrões desfavoráveis de composição corporal. Tese (Doutorado em Ciências) - Escola Paulista de Medicina, Universidade Federal de São Paulo (UNIFESP), São Paulo, 2018.2018 PIOVEZAN, RONALDO DELMONTE.Doutorado.pdfhttps://repositorio.unifesp.br/handle/11600/52886porSão Pauloinfo:eu-repo/semantics/openAccessreponame:Repositório Institucional da UNIFESPinstname:Universidade Federal de São Paulo (UNIFESP)instacron:UNIFESP2024-08-10T14:47:04Zoai:repositorio.unifesp.br/:11600/52886Repositório InstitucionalPUBhttp://www.repositorio.unifesp.br/oai/requestbiblioteca.csp@unifesp.bropendoar:34652024-08-10T14:47:04Repositório Institucional da UNIFESP - Universidade Federal de São Paulo (UNIFESP)false
dc.title.none.fl_str_mv Interações entre sono e marcadores de padrões desfavoráveis de composição corporal
Interactions between sleep and markers of unfavorable body composition
title Interações entre sono e marcadores de padrões desfavoráveis de composição corporal
spellingShingle Interações entre sono e marcadores de padrões desfavoráveis de composição corporal
Piovezan, Ronaldo Delmonte [UNIFESP]
Sleep
Body composition
Sleep disorders
Obstructive sleep apnea
Sarcopenia
Sarcopenic obesity
Sono
Composição corporal
Distúrbios do sono
Apneia obstrutiva do sono
Sarcopenia
Obesidade sarcopênica
title_short Interações entre sono e marcadores de padrões desfavoráveis de composição corporal
title_full Interações entre sono e marcadores de padrões desfavoráveis de composição corporal
title_fullStr Interações entre sono e marcadores de padrões desfavoráveis de composição corporal
title_full_unstemmed Interações entre sono e marcadores de padrões desfavoráveis de composição corporal
title_sort Interações entre sono e marcadores de padrões desfavoráveis de composição corporal
author Piovezan, Ronaldo Delmonte [UNIFESP]
author_facet Piovezan, Ronaldo Delmonte [UNIFESP]
author_role author
dc.contributor.none.fl_str_mv Poyares, Dalva Lucia Rollemberg [UNIFESP]
Universidade Federal de São Paulo (UNIFESP)
dc.contributor.author.fl_str_mv Piovezan, Ronaldo Delmonte [UNIFESP]
dc.subject.por.fl_str_mv Sleep
Body composition
Sleep disorders
Obstructive sleep apnea
Sarcopenia
Sarcopenic obesity
Sono
Composição corporal
Distúrbios do sono
Apneia obstrutiva do sono
Sarcopenia
Obesidade sarcopênica
topic Sleep
Body composition
Sleep disorders
Obstructive sleep apnea
Sarcopenia
Sarcopenic obesity
Sono
Composição corporal
Distúrbios do sono
Apneia obstrutiva do sono
Sarcopenia
Obesidade sarcopênica
description Background: Evidence suggests that patterns of body composition such as obesity, sarcopenia and sarcopenic obesity (SO) are associated with sleep changes beginning in middle age. Circadian hormonal oscillations also undergo significant transformations along aging and may affect body composition. However, investigations into the associations between sleep and body composition are still scarce. Objectives: To investigate, using three studies, the interactions between sleep and its disturbances with unfavorable patterns of body composition in adults. First, we evaluated the effects of a pharmacological agent on sleep and the hormonal axes involved in body metabolism in older men. Second, we analyzed the association between sleep and serum levels of 25-hydroxyvitamin D (25(OH)D), a possible mediator of muscle and lipid metabolism, in a sample from a clinical setting. Finally, we investigated associations of poor sleep markers and sleep disturbances with adverse body composition patterns in a population-based sample. Methods: In study 1, a double-blind, randomized, placebo-controlled, crossover clinical trial tested the effects of gabapentin 300mg on serum hormone levels and sleep parameters in healthy older men (>60 years). Nocturnal growth hormone (GH), testosterone, and cortisol serum measures were collected every 20 minutes. Polysomnography (PSG) measured the effects of the intervention on sleep structure and respiratory parameters. In study 2, PSG data and serum quantification of 25 (OH)D were analyzed in adults from a clinically evaluated sample. Logistic regression models assessed the cross-sectional associations between the risk of 25 (OH) D deficiency (<30 ng / mL) and indicators of poor sleep and sleep disorders. In study 3, in a population-based adult sample, sleep was evaluated by several methods, and electrical bioimpedance (BIA) evaluated body composition. Appendicular skeletal muscle mass (ASMM) adjusted for body mass index (BMI) morphologically defined sarcopenia (men <0.789; women <0.512). Total body fat defined obesity (men> 30%, women> 40%) and SO was defined by the overlap between the two conditions. The cross-sectional associations between sleep and body composition were analyzed using multinomial logistic regression models. Results: In 8 older men, gabapentin 300mg did not increase the percentage of sleep stage 3 (N3) and total nocturnal GH secretion (median: 1.63 ng/mL, p = 0.21) did not differ from placebo (median 1.08 ng/mL). The apnea and hypopnea index (AHI) and the oxygen esaturation index (ODI) increased in the comparisons between placebo and gabapentin (median AHI: 6.90 vs. 21.4, p = 0.01; ODI: 6.45 vs. 15.2, p = 0.01). In the 657 participants in study 2, the risk of 25(OH)D deficiency was associated with obstructive sleep apnea (OSA) (OR: 1.89, 95%CI: 1.29-2.77), nocturnal hypoxemia (OR: 2.62, 95%CI 95 %: 1.56-4.32) and short duration of sleep (< 6hs) (OR: 1.56, 95%CI: 1.11-2.21). In the 707 participants in study 3, severe OSA (AHI>30) was associated with OS (OR: 3.23, 95%CI: 1.10-9.53) and nocturnal hypoxemia was associated with obesity (OR: 2.48, 95%CI: 1.45-4.25) and OS (OR = 2.12, 95%CI: 1.10-4.10). Conclusions: Taken together, our findings derived from different studies suggest an intricate pathophysiologic relationship between sleep disorders, especially OSA, and adverse body composition patterns, which may go beyond fat deposition and involve muscle metabolism. Likewise, vitamin D may play a modulatory role in the associations between sleep and body composition and, in older men, not only the increase in adipose tissue but also the morphofunctional muscle decline may be a risk factor for OSA.
publishDate 2018
dc.date.none.fl_str_mv 2018-06-28
2020-03-25T12:10:39Z
2020-03-25T12:10:39Z
dc.type.driver.fl_str_mv info:eu-repo/semantics/doctoralThesis
dc.type.status.fl_str_mv info:eu-repo/semantics/publishedVersion
format doctoralThesis
status_str publishedVersion
dc.identifier.uri.fl_str_mv https://sucupira.capes.gov.br/sucupira/public/consultas/coleta/trabalhoConclusao/viewTrabalhoConclusao.jsf?popup=true&id_trabalho=6329206
PIOVEZAN, Ronaldo Delmonte. Interações entre sono e marcadores de padrões desfavoráveis de composição corporal. Tese (Doutorado em Ciências) - Escola Paulista de Medicina, Universidade Federal de São Paulo (UNIFESP), São Paulo, 2018.
2018 PIOVEZAN, RONALDO DELMONTE.Doutorado.pdf
https://repositorio.unifesp.br/handle/11600/52886
url https://sucupira.capes.gov.br/sucupira/public/consultas/coleta/trabalhoConclusao/viewTrabalhoConclusao.jsf?popup=true&id_trabalho=6329206
https://repositorio.unifesp.br/handle/11600/52886
identifier_str_mv PIOVEZAN, Ronaldo Delmonte. Interações entre sono e marcadores de padrões desfavoráveis de composição corporal. Tese (Doutorado em Ciências) - Escola Paulista de Medicina, Universidade Federal de São Paulo (UNIFESP), São Paulo, 2018.
2018 PIOVEZAN, RONALDO DELMONTE.Doutorado.pdf
dc.language.iso.fl_str_mv por
language por
dc.rights.driver.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv 190 f.
application/pdf
dc.coverage.none.fl_str_mv São Paulo
dc.publisher.none.fl_str_mv Universidade Federal de São Paulo (UNIFESP)
publisher.none.fl_str_mv Universidade Federal de São Paulo (UNIFESP)
dc.source.none.fl_str_mv reponame:Repositório Institucional da UNIFESP
instname:Universidade Federal de São Paulo (UNIFESP)
instacron:UNIFESP
instname_str Universidade Federal de São Paulo (UNIFESP)
instacron_str UNIFESP
institution UNIFESP
reponame_str Repositório Institucional da UNIFESP
collection Repositório Institucional da UNIFESP
repository.name.fl_str_mv Repositório Institucional da UNIFESP - Universidade Federal de São Paulo (UNIFESP)
repository.mail.fl_str_mv biblioteca.csp@unifesp.br
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