A randomized controlled trial: branched-chain amino acid levels and glucose metabolism in patients with obesity and sleep apnea


Por: Barcelo, A, Morell-Garcia, D, Salord, N, Esquinas, C, Perez, G, Perez, A, Monasterio, C, Gasa, M, Fortuna, AM, Montserrat, JM, Mayos, M

Publicada: 1 dic 2017
Resumen:
There is evidence that changes in branched-chain amino acid (BCAA) levels may correlate with the efficacy of therapeutic interventions for affecting improvement in metabolic control. The objective of this study was to evaluate whether serum concentrations of BCAAs (leucine, isoleucine, valine) could mediate in insulin sensitivity and glucose tolerance after continuous positive airway pressure (CPAP) treatment in patients with obstructive sleep apnea (OSA). A prospective randomized controlled trial of OSA patients with morbid obesity was conducted. Eighty patients were randomized into two groups: 38 received conservative treatment and 42 received CPAP treatment for 12 weeks. Plasma levels of BCAA, glucose tolerance and insulin resistance were evaluated at baseline and after treatment. After treatment, significant decreases of leucine levels were observed in both groups when compared with baseline levels (P < 0.005). With respect to patients with normal glucose tolerance (NGT), patients with impaired glucose tolerance (IGT) had higher baseline levels of isoleucine (78 +/- 16 versus 70 +/- 13 mu mol L-1, P = 0.014) and valine (286 +/- 36 versus 268 +/- 41 mu mol L-1, P = 0.049), respectively. Changes in levels of leucine and isoleucine after treatment were related negatively to changes in fasting plasma glucose and glycosylated haemoglobin values only in the conservative group (P < 0.05). In summary, we found that the treatment with CPAP for 12 weeks caused similar changes in circulating BCAAs concentrations to conservative treatment and a differential metabolic response of CPAP and conservative treatment was observed between the relationship of BCAAs and glucose homeostasis. Additional studies are needed to determine the interplay between branched-chain amino acids and glucose metabolism in patients with sleep apnea.

Filiaciones:
Barcelo, A:
 Hosp Univ Son Espases, Serv Anal Clin, Palma De Mallorca, Spain

 CIBER Enfermedades Resp CibeRes CB06 06, Madrid, Spain

 Inst Invest Sanitaria Palma IdISPa, Palma De Mallorca, Spain

Morell-Garcia, D:
 Hosp Univ Son Espases, Serv Anal Clin, Palma De Mallorca, Spain

 Inst Invest Sanitaria Palma IdISPa, Palma De Mallorca, Spain

Salord, N:
 CIBER Enfermedades Resp CibeRes CB06 06, Madrid, Spain

 Hosp Univ Bellvitge, Sleep Unit, Dept Resp Med, Lhospitalet De Llobregat, Spain

 Bellvitge Biomed Res Inst IDIBELL, Resp Med Sect, Lhospitalet De Llobregat, Spain

 Univ Autonoma Barcelona, Dept Med, Barcelona, Spain

Esquinas, C:
 Hosp Univ Vall dHebron, Dept Resp Med, Barcelona, Spain

Perez, G:
 Hosp Univ Son Espases, Serv Anal Clin, Palma De Mallorca, Spain

Perez, A:
 Univ Autonoma Barcelona, Dept Med, Barcelona, Spain

 Hosp Santa Creu & Sant Pau, Dept Endocrinol & Nutr, Barcelona, Spain

 CIBER Diabet & Enfermedades Metab CIBERDEM, Madrid, Spain

Monasterio, C:
 CIBER Enfermedades Resp CibeRes CB06 06, Madrid, Spain

 Hosp Univ Bellvitge, Sleep Unit, Dept Resp Med, Lhospitalet De Llobregat, Spain

 Bellvitge Biomed Res Inst IDIBELL, Resp Med Sect, Lhospitalet De Llobregat, Spain

Gasa, M:
 Hosp Univ Bellvitge, Sleep Unit, Dept Resp Med, Lhospitalet De Llobregat, Spain

 Bellvitge Biomed Res Inst IDIBELL, Resp Med Sect, Lhospitalet De Llobregat, Spain

Fortuna, AM:
 CIBER Enfermedades Resp CibeRes CB06 06, Madrid, Spain

 Univ Autonoma Barcelona, Dept Med, Barcelona, Spain

 Hosp Santa Creu & Sant Pau, Sleep Unit, Dept Resp Med, Barcelona, Spain

Montserrat, JM:
 CIBER Enfermedades Resp CibeRes CB06 06, Madrid, Spain

 Hosp Clin Barcelona, Sleep Unit, Dept Resp Med, Barcelona, Spain

Mayos, M:
 CIBER Enfermedades Resp CibeRes CB06 06, Madrid, Spain

 Univ Autonoma Barcelona, Dept Med, Barcelona, Spain

 Hosp Santa Creu & Sant Pau, Sleep Unit, Dept Resp Med, Barcelona, Spain
ISSN: 09621105
Editorial
WILEY, 111 RIVER ST, HOBOKEN 07030-5774, NJ USA, Reino Unido
Tipo de documento: Article
Volumen: 26 Número: 6
Páginas: 773-781
WOS Id: 000416682000013
ID de PubMed: 28513068
imagen Bronze, Green Accepted

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