Increased Neck Soft Tissue Mass and Worsening of Obstructive Sleep Apnea after Growth Hormone Treatment in Men with Abdominal Obesity
Autor: | Lars Lönn, Derek N. Eder, Josef Koranyi, Johan Svensson, Mahssa Karimi, Ludger Grote, Yüksel Peker, Bengt-Åke Bengtsson, Jan Hedner, Celina Franco, Jan-Erik Angelhed, Gudmundur Johannsson |
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Rok vydání: | 2010 |
Předmět: |
Adult
Male Radiography Abdominal Pulmonary and Respiratory Medicine medicine.medical_specialty Polysomnography Severity of Illness Index Double-Blind Method Internal medicine Glucose Intolerance Severity of illness medicine Humans Body Weights and Measures Prospective Studies Insulin-Like Growth Factor I Prospective cohort study Abdominal obesity Aged Sleep Apnea Obstructive medicine.diagnostic_test Human Growth Hormone business.industry Sleep apnea New Research Middle Aged medicine.disease Obesity nervous system diseases respiratory tract diseases Growth hormone treatment Obstructive sleep apnea Endocrinology Neurology Obesity Abdominal Body Composition Cardiology Neurology (clinical) medicine.symptom Tomography X-Ray Computed business Neck Follow-Up Studies |
Zdroj: | Scopus-Elsevier Europe PubMed Central |
ISSN: | 1550-9397 1550-9389 |
DOI: | 10.5664/jcsm.27823 |
Popis: | Risk factors for obstructive sleep apnea (OSA) are male gender, obesity and abnormalities in neck soft tissue mass. OSA is associated with both growth hormone (GH) excess and severe GH deficiency in adults. Adults with abdominal obesity have markedly suppressed GH secretion.To study the effect of GH treatment on OSA in abdominally obese men with impaired glucose tolerance.Forty men with abdominal obesity and glucose intolerance were randomized in a prospective, 12-month double-blind trial to receive either GH or placebo. The treatment groups had similar BMI and waist circumference. Overnight polysomnography and computed tomography to assess muscle and fat distribution in the neck and abdomen were performed at baseline and after 12 months.GH treatment increased insulin-like growth-factor-1i from (mean [SD]) 168 (72) to 292 (117) microg/L, the apnea-hypopnea index from (n/h) 31 (20) to 43 (25) and oxygen-desaturation index from (n/h) 18 (14) to 29 (21) (p = 0.0001, 0.001, 0.002). Neck transverse diameter, circumference and total cross-sectional area (p = 0.007, 0.01, 0.02) increased, while abdominal visceral adipose tissue (p = 0.007) was reduced. No between-group differences in total sleep time, REM sleep, NREM sleep, and time spent in supine position were found. The Epworth sleepiness scale score was unchanged.GH treatment increased the severity of OSA in abdominally obese men. The possible mechanism appears to be reflected by the GH-induced increase of measures of neck volume. The present results, to some extent, argue against that low GH/IGF-I activity is a primary cause of OSA in abdominally obese men. |
Databáze: | OpenAIRE |
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