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Patial K, Mishra HP, Pal G, Suvvari TK, Ghosh T, Mishra SS, Mahapatra C, Amanullah NA, Shukoor SA, Kamal S, Singh I, Israr J, Sharma PS, Gaur SN, Behera RK. Understanding the Association Between Obesity and Obstructive Sleep Apnea Syndrome: A Case-Control Study. Cureus 2023; 15:e45843. [PMID: 37881397 PMCID: PMC10594396 DOI: 10.7759/cureus.45843] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/23/2023] [Indexed: 10/27/2023] Open
Abstract
Introduction Obstructive sleep apnea (OSA) represents a sleep-related impairment linked to upper airway function. The question of whether OSA drives obesity or if shared underlying factors contribute to both conditions remains unresolved. Hence, this present study aims to understand the interplay between obstructive sleep apnea syndrome (OSAS) and obesity through in-depth analysis of anthropometric data within control subjects and OSA patients. Methodology A case-control study was conducted, which included 40 cases and 40 matched healthy controls. Study participants with reported symptoms of snoring, daytime drowsiness, or both were included in the study. All the study participants underwent comprehensive anthropometric assessments such as height, weight, body mass index (BMI), neck circumference, waist circumference, hip circumference, waist-to-hip ratio, skin-fold thickness, and thickness measurements of biceps, triceps, suprailiac, and subscapular muscles. Results Within the OSA group, significant disparities emerged in mean age, waist circumference, waist-to-hip ratio, and diverse fat accumulations encompassing visceral, subcutaneous, trunk, and subcutaneous leg fat. Notably, skin-fold thickness at specific sites - biceps, triceps, subscapula, and suprailiac - demonstrated considerable augmentation relative to the control group. Furthermore, mean values associated with height, weight, BMI, neck circumference, fat percentage, subcutaneous arm fat, entire arm composition, and trunk skeletal muscle either equaled or exceeded those in the control group. However, statistical significance was not attained in these comparisons. Conclusion This investigation underscored a pronounced correlation between numerous endpoints characterizing OSA patients and markers of obesity. Consequently, addressing altered levels of obesity-linked anthropometric variables through pharmacological interventions might hold promise as a pivotal strategy for improving symptoms associated with OSA.
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Affiliation(s)
- Kuldeep Patial
- Sleep Medicine, Vallabhbhai Patel Chest Institute, University of Delhi, Delhi, IND
| | - Hara Prasad Mishra
- Clinical Trial, All India Institute of Medical Sciences, New Delhi, Delhi, IND
- Pharmacology and Therapeutics, University College of Medical Sciences, University of Delhi, Delhi, IND
| | - Giridhari Pal
- Pharmacology, Vallabhbhai Patel Chest Institute, University of Delhi, Delhi, IND
| | - Tarun Kumar Suvvari
- General Medicine, Rangaraya Medical College, Kakinada, IND
- Research, Squad Medicine and Research (SMR), Visakhapatnam, IND
| | - Tamoghna Ghosh
- Medicine, All India Institute of Medical Sciences, New Delhi, Delhi, IND
| | - Smruti Sikta Mishra
- Occupational Therapy, Pandit Deendayal Upadhyaya National Institute for Persons with Physical Disabilities, New Delhi, IND
| | | | - Nidhal A Amanullah
- Psychiatry and Behavioral Sciences, Sree Ramakrishna Mission Hospital, Thiruvananthapuram, IND
| | - Sara A Shukoor
- Psychiatry, Government Medical College, Trivandrum, Trivandrum, IND
| | - Sibin Kamal
- Pain and Palliative Medicine, IQRAA International Hospital & Research Centre, Kandhla, IND
| | | | - Juveriya Israr
- Biosciences and Technology, Shri Ramswaroop Memorial University, Lucknow, IND
| | - Prem S Sharma
- Biostatistics & Medical Informatics, University College of Medical Sciences, Delhi, IND
| | - S N Gaur
- Pulmonary Medicine, Vallabhbhai Patel Chest Institute, University of Delhi, Delhi, IND
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Sureshchandra S, Marshall NE, Messaoudi I. Impact of pregravid obesity on maternal and fetal immunity: Fertile grounds for reprogramming. J Leukoc Biol 2019; 106:1035-1050. [PMID: 31483523 DOI: 10.1002/jlb.3ri0619-181r] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2019] [Revised: 07/31/2019] [Accepted: 08/01/2019] [Indexed: 12/12/2022] Open
Abstract
Maternal pregravid obesity results in several adverse health outcomes during pregnancy, including increased risk of gestational diabetes, preeclampsia, placental abruption, and complications at delivery. Additionally, pregravid obesity and in utero exposure to high fat diet have been shown to have detrimental effects on fetal programming, predisposing the offspring to adverse cardiometabolic, endocrine, and neurodevelopmental outcomes. More recently, a deeper appreciation for the modulation of offspring immunity and infectious disease-related outcomes by maternal pregravid obesity has emerged. This review will describe currently available animal models for studying the impact of maternal pregravid obesity on fetal immunity and review the data from clinical and animal model studies. We also examine the burden of pregravid obesity on the maternal-fetal interface and the link between placental and systemic inflammation. Finally, we discuss future studies needed to identify key mechanistic underpinnings that link maternal inflammatory changes and fetal cellular reprogramming events.
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Affiliation(s)
- Suhas Sureshchandra
- Department of Molecular Biology and Biochemistry, University of California Irvine, Irvine, CA, USA
| | - Nicole E Marshall
- Maternal-Fetal Medicine, Oregon Health and Science University, Portland, Oregon, USA
| | - Ilhem Messaoudi
- Department of Molecular Biology and Biochemistry, University of California Irvine, Irvine, CA, USA
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Pendeloski KPT, Ono E, Torloni MR, Mattar R, Daher S. Maternal obesity and inflammatory mediators: A controversial association. Am J Reprod Immunol 2017; 77. [PMID: 28328066 DOI: 10.1111/aji.12674] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2017] [Accepted: 02/22/2017] [Indexed: 12/11/2022] Open
Abstract
The link between maternal obesity and inflammatory mediators is still unclear. Our aim was to summarize the main findings of recently published studies on this topic. We performed a search in Medline for studies published in the last years on obesity, human pregnancy, and inflammatory mediators. We report the findings of 30 studies. The characteristics and number of participants, study design, gestational age at sample collection, and type of sample varied widely. Approximately two-thirds of them investigated more than one mediator, and 50% included participants in only one trimester of pregnancy. The most frequently investigated mediators were leptin, tumour necrosis factor-alpha (TNF-α), and interleukin (IL)-6. Almost all studies reported an association between maternal obesity, leptin, and C-reactive protein (CRP) serum levels but not with IL-1β and IL-10. The association of IL-6, TNF-α, monocyte chemo-attractant protein-1 (MCP-1), adiponectin, and resistin with maternal obesity is still controversial. To clarify the physiopathological link between maternal obesity and inflammation, more high-quality studies are needed.
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Affiliation(s)
| | - Erika Ono
- Department of Obstetrics, Universidade Federal de São Paulo, São Paulo, Sao Paulo, Brazil
| | - Maria Regina Torloni
- Department of Obstetrics, Universidade Federal de São Paulo, São Paulo, Sao Paulo, Brazil
| | - Rosiane Mattar
- Department of Obstetrics, Universidade Federal de São Paulo, São Paulo, Sao Paulo, Brazil
| | - Silvia Daher
- Department of Obstetrics, Universidade Federal de São Paulo, São Paulo, Sao Paulo, Brazil
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Carlhäll S, Bladh M, Brynhildsen J, Claesson IM, Josefsson A, Sydsjö G, Thorsell A, Blomberg M. Maternal obesity (Class I-III), gestational weight gain and maternal leptin levels during and after pregnancy: a prospective cohort study. BMC OBESITY 2016; 3:28. [PMID: 27257506 PMCID: PMC4875677 DOI: 10.1186/s40608-016-0108-2] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/18/2016] [Accepted: 05/12/2016] [Indexed: 11/10/2022]
Abstract
BACKGROUND Maternal obesity is accompanied by maternal and fetal complications during and after pregnancy. The risks seem to increase with degree of obesity. Leptin has been suggested to play a role in the development of obesity related complications. Whether maternal leptin levels differ between obese and morbidly obese women, during and after pregnancy, have to our knowledge not been previously described. Neither has the association between maternal leptin levels and gestational weight gain in obese women. The aim was to evaluate if maternal plasma leptin levels were associated with different degrees of maternal obesity and gestational weight gain. METHODS Prospective cohort study including women categorized as obesity class I-III (n = 343) and divided into three gestational weight gain groups (n = 304). Maternal plasma leptin was measured at gestational week 15, 29 and 10 weeks postpartum. Maternal Body Mass Index (BMI) was calculated from early pregnancy weight. Gestational weight gain was calculated using maternal weight in delivery week minus early pregnancy weight. The mean value and confidence interval of plasma-leptin were analysed with a two-way ANOVA model. Interaction effect between BMI and gestational weight gain group was tested with a two-way ANOVA model. RESULTS The mean maternal leptin concentrations were significantly higher in women with obesity class III compared to women in obesity class I, at all times when plasma leptin were measured. The mean leptin concentrations were also significantly higher in women with obesity class II compared to women in obesity class I, except in gestational week 29. There was no difference in mean levels of plasma leptin between the gestational weight gain groups. No significant interaction between BMI and gestational weight gain group was found. CONCLUSIONS Plasma leptin levels during and after pregnancy were associated with obesity class but not with degree of gestational weight gain. These results are in concordance with epidemiological findings where the risk of obstetric complications increases with increased maternal obesity class. The effect on obstetric outcome by degree of gestational weight gain is less pronounced than the adverse effects associated with maternal obesity.
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Affiliation(s)
- Sara Carlhäll
- Department of Obstetrics and Gynaecology and Department of Clinical and Experimental Medicine, Linköping University, 58185 Linköping, Sweden
| | - Marie Bladh
- Department of Obstetrics and Gynaecology and Department of Clinical and Experimental Medicine, Linköping University, 58185 Linköping, Sweden
| | - Jan Brynhildsen
- Department of Obstetrics and Gynaecology and Department of Clinical and Experimental Medicine, Linköping University, 58185 Linköping, Sweden
| | - Ing-Marie Claesson
- Department of Obstetrics and Gynaecology and Department of Clinical and Experimental Medicine, Linköping University, 58185 Linköping, Sweden
| | - Ann Josefsson
- Department of Obstetrics and Gynaecology and Department of Clinical and Experimental Medicine, Linköping University, 58185 Linköping, Sweden
| | - Gunilla Sydsjö
- Department of Obstetrics and Gynaecology and Department of Clinical and Experimental Medicine, Linköping University, 58185 Linköping, Sweden
| | - Annika Thorsell
- Division of Cell Biology, Department of Clinical and Experimental Medicine, Faculty of Health Sciences, Linköping University, 58185 Linköping, Sweden
| | - Marie Blomberg
- Department of Obstetrics and Gynaecology and Department of Clinical and Experimental Medicine, Linköping University, 58185 Linköping, Sweden
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Serum Adipsin Levels throughout Normal Pregnancy and Preeclampsia. Sci Rep 2016; 6:20073. [PMID: 26832661 PMCID: PMC4735521 DOI: 10.1038/srep20073] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2015] [Accepted: 12/18/2015] [Indexed: 01/08/2023] Open
Abstract
Adipsin is a protease produced at high levels by adipose tissue. It is involved in complement activation and metabolic control. The objective of this study was to determine the changes in adipsin levels during different stages of normal pregnancy, and its association with obstetric outcomes, such as preeclampsia. This nested case-control study in a longitudinal cohort included normal pregnant (n = 54) and preeclamptic (n = 18) women, both followed throughout pregnancy. Additionally, some of the normal pregnant women were followed up three months postpartum (n = 18). Healthy non-pregnant women were also studied during their menstrual cycle (n = 20). The results of this study show that in healthy non-pregnant women, adipsin levels did not change significantly during the menstrual cycle. In normal pregnant women, adipsin levels were lower (p < 0.01) when compared with non-pregnant healthy women, but these serum levels increased again during postpartum (p < 0.001). Adipsin levels were significantly elevated in preeclamptic women in late pregnancy (P < 0.01). A significant correlation was not found between leptin and adipsin during the three periods of gestation studied in healthy pregnant and preeclamptic women. Our results suggest that adipsin may be involved in pregnancy-associated metabolic changes. Moreover, the increase of adipsin levels towards late gestation in preeclamptic women could be related to the pathophysiology of this disease.
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Dodd JM, Kannieappan LM, Grivell RM, Deussen AR, Moran LJ, Yelland LN, Owens JA. Effects of an antenatal dietary intervention on maternal anthropometric measures in pregnant women with obesity. Obesity (Silver Spring) 2015; 23:1555-62. [PMID: 26175260 PMCID: PMC5054850 DOI: 10.1002/oby.21145] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2014] [Accepted: 04/11/2015] [Indexed: 01/29/2023]
Abstract
OBJECTIVE The effect of providing antenatal dietary and lifestyle advice on secondary measures of maternal anthropometry was evaluated and their correlation with both gestational weight gain and infant birth weight was assessed. METHODS In a multicenter, randomized controlled trial, pregnant women with BMI of ≥25 kg/m(2) received either Lifestyle Advice or Standard Care. Maternal anthropometric outcomes included arm circumference, biceps, triceps, and subscapular skinfold thickness measurements (SFTM), percentage body fat (BF), gestational weight gain, and infant birth weight. The intention to treat principles were utilized by the analyses. RESULTS The measurements were obtained from 807 (74.7%) women in the Lifestyle Advice Group and 775 (72.3%) women in the Standard Care Group. There were no statistically significant differences identified between the treatment groups with regards to arm circumference, biceps, triceps, and subscapular SFTM, or percentage BF at 36-week gestation. Maternal anthropometric measurements were not significantly correlated with either gestational weight gain or infant birth weight. CONCLUSIONS Among pregnant women with a BMI of ≥25 kg/m(2) , maternal SFTM were not modified by an antenatal dietary and lifestyle intervention. Furthermore, maternal SFTM correlate poorly with both gestational weight gain and infant birth weight.
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Affiliation(s)
- Jodie M. Dodd
- School of Paediatrics and Reproductive Health Discipline of Obstetrics and Gynaecology, The University of AdelaideAdelaideAustralia
- The Robinson Research Institute, The University of AdelaideAdelaideAustralia
- Department of Perinatal MedicineWomen's and Babies DivisionThe Women's and Children's HospitalNorth AdelaideAustralia
| | - Lavern M. Kannieappan
- School of Paediatrics and Reproductive Health Discipline of Obstetrics and Gynaecology, The University of AdelaideAdelaideAustralia
- The Robinson Research Institute, The University of AdelaideAdelaideAustralia
| | - Rosalie M. Grivell
- School of Paediatrics and Reproductive Health Discipline of Obstetrics and Gynaecology, The University of AdelaideAdelaideAustralia
- The Robinson Research Institute, The University of AdelaideAdelaideAustralia
- Department of Perinatal MedicineWomen's and Babies DivisionThe Women's and Children's HospitalNorth AdelaideAustralia
| | - Andrea R. Deussen
- School of Paediatrics and Reproductive Health Discipline of Obstetrics and Gynaecology, The University of AdelaideAdelaideAustralia
- The Robinson Research Institute, The University of AdelaideAdelaideAustralia
| | - Lisa J. Moran
- School of Paediatrics and Reproductive Health Discipline of Obstetrics and Gynaecology, The University of AdelaideAdelaideAustralia
- The Robinson Research Institute, The University of AdelaideAdelaideAustralia
| | - Lisa N. Yelland
- School of Paediatrics and Reproductive Health Discipline of Obstetrics and Gynaecology, The University of AdelaideAdelaideAustralia
- The Robinson Research Institute, The University of AdelaideAdelaideAustralia
- Women's and Children's Health Research InstituteNorth AdelaideAustralia
- School of Population HealthDiscipline of Public HealthThe University of AdelaideAdelaideAustralia
| | - Julie A. Owens
- School of Paediatrics and Reproductive Health Discipline of Obstetrics and Gynaecology, The University of AdelaideAdelaideAustralia
- The Robinson Research Institute, The University of AdelaideAdelaideAustralia
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