Leticia Maria Tedesco Silva

Exercise, Occupational Activity, and Risk of Sleep Apnea: A Cross-Sectional Study.

STUDY OBJECTIVES To investigate whether structured exercise and occupational activity are associated with obstructive sleep apnea (OSA) severity. METHODS The International Physical Activity Questionnaire was answered by 5,453 individuals who underwent full-night polysomnography. Participants were classified as exercisers or non-exercisers and also as occupationally active or non-active. The apnea-hypopnea index (AHI), minimum oxygen saturation (SaO2min), and time with saturation below 90% (TB90%) during polysomnography were used as indicators of OSA severity. RESULTS The sample included mostly men (59%), non-exercisers (56%), and occupationally non-active individuals (75%). Mean age (± standard deviation) was 44 ± 14 years, and mean body mass index was 29.9 ± 7.3 kg/m2. Non-exercisers had higher AHI (median 14, 25-75% interquartile range 4-34) than exercisers (8 [2-24]), lower SaO2min (83 ± 9 vs. 86 ± 8%), and longer TB90% (2 [0-18] vs. 0 [0-7] minutes), with p < 0.001 for all comparisons. AHI was higher in active (16 [6-34]) vs. non-active occupations (10 [3-27]; p < 0.001). Multinomial logistic regression with control for age, sex, overweight, obesity, and occupational activity showed that structured exercise was significantly associated with a 23% lower odds ratio for moderate OSA and 34% lower odds ratio for severe OSA. Active occupation was not associated with OSA. CONCLUSIONS Structured physical exercise is associated with lower odds for OSA, independently of confounders. Occupational activity does not seem to replace the effects of regular exercise. Compensatory behaviors may be involved in these diverging outcomes. Our results warrant further research about the effect of occupational activity on OSA severity.

24-hour blood pressure homeostasis and renal function in subjects with and without metabolic syndrome

Materials and methods We designed a cross-sectional study of consecutive individuals (n=108; females 74%; 52.8±12.7 yrs.; mean±SD) from the Diabetes Clinic of a university hospital. MS was defined by the International Diabetes Federation criteria. BP was measured at office and its circadian variation was determined by 24-h ambulatory BP monitoring, after withdrawal from anti-hypertensive medications. Patients were classified according to their BP behavior: normotension (NT; n=29), white-coat hypertension (WCH; n=19) and ambulatory hypertension (AHT; n=57). Fasting and 2h-plasma glucose levels, lipid profile, creatinine and 24-h urinary albumin excretion (UAER) were measured. Glomerular filtration rate (GFR) was estimated by the CKD-EPI equation. A two-sided P value <0.05 was considered significant. Results Estimated GFR (EGFR) was lower in subjects with MS than in those without MS (Mean±SD; 90±20 vs 98.8±16.5; P=0.047). EGFR was related to age (r=-0.666; P<0.001), fasting glucose (r=0.223; P=0.021), and 24-h systolic BP (r=-0.196; P=0.044), but not to diastolic BP. EGFR was inversely related to sleep-time BP (r=-0.224; P=0.021), morning systolic BP (r=-0.224; P=0.030) and pulse pressure (r=-0.233; P=0.170). Subjects with WCH and AHT compared to those with NT had lower EGFR (Mean±SD; 89.3±18 vs 89.6±26.3 vs 100.2±14.8; P=0.036) and higher UAER (Median [P25-75]; 1 [0-5.3] vs 6.1 [1-19] vs 6.3 [1-16.8]; P=0.031).

The effect of caffeine supplementation on exercise performance evaluated by a novel animal model

Introduction: Caffeinated drinks are used for improve performance. Animal models represent investigational strategy that circumvents most of the drawbacks of research in humans, including motivational factors and the placebo effect. No animal model that could test whether different forms of administering caffeine affect exercise propensity was found in the literature. Methods: An animal model of grouped voluntary exercise was tested. Two-month-old male C57/bl mice were housed in a cage fitted with one running wheel and a monitoring system. Six animals per cage were introduced individually. To assess the sensitivity of the model, the effect of different caffeinated drinks was observed in mice exercising ad libitum . During 2 days, the mice received: 1) pure anhydrous caffeine 0.125 mg/mL (PC), 2) cola drink (CC), and 3) caffeine-taurine-glucuronolactone drink (CTG), intercalating wash-out periods of 2 days, receiving pure water. Results: The distance run during the periods of water ingestion was significantly lower than during the periods of stimulant drinks ingestion: PC (5.6±1.3 km; p = 0.02), of CC ingestion (7.6±0.6 km; p = 0.001), and of CTG ingestion (8.3±1.6 km; p = 0.009). The performances when ingesting the three caffeinated drinks do not follow a dose-response curve. Conclusions: The model described here was able to measure the effect of caffeine intake on voluntary exercise of mice. The sensitivity of the model to the effect of caffeine needs to be further validated. The action of each component of the drinks on exercise performance needs to be clarified in future research. The present model is adequate for such investigation. Key words: Exercise; caffeine; energy drinks; running

Waist-to-height ratio as a predictor of metabolic syndrome in a population with different degrees of glucose tolerance

Waist-to-height ratio as a predictor of metabolic syndrome in a population with different degrees of glucose tolerance Tassia Cividanes Pazinato, Barbara Limberger Nedel, Anize Delfino von Frankenberg, Vanessa Piccoli, Luciana Pavan Antoniolli, Mayara Abichequer Beer, Leticia Maria Tedesco Silva, Rodrigo Soares de Souza Marques, Leonardo de Andrade Mesquita, Monique de Moura Machado, Andre Fernandes Reis, Fernando Gerchman

Diabetes mellitus and symptoms of sleep apnea are associated with adverse delivery outcomes

Materials and methods In a prospective cohort design, 158 women answered a version of the STOP-Bang questionnaire adapted for pregnant women using age cutoff at 35 yrs. and excluding male gender (STOP-Ban); risk for sleep apnea was considered present when score>2. Obstetric history and physical examination were obtained. Both gestational and pre-gestational diabetes were considered for the analyses. The hospital records were reviewed for delivery outcomes. Preterm birth, premature rupture of membranes, non-elective cesarean section, low birth weight, and non-reassuring fetal condition were considered adverse delivery outcomes. Seven classical gestational risk factors were used to adjust the multivariate models.

Association of pulse pressure with fasting and 2-h plasma glucose in subjects with different degrees of glucose tolerance

Materials and methods In a cross-sectional study, 128 subjects (53.1±12.3 y, females 72%) were submitted to a 75-g OGTT (measurement of glucose and insulin) and divided according to glucose tolerance status (normal glucose tolerance [NGT; n=38], prediabetes [PDM; n=53] and diabetes [DM; n=37]). 24-h ABPM was performed. Mean 24h PP was calculated as the difference between mean systolic and diastolic blood pressure (BP), obtained through 24-h ABPM. Fasting C-peptide and A1c were collected. Body size (BMI) and central obesity (waist circumference) were assessed. Insulin sensitivity index (ISI Stumvoll), insulin resistance (HOMA-IR) and b-cell function (insulinogenic index; ΔIns30′-0′/ΔGli30′-0′) were estimated. A two-sided P value < 0.05 was considered significant. Results By ABPM, 24-hour PP progressively increased from NGT to DM (mean±SD; NGT 45.9±8.5 vs PDM 51.9±10.4 vs DM 57.8±11.1 mmHg; P<0.001). 24-hour PP was positively related to age (r=0.316; P<0.001), waist circumference (r=0.263; P=0.003), BMI (r=0.35; P<0.001), A1C (r=0.438; P<0.001), 2-h glucose level (r=0.424; P<0.001), C-peptide (r=0.286; P=0.001), HOMA-IR (r=0.155; P=0.085) and it was inversely related to ISI Stumvoll (r=-0.474; P <0.001) and to insulinogenic index (r=-0.184; P=0.048). While adjusting for age and waist circumference, pulse pressure was independently associated with 2 hour plasma glucose (R=0.287; P=0.002) and A1c (R=0.241; P=0.010).