Sleep apnoea attenuates the effects of a lifestyle intervention programme in men with visceral obesity

Background Excess visceral adiposity and sleep apnoea are two conditions independently associated with cardiovascular diseases. The two conditions are often combined and are believed to interact in a vicious circle. Objectives To compare the response of men with visceral obesity with or without sleep apnoea syndrome to a 1-year healthy eating, physical activity/exercise intervention programme. Methods 77 men, selected on the basis of increased waist circumference (>= 90 cm) and dyslipidaemia (triglycerides >= 1.69 and/or high-density lipoprotein (HDL) cholesterol <1.03 mmol/litre), participated in this study. Body composition and fat distribution were assessed by dual-emission X-ray absorptiometry or CT and sleep breathing disorders by home-based polygraphic recording. Cardiorespiratory fitness, plasma adipokines, plasma inflammatory markers, fasting lipoproteine-lipid profile and oral glucose tolerance test were assessed. Results After the 1-year lifestyle intervention, the mean oxygen desaturation index (ODI) of the whole sample decreased (-3 +/- 13 events/h, p<0.05). Men with sleep apnoea syndrome at baseline (ODI >= 10 events/h, n-28) showed smaller reductions in body mass index, waist circumference, triglycerides and smaller increases in HDL cholesterol and adiponectin than men without sleep apnoea (ODI <10 events/h, n-49), despite similar compliance to the programme. The higher the baseline ODI and the time spent under 90% saturation, the lower the reductions in fat mass and visceral adiposity, and the smaller the improvement in glucose/insulin homeostasis indices after 1 year. Conclusions Men with sleep apnoea syndrome at baseline had smaller reduction in body weight and less metabolic improvements associated with the lifestyle intervention programme than men without sleep apnoea syndrome.