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Obesity Surgery
Published in: Obesity Surgery 12/2017

01-12-2017 | Original Contributions

Bariatric Surgery-Induced Resolution of Hypertension and Obstructive Sleep Apnea: Impact of Modulation of Body Fat, Ectopic Fat, Autonomic Nervous Activity, Inflammatory and Adipokine Profiles

Authors: Audrey Auclair, Laurent Biertho, Simon Marceau, Frédéric-Simon Hould, Simon Biron, Stéfane Lebel, François Julien, Odette Lescelleur, Yves Lacasse, Marie-Eve Piché, Katherine Cianflone, Sebastian Demian Parlee, Kerry Goralski, Julie Martin, Marjorie Bastien, David H. St-Pierre, Paul Poirier

Published in: Obesity Surgery | Issue 12/2017

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Abstract

Background

Obesity-associated systemic hypertension (HTN) and obstructive sleep apnea (OSA) have multiple pathophysiological pathways including ectopic fat deposition, inflammation, altered adipokine profile, and increased sympathetic nervous activity. We characterized these potential mechanisms in severely obese patients with or without HTN and OSA. We also compared changes of these mechanisms at 12 months following biliopancreatic diversion with duodenal switch (BPD-DS) surgery according to HTN and OSA resolution.

Methods

Sixty-two severely obese patients were evaluated at baseline and 12 months; 40 patients underwent BPD-DS. Blood samples, bioelectrical impedance analysis, computed tomography scan, and 24-h heart rate monitoring were performed. OSA have been determined with polysomnography and HTN with blood pressure measurement and medical file.

Results

Patients with HTN (n = 35) and OSA (n = 32) were older men with higher ectopic fat deposition and lower parasympathetic nervous activity without difference in adipokines and inflammatory markers. Lower reduction in weight was observed in patients with unresolved HTN (−40.9 ± 3.3 kg vs. −55.6 ± 3.8 kg; p = 0.001) and OSA (−41.4 ± 10.7 kg vs. −51.0 ± 15.2 kg; p = 0.006). Visceral adipose tissue reduction was lower in patients with unresolved HTN (−171.0 ± 25.7 cm2 vs. −274.5 ± 29.0 cm2; p = 0.001) in contrast to a trend for lower abdominal subcutaneous adipose tissue reduction in patients with unresolved OSA (−247.7 ± 91.5 cm2 vs. −390.5 ± 109.1 cm2; p = 0.08). At 12 months, parasympathetic activity was lowest in unresolved HTN and OSA patients, without difference in adipokines and inflammatory biomarkers.

Conclusion

Lower ectopic fat mobilization, lower level of parasympathetic nervous activity, and lower subcutaneous adiposity mobilization may play a role in the pathophysiology of unresolved HTN and OSA following BPD-DS surgery.
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Metadata
Title
Bariatric Surgery-Induced Resolution of Hypertension and Obstructive Sleep Apnea: Impact of Modulation of Body Fat, Ectopic Fat, Autonomic Nervous Activity, Inflammatory and Adipokine Profiles
Authors
Audrey Auclair
Laurent Biertho
Simon Marceau
Frédéric-Simon Hould
Simon Biron
Stéfane Lebel
François Julien
Odette Lescelleur
Yves Lacasse
Marie-Eve Piché
Katherine Cianflone
Sebastian Demian Parlee
Kerry Goralski
Julie Martin
Marjorie Bastien
David H. St-Pierre
Paul Poirier
Publication date
01-12-2017
Publisher
Springer US
Published in
Obesity Surgery / Issue 12/2017
Print ISSN: 0960-8923
Electronic ISSN: 1708-0428
DOI
https://doi.org/10.1007/s11695-017-2737-z

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