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A Pilot Study About the Dysfunction of Adipose Tissue in Male, Sleep Apneic Patients in Relation to Psychological Symptoms

Introduction: Obstructive sleep apnea (OSA) and its cardiometabolic alterations are closely associated with visceral obesity. Patients with OSA frequently present with symptoms of depression and anxiety. Although these subjective symptoms of OSA are the result of complex biological dysregulation, it...

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Autores principales: Trakada, Georgia, Nikolaidis, Pantelis T., Economou, Nicholas-Tiberio, Sakkas, Dimitrios, Giagkou, Giorgos, Sakellariou, Stratigoula, Kyriakopoulou, Konstantina, Patsouris, Efstratios, Ferini-Strambi, Luigi, Velentza, Lemonia, Kallianos, Anastasios, Rosemann, Thomas, Knechtle, Beat, Mitrakou, Asimina
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6673696/
https://www.ncbi.nlm.nih.gov/pubmed/31404145
http://dx.doi.org/10.3389/fpsyt.2019.00527
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author Trakada, Georgia
Nikolaidis, Pantelis T.
Economou, Nicholas-Tiberio
Sakkas, Dimitrios
Giagkou, Giorgos
Sakellariou, Stratigoula
Kyriakopoulou, Konstantina
Patsouris, Efstratios
Ferini-Strambi, Luigi
Velentza, Lemonia
Kallianos, Anastasios
Rosemann, Thomas
Knechtle, Beat
Mitrakou, Asimina
author_facet Trakada, Georgia
Nikolaidis, Pantelis T.
Economou, Nicholas-Tiberio
Sakkas, Dimitrios
Giagkou, Giorgos
Sakellariou, Stratigoula
Kyriakopoulou, Konstantina
Patsouris, Efstratios
Ferini-Strambi, Luigi
Velentza, Lemonia
Kallianos, Anastasios
Rosemann, Thomas
Knechtle, Beat
Mitrakou, Asimina
author_sort Trakada, Georgia
collection PubMed
description Introduction: Obstructive sleep apnea (OSA) and its cardiometabolic alterations are closely associated with visceral obesity. Patients with OSA frequently present with symptoms of depression and anxiety. Although these subjective symptoms of OSA are the result of complex biological dysregulation, it remains unclear if they have a direct effect on the dysfunction of adipose tissue. Methods: In a pilot, prospective, randomized study, we evaluated 10 recently diagnosed male patients with severe OSA by full polysomnography (PSG) and 4 male non-apneic subjects matched for age and body mass index (BMI) with abdomen adipose tissue biopsies. Subjects with diabetes/prediabetes and cardiovascular and psychiatric diseases and who are current smokers were excluded. All patients underwent anthropometric measurements and completed the following questionnaires: Epworth Sleepiness Scale (ESS), Fatigue Severity Scale (FSS), and Hospital Anxiety and Depression Scale (HADS-A and HADS-D). Fasting venous blood samples were collected on the day after PSG, between 8:00 and 9:00 a.m., after an overnight fast. Fat biopsies were performed at the same time periods and adipose tissue samples of 300 mg were obtained from abdominal fat. Fat cell size, extent of fibrosis, vascularity, leukocyte common antigen inflammatory infiltration, and tissue macrophage accumulation were microscopically evaluated. Results: The mean age of the group was 47.4 ± 13.8 years, with mean BMI of 35.8 ± 4.8 kg/m(2) and mean apnea-hypopnea index of 79.4 ± 46.1 events per hour of sleep (severe OSA). HADS-A and HADS-D scores were 5.8 ± 2.3 (3.0–8.0) and 4.7 ± 2.3 (2.0–8.0), respectively. HADS-A score correlated positively with macrophage accumulation in fat biopsy (r = 0.82, p = 0.047), whereas ESS, FSS, and HADS-D did not. Severity of fibrosis correlated largely with waist circumference (r = -0.66, p = 0.038) and neck circumference (r = -0.790, p = 0.006). Respiratory events correlated negatively with the extent of vascularization of adipose tissue (r = -0.614, p = 0.05). Conclusions: In the preliminary results of our pilot study, we assessed that the symptoms of anxiety mainly contribute to macrophage accumulation, whereas the increased number of respiratory events reduces the extent of vascularization in visceral fat in OSA. Based on this observation, further larger studies are required to verify if anxious OSA patients are more vulnerable to the metabolic manifestations of the syndrome.
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spelling pubmed-66736962019-08-09 A Pilot Study About the Dysfunction of Adipose Tissue in Male, Sleep Apneic Patients in Relation to Psychological Symptoms Trakada, Georgia Nikolaidis, Pantelis T. Economou, Nicholas-Tiberio Sakkas, Dimitrios Giagkou, Giorgos Sakellariou, Stratigoula Kyriakopoulou, Konstantina Patsouris, Efstratios Ferini-Strambi, Luigi Velentza, Lemonia Kallianos, Anastasios Rosemann, Thomas Knechtle, Beat Mitrakou, Asimina Front Psychiatry Psychiatry Introduction: Obstructive sleep apnea (OSA) and its cardiometabolic alterations are closely associated with visceral obesity. Patients with OSA frequently present with symptoms of depression and anxiety. Although these subjective symptoms of OSA are the result of complex biological dysregulation, it remains unclear if they have a direct effect on the dysfunction of adipose tissue. Methods: In a pilot, prospective, randomized study, we evaluated 10 recently diagnosed male patients with severe OSA by full polysomnography (PSG) and 4 male non-apneic subjects matched for age and body mass index (BMI) with abdomen adipose tissue biopsies. Subjects with diabetes/prediabetes and cardiovascular and psychiatric diseases and who are current smokers were excluded. All patients underwent anthropometric measurements and completed the following questionnaires: Epworth Sleepiness Scale (ESS), Fatigue Severity Scale (FSS), and Hospital Anxiety and Depression Scale (HADS-A and HADS-D). Fasting venous blood samples were collected on the day after PSG, between 8:00 and 9:00 a.m., after an overnight fast. Fat biopsies were performed at the same time periods and adipose tissue samples of 300 mg were obtained from abdominal fat. Fat cell size, extent of fibrosis, vascularity, leukocyte common antigen inflammatory infiltration, and tissue macrophage accumulation were microscopically evaluated. Results: The mean age of the group was 47.4 ± 13.8 years, with mean BMI of 35.8 ± 4.8 kg/m(2) and mean apnea-hypopnea index of 79.4 ± 46.1 events per hour of sleep (severe OSA). HADS-A and HADS-D scores were 5.8 ± 2.3 (3.0–8.0) and 4.7 ± 2.3 (2.0–8.0), respectively. HADS-A score correlated positively with macrophage accumulation in fat biopsy (r = 0.82, p = 0.047), whereas ESS, FSS, and HADS-D did not. Severity of fibrosis correlated largely with waist circumference (r = -0.66, p = 0.038) and neck circumference (r = -0.790, p = 0.006). Respiratory events correlated negatively with the extent of vascularization of adipose tissue (r = -0.614, p = 0.05). Conclusions: In the preliminary results of our pilot study, we assessed that the symptoms of anxiety mainly contribute to macrophage accumulation, whereas the increased number of respiratory events reduces the extent of vascularization in visceral fat in OSA. Based on this observation, further larger studies are required to verify if anxious OSA patients are more vulnerable to the metabolic manifestations of the syndrome. Frontiers Media S.A. 2019-07-25 /pmc/articles/PMC6673696/ /pubmed/31404145 http://dx.doi.org/10.3389/fpsyt.2019.00527 Text en Copyright © 2019 Trakada, Nikolaidis, Economou, Sakkas, Giagkou, Sakellariou, Kyriakopoulou, Patsouris, Ferini-Strambi, Velentza, Kallianos, Rosemann, Knechtle and Mitrakou http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Psychiatry
Trakada, Georgia
Nikolaidis, Pantelis T.
Economou, Nicholas-Tiberio
Sakkas, Dimitrios
Giagkou, Giorgos
Sakellariou, Stratigoula
Kyriakopoulou, Konstantina
Patsouris, Efstratios
Ferini-Strambi, Luigi
Velentza, Lemonia
Kallianos, Anastasios
Rosemann, Thomas
Knechtle, Beat
Mitrakou, Asimina
A Pilot Study About the Dysfunction of Adipose Tissue in Male, Sleep Apneic Patients in Relation to Psychological Symptoms
title A Pilot Study About the Dysfunction of Adipose Tissue in Male, Sleep Apneic Patients in Relation to Psychological Symptoms
title_full A Pilot Study About the Dysfunction of Adipose Tissue in Male, Sleep Apneic Patients in Relation to Psychological Symptoms
title_fullStr A Pilot Study About the Dysfunction of Adipose Tissue in Male, Sleep Apneic Patients in Relation to Psychological Symptoms
title_full_unstemmed A Pilot Study About the Dysfunction of Adipose Tissue in Male, Sleep Apneic Patients in Relation to Psychological Symptoms
title_short A Pilot Study About the Dysfunction of Adipose Tissue in Male, Sleep Apneic Patients in Relation to Psychological Symptoms
title_sort pilot study about the dysfunction of adipose tissue in male, sleep apneic patients in relation to psychological symptoms
topic Psychiatry
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6673696/
https://www.ncbi.nlm.nih.gov/pubmed/31404145
http://dx.doi.org/10.3389/fpsyt.2019.00527
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