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Influence of diet and sport on the risk of sleep apnea in patients with metabolic syndrome associated with hypothyroidism — a 4-year survey

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Abstract

Apnea is a common problem observed among obese individuals, affecting the quality of sleep and increasing cardiovascular risk and mortality. The current study monitored the risk of obstructive sleep apnea (OSA) following diet therapy and sports-associated diet therapy in patients with metabolic syndrome (MS) and hypothyroidism. The subjects included in the study were divided into 3 groups: control group (CG) (n=36), diet therapy group (DG) (including patients following a personalized diet therapy program) (n=76), and diet therapy and sports group (DSG) (which considered patients doing sports in addition to following a personalized diet therapy program) (n=80). The evaluation methods included body analysis (body mass index, fat mass, and visceral fat), paraclinical analysis (homeostasis model assessment of insulin resistance), assessment of difficulty in breathing, stress monitoring, hypothyroidism, and risk of OSA. The OSA index was assessed using the Berlin Questionnaire of Sleep Apnea and Epworth Sleepiness Scale. The correlation between OSA with body mass index (BMI), homeostasis model assessment of insulin resistance (HOMA-IR) index, fat mass, and visceral fat showed a statistically significant positive ratio (p<0.05; F=3.871). The obtained results indicated that diet therapy and physical activity reduced the OSA risk by 78.72%.

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All data generated or analyzed during this study are included in the manuscript.

References

  • Anonymous (2018) World Medical Association, 2018. https://www.wma.net/policies-post/wma-declaration-of-helsinki-ethical-principles-for-medical-research-involving-human-subjects/ (accesed on 22 June 2020)

  • Azo Najeeb H, Ahmad Qasim B, Ahmad Mohammed A (2020) Parental history of coronary artery disease among adults with hypothyroidism: case controlled study. Ann Med Surg (Lond) 60:92–101

    Article  Google Scholar 

  • Baskin HJ, Cobin RH, Duick DS, Gharib H, Guttler RB, Kaplan MM, Segal RL (2002) American Association of Clinical Endocrinologists medical guidelines for clinical practice for the evaluation and treatment of hyperthyroidism and hypothyroidism. Endocr Pract 8:457–69

    Article  Google Scholar 

  • Basoglu OK, Sarac F, Sarac S, Uluer H, Yilmaz C (2011) Metabolic syndrome, insulin resistance, fibrinogen, homocysteine, leptin, and C-reactive protein in obese patients with obstructive sleep apnea syndrome. Ann Thorac Med 6:120–5

    Article  CAS  Google Scholar 

  • Behl T, Bungau S, Kumar K, Zengin G, Khan F, Kumar A, Kaur R, Venkatachalam T, Tit DM, Vesa CM (2020) Pleotropic effects of polyphenols in cardiovascular system. Biomed Pharmacother 130:110714

    Article  CAS  Google Scholar 

  • Bogdanov AR, Derbeneva SA (2013) Influence of dietotherapy enriched with conjugated linoleic acid on anthropometrical indicators and body composite structure in patients with an overweight. Vopr Pitan 82:55–62

    CAS  Google Scholar 

  • Borovac JA, D’Amario D, Bozic J, Glavas D (2020) Sympathetic nervous system activation and heart failure: current state of evidence and the pathophysiology in the light of novel biomarkers. World J Cardiol 12:373–408

    Article  Google Scholar 

  • Bungau CC, Prada IF, Prada M, Bungau C (2019) Design and operation of constructions: a healthy living environment-parametric studies and new solutions. Sustainability 11(23):6824. https://doi.org/10.3390/su11236824

    Article  Google Scholar 

  • Cappola AR et al (2019) Thyroid and cardiovascular disease. Circulation 139:2892–2909

    Article  Google Scholar 

  • Chaker L, Bianco AC, Jonklaas J, Peeters RP (2017) Hypothyroidism. Lancet 390:1550–1562

    Article  CAS  Google Scholar 

  • Charman SJ, Okwose NC, Stefanetti RJ, Bailey K, Skinner J, Ristic A, Seferovic PM, Scott M, Turley S, Fuat A, Mant J, Hobbs RFD, MacGowan GA, Jakovljevic DG (2018) A novel cardiac output response to stress test developed to improve diagnosis and monitoring of heart failure in primary care. ESC Heart Fail 5:703–712

    Article  Google Scholar 

  • Chiu H-Y, Chen P-Y, Chuang L-P, Chen N-H, Tu Y-K, Hsieh Y-J, Wang Y-C, Guilleminault C (2017) Diagnostic accuracy of the Berlin questionnaire, STOP-BANG, STOP, and Epworth sleepiness scale in detecting obstructive sleep apnea: a bivariate meta-analysis. Sleep Med Rev 36:57–70. https://doi.org/10.1016/j.smrv.2016.10.004

    Article  Google Scholar 

  • Engin A (2017) The definition and prevalence of obesity and metabolic syndrome. Adv Exp Med Biol 960:1–17. https://doi.org/10.1007/978-3-319-48382-5_1

    Article  CAS  Google Scholar 

  • Framnes SN, Arble DM (2018) The bidirectional relationship between obstructive sleep apnea and metabolic disease. Front Endocrinol (Lausanne) 9:440. https://doi.org/10.3389/fendo.2018.00440

    Article  Google Scholar 

  • Gill M, Natoli MJ, Vacchiano C, MacLeod DB, Ikeda K, Qin M, Pollock NW, Moon RE, Pieper C (1985) Vann RD (2014): Effects of elevated oxygen and carbon dioxide partial pressures on respiratory function and cognitive performance. J Appl Physiol 117:406–12

    Article  Google Scholar 

  • Gosadi IM (2016) Assessment of the environmental and genetic factors influencing prevalence of metabolic syndrome in Saudi Arabia. Saudi Med J 37:12

    Article  Google Scholar 

  • Hyland ME, Bott J, Singh S, Kenyon CAP (1994) Domains, constructs and the development of the breathing problems questionnaire. Qual Life Res 3:245–256

    Article  CAS  Google Scholar 

  • Hyland ME, Singh SJ, Sodergren SC, Morgan MPL (1998) Development of a shortened version of the Breathing Problems Questionnaire suitable for use in a pulmonary rehabilitation clinic: a purpose-specific, disease-specific questionnaire. Qual Life Res 7:227–233

    Article  CAS  Google Scholar 

  • Iftikhar IH, Hoyos CM, Phillips CL, Magalang UJ (2015) Meta-analyses of the association of sleep apnea with insulin resistance, and the effects of CPAP on HOMA-IR, adiponectin, and visceral adipose fat. J Clin Sleep Med 11:475–85

    Article  Google Scholar 

  • Jabłonowska-Lietz B, Wrzosek M, Włodarczyk M, Nowicka G (2017) New indexes of body fat distribution, visceral adiposity index, body adiposity index, waist-to-height ratio, and metabolic disturbances in the obese. Kardiol Pol 75:1185–1191

    Article  Google Scholar 

  • Katsiki N, Stoian AP, Steiropoulos P, Papanas N, Suceveanu AI, Mikhailidis DP (2020) Metabolic syndrome and abnormal peri-organ or intra-organ fat (APIFat) deposition in chronic obstructive pulmonary disease: an overview. Metabolites 10

  • Klaunig JE (2018) Oxidative stress and cancer. Curr Pharm Des 24:4771–4778

    Article  CAS  Google Scholar 

  • Kostoglou-Athanassiou I, Athanassiou P (2008) Metabolic syndrome and sleep apnea. Hippokratia 12:81–6

    CAS  Google Scholar 

  • Kyritsi EM, Kanaka-Gantenbein C (2020) Autoimmune thyroid disease in specific genetic syndromes in childhood and adolescence. Front Endocrinol (Lausanne) 11:543

    Article  Google Scholar 

  • Lee DH, Giovannucci EL (2018) Body composition and mortality in the general population: a review of epidemiologic studies. Exp Biol Med (Maywood) 243:1275–1285

    Article  CAS  Google Scholar 

  • Lin YS, Tung YT, Yen YC, Chien YW (2020) Food addiction mediates the relationship between perceived stress and body mass index in Taiwan young adults. Nutrients 12

  • Lusic Kalcina L, Pavlinac Dodig I, Pecotic R, Valic M, Dogas Z (2020) Psychomotor performance in patients with obstructive sleep apnea syndrome. Nat Sci Sleep 12:183–195

    Article  Google Scholar 

  • Maarman GJ, Andrew BM, Blackhurst DM (1985) Ojuka EO (2017): Melatonin protects against uric acid-induced mitochondrial dysfunction, oxidative stress, and triglyceride accumulation in C2C12 myotubes. J Appl Physiol 122:1003–1010

    Article  Google Scholar 

  • Maciejczyk M, Więcek M, Szymura J, Szyguła Z, Wiecha S, Cempla J (2014) The influence of increased body fat or lean body mass on aerobic performance. PLoS One 9:e95797

    Article  Google Scholar 

  • Mallat J, Lemyze M, Tronchon L, Vallet B, Thevenin D (2016) Use of venous-to-arterial carbon dioxide tension difference to guide resuscitation therapy in septic shock. World J Crit Care Med 47–56

  • Moisi MI, Bungau SG, Vesa CM, Diaconu CC, Behl T, Stoicescu M, Toma MM, Bustea C, Sava C, Popescu MI (2021) Framing cause-effect relationship of acute coronary syndrome in patients with chronic kidney disease. Diagnostics 11(8):1518. https://doi.org/10.3390/diagnostics11081518

    Article  CAS  Google Scholar 

  • Mukherjee S, Saxena R, Palmer LJ (2018) The genetics of obstructive sleep apnoea. Respirology 23:18–27

    Article  Google Scholar 

  • Otrisal P, Bungau C, Obsel V, Melicharik Z, Tont G (2021) Selected respiratory protective devices: respirators and significance of some markings. Sustainability 13(9):4988. https://doi.org/10.3390/su13094988

    Article  Google Scholar 

  • Pallag A, Bungau SG, Tit DM, Jurca T, Sirbu V, Honiges A, Horhogea C (2016) Comparative study of polyphenols, flavonoids, and chlorophylls in Equisetum arvense T. populations. Rev Chim 67(3):530–533

    CAS  Google Scholar 

  • Pallag A, Rosca E, Tit DM, Mutiu G, Bungau SG, Pop OL (2015) Monitoring the effects of treatment in colon cancer cells using immunohistochemical and histoenzymatic techniques. Rom J Morphol Embryol 56:1103–9

    Google Scholar 

  • Parsanathan R, Jain SK (2020) Novel invasive and noninvasive cardiac-specific biomarkers in obesity and cardiovascular diseases. Metab Syndr Relat Disord 18:10–30

    Article  Google Scholar 

  • Romero-Corral A, Caples SM, Lopez-Jimenez F, Somers VK (2010) Interactions between obesity and obstructive sleep apnea: implications for treatment. Chest 137:711–9

    Article  CAS  Google Scholar 

  • Saint Martin M, Roche F, Thomas T, Collet P, Barthélémy JC, Sforza E (2015) Association of body fat composition and obstructive sleep apnea in the elderly: a longitudinal study. Obesity (Silver Spring) 23:1511–6

    Article  Google Scholar 

  • Santos C, Marques da Silva P (2018) Hemodynamic patterns in obesity associated hypertension. BMC Obes 5:13

    Article  Google Scholar 

  • Segman Y, Sheiman E (2018) Post marketing study of hemodynamic and hematological noninvasive readings in a blood bank. SAGE Open Med 6:2050312118796065

    Article  Google Scholar 

  • Serter R, Demirbas B, Korukluoglu B, Culha C, Cakal E, Aral Y (2004) The effect of L-thyroxine replacement therapy on lipid based cardiovascular risk in subclinical hypothyroidism. J Endocrinol Invest 27:897–903

    Article  CAS  Google Scholar 

  • Shantha GP, Kumar AA, Jeyachandran V, Rajamanickam D, Rajkumar K, Salim S, Subramanian KK, Natesan S (2009) Association between primary hypothyroidism and metabolic syndrome and the role of C reactive protein: a cross-sectional study from South India. Thyroid Res 2:2

    Article  Google Scholar 

  • Shuster A, Patlas M, Pinthus JH, Mourtzakis M (2012) The clinical importance of visceral adiposity: a critical review of methods for visceral adipose tissue analysis. Br J Radiol 85:1–10

    Article  CAS  Google Scholar 

  • Tietjens JR, Claman D, Kezirian EJ, De Marco T, Mirzayan A, Sadroonri B, Goldberg AN, Long C, Gerstenfeld EP, Yeghiazarians Y (2019) Obstructive sleep apnea in cardiovascular disease: a review of the literature and proposed multidisciplinary clinical management strategy. J Am Heart Assoc 8:e010440

    Article  CAS  Google Scholar 

  • Touyz RM, Rios FJ, Alves-Lopes R, Neves KB, Camargo LL, Montezano AC (2020) Oxidative stress: a unifying paradigm in hypertension. Can J Cardiol 36:659–670

    Article  Google Scholar 

  • Vesa CM, Behl T, Nemeth S, Bratu OG, Diaconu CC, Moleriu RD, Negrut N, Zaha DC, Bustea C, Ionita Radu F, Bungau S (2020) Prediction of NAFLD occurrence in prediabetes patients. Exp Ther Med 20(6):190. https://doi.org/10.3892/etm.2020.9320

    Article  Google Scholar 

  • Vgontzas AN, Bixler EO, Chrousos GP (2005) Sleep apnea is a manifestation of the metabolic syndrome. Sleep Med Rev 9:211–24

    Article  Google Scholar 

  • Vozoris NT (2012) Sleep apnea-plus: prevalence, risk factors, and association with cardiovascular diseases using United States population-level data. Sleep Med 13:637–44

    Article  Google Scholar 

  • World Health O (2020) Overweight and obesity. https://www.who.int/news-room/fact-sheets/detail/obesity-and-overweight (accesed on 28 May 2021)

  • Yisireyili M, Alimujiang A, Aili A, Li Y, Yisireyili S, Abudureyimu K (2020) Chronic restraint stress induces gastric mucosal inflammation with enhanced oxidative stress in a murine model. Psychol Res Behav Manag 13:383–393

    Article  Google Scholar 

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Authors and Affiliations

  1. Department of Pharmacy, Faculty of Medicine and Pharmacy, University of Oradea, 410028, Oradea, Romania

    Timea Claudia Ghitea, Delia Mirela Tit, Annamaria Pallag & Simona Bungau

  2. Laboratoire Chrono-environment, CNRS 6249, Université de Franche-Comté, Besançon, France

    Lotfi Aleya

  3. Doctoral School of Biological and Biomedical Sciences, University of Oradea, 410073, Oradea, Romania

    Delia Mirela Tit, Annamaria Pallag & Simona Bungau

  4. Department of Pharmacology, Chitkara College of Pharmacy, Chitkara University, Punjab, 140401, India

    Tapan Behl

  5. Department of Medical Disciplines, Faculty of Medicine and Pharmacy, University of Oradea, 410073, Oradea, Romania

    Manuela Stoicescu, Cristian Sava & Amina El-Kharoubi

  6. Department of Preclinical Disciplines, Faculty of Medicine and Pharmacy, University of Oradea, 410068, Oradea, Romania

    Ciprian Iovan & Diana Uivarosan

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  1. Timea Claudia Ghitea
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  2. Lotfi Aleya
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  4. Tapan Behl
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  11. Simona Bungau
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Contributions

Conceptualization, Timea Claudia Ghitea, Lotfi Aleya, Delia Mirela Tit, Anamaria Pallag and Simona Bungau; data curation, Manuela Stoicescu, Amina El-Kharoubi, and Diana Uivarosan; formal analysis, Tapan Behl and Diana Uivarosan; investigation, Timea Claudia Ghitea, Ciprian Iovan, Manuela Stoicescu, and Delia Mirela Tit; methodology, Timea Claudia Ghitea, Cristian Sava, and Annamaria Pallag; software, Timea Claudia Ghitea and Tapan Behl; supervision, Lotfi Aleya and Simona Bungau; visualization, Delia Mirela Tit; writing — original draft, Timea Claudia Ghitea, Delia Mirela Tit, and Simona Bungau; writing — review and editing, Simona Bungau and Delia Mirela Tit. All the authors read and agreed with the final version of this manuscript.

Corresponding authors

Correspondence to Lotfi Aleya or Simona Bungau.

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Ethics approval and consent to participate

The study was conducted according to the guidelines of the Declaration of Helsinki and approved by the Research Ethics Committee of the Faculty of Medicine and Pharmacy, University of Oradea, Romania, no. 12/01.04.2019. Informed consent was obtained from all subjects involved in the study.

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Not applicable.

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The authors declare no competing interests.

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Responsible Editor: Philippe Garrigues

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Delia Mirela Tit and Tapan Behl are contributed equally

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Ghitea, T.C., Aleya, L., Tit, D.M. et al. Influence of diet and sport on the risk of sleep apnea in patients with metabolic syndrome associated with hypothyroidism — a 4-year survey. Environ Sci Pollut Res 29, 23158–23168 (2022). https://doi.org/10.1007/s11356-021-17589-x

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