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The Effect of Changes in Cardiorespiratory Fitness and Weight on Obstructive Sleep Apnea Severity in Overweight Adults with Type 2 Diabetes
Journal article   Open access   Peer reviewed

The Effect of Changes in Cardiorespiratory Fitness and Weight on Obstructive Sleep Apnea Severity in Overweight Adults with Type 2 Diabetes

Christopher E Kline, David M Reboussin, Gary D Foster, Thomas B Rice, Elsa S Strotmeyer, John M Jakicic, Richard P Millman, F Xavier Pi-Sunyer, Anne B Newman, Thomas A Wadden, …
Sleep (New York, N.Y.), v 39(2), pp 317-325
01 Feb 2016
DOI: https://doi.org/10.5665/sleep.5436
PMID: 26446118
Featured in Collection :   UN Sustainable Development Goals @ Drexel
url
https://academic.oup.com/sleep/article-pdf/39/2/317/26673478/aasm.39.2.317.pdfView
Published, Version of Record (VoR) Open
url
https://doi.org/10.5665/sleep.5436View
Published, Version of Record (VoR) Open

Abstract

Aged Body Mass Index Cardiovascular Physiological Phenomena Diabetes Mellitus, Type 2 - complications Diabetes Mellitus, Type 2 - physiopathology Female Health Status Humans Life Style Male Middle Aged Obesity - complications Obesity - physiopathology Overweight - complications Overweight - physiopathology Patient Education as Topic Physical Fitness - physiology Respiratory Physiological Phenomena Sleep Apnea, Obstructive - complications Sleep Apnea, Obstructive - diagnosis Sleep Apnea, Obstructive - physiopathology Treatment Outcome Weight Loss
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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Collaboration types
Domestic collaboration
Web of Science research areas
Clinical Neurology
Neurosciences
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