Journal article
The Effect of Changes in Cardiorespiratory Fitness and Weight on Obstructive Sleep Apnea Severity in Overweight Adults with Type 2 Diabetes
Sleep (New York, N.Y.), v 39(2), pp 317-325
01 Feb 2016
PMCID: PMC4712401
PMID: 26446118
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
To examine the effect of changes in cardiorespiratory fitness on obstructive sleep apnea (OSA) severity prior to and following adjustment for changes in weight over the course of a 4-y weight loss intervention.
As secondary analyses of a randomized controlled trial, 263 overweight/obese adults with type 2 diabetes and OSA participated in an intensive lifestyle intervention or education control condition. Measures of OSA severity, cardiorespiratory fitness, and body weight were obtained at baseline, year 1, and year 4. Change in the apnea-hypopnea index (AHI) served as the primary outcome. The percentage change in fitness (submaximal metabolic equivalents [METs]) and change in weight (kg) were the primary independent variables. Primary analyses collapsed intervention conditions with statistical adjustment for treatment group and baseline METs, weight, and AHI among other relevant covariates.
At baseline, greater METs were associated with lower AHI (B [SE] = -1.48 [0.71], P = 0.038), but this relationship no longer existed (B [SE] = -0.24 [0.73], P = 0.75) after adjustment for weight (B [SE] = 0.31 [0.07], P < 0.0001). Fitness significantly increased at year 1 (+16.53 ± 28.71% relative to baseline), but returned to near-baseline levels by year 4 (+1.81 ± 24.48%). In mixed-model analyses of AHI change over time without consideration of weight change, increased fitness at year 1 (B [SE] = -0.15 [0.04], P < 0.0001), but not at year 4 (B [SE] = 0.04 [0.05], P = 0.48), was associated with AHI reduction. However, with weight change in the model, greater weight loss was associated with AHI reduction at years 1 and 4 (B [SE] = 0.81 [0.16] and 0.60 [0.16], both P < 0.0001), rendering the association between fitness and AHI change at year 1 nonsignificant (B [SE] = -0.04 [0.04], P = 0.31).
Among overweight/obese adults with type 2 diabetes, fitness change did not influence OSA severity change when weight change was taken into account.
ClinicalTrials.gov identification number NCT00194259.
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Details
- Title
- The Effect of Changes in Cardiorespiratory Fitness and Weight on Obstructive Sleep Apnea Severity in Overweight Adults with Type 2 Diabetes
- Creators
- Christopher E Kline - University of PittsburghDavid M Reboussin - Wake Forest UniversityGary D Foster - Temple UniversityThomas B Rice - University of PittsburghElsa S Strotmeyer - University of PittsburghJohn M Jakicic - University of PittsburghRichard P Millman - Brown UniversityF Xavier Pi-Sunyer - Columbia UniversityAnne B Newman - University of PittsburghThomas A Wadden - University of PennsylvaniaGary Zammit - ClinilabsSamuel T Kuna - University of PennsylvaniaSleep AHEAD Research Group of the Look AHEAD Research GroupEllen Stephanie Krauthamer Ewing - Drexel University
- Publication Details
- Sleep (New York, N.Y.), v 39(2), pp 317-325
- Grant note
- K23 HL118318 / NHLBI NIH HHS U01 DK057136 / NIDDK NIH HHS DK057135 / NIDDK NIH HHS U01 DK056992 / NIDDK NIH HHS DK56992 / NIDDK NIH HHS U01 DK057151 / NIDDK NIH HHS HL070301 / NHLBI NIH HHS U01 DK057131 / NIDDK NIH HHS U01 DK057219 / NIDDK NIH HHS P30 DK026687 / NIDDK NIH HHS U01 DK057135 / NIDDK NIH HHS U01 DK057002 / NIDDK NIH HHS U01 DK057154 / NIDDK NIH HHS DK60426 / NIDDK NIH HHS U01 DK057178 / NIDDK NIH HHS HL118318 / NHLBI NIH HHS U01 DK057177 / NIDDK NIH HHS U01 DK057182 / NIDDK NIH HHS
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Counseling and Family Therapy; Drexel University
- Web of Science ID
- WOS:000368938100008
- Scopus ID
- 2-s2.0-84957084468
- Other Identifier
- 991020099920504721
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- Collaboration types
- Domestic collaboration
- Web of Science research areas
- Clinical Neurology
- Neurosciences