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Sympathetic activity in obese subjects with and without obstructive sleep apnea
K Narkiewicz1, P J van de Borne, R L Cooley
1Department of Internal Medicine, University of Iowa College of Medicine, Iowa City, USA.
Obesity alone does not increase muscle sympathetic nerve activity (MSNA). However, occult obstructive sleep apnea (OSA) in obese individuals significantly elevates MSNA, suggesting OSA is the primary driver of sympathetic activation in this population.
Area of Science:
- Cardiovascular Physiology
- Sleep Medicine
- Metabolic Disorders
Background:
- Obesity is linked to increased muscle sympathetic nerve activity (MSNA).
- Obstructive sleep apnea (OSA) is also associated with elevated MSNA.
- The high prevalence of OSA in obesity complicates the understanding of MSNA in obesity.
Purpose of the Study:
- To determine if obesity itself, independent of OSA, elevates MSNA.
- To investigate the role of OSA as a potential confounder in MSNA measurements in obese individuals.
Main Methods:
- Measured MSNA in normal-weight and obese subjects.
- Screened all participants for OSA using polysomnography.
- Excluded individuals with hypertension or diagnosed OSA prior to the study.
Main Results:
- Obese subjects without OSA had similar MSNA to normal-weight subjects.
- A subset of obese subjects had undiagnosed (occult) OSA.
- Obese subjects with occult OSA exhibited significantly higher MSNA compared to both normal-weight and obese subjects without OSA.
Conclusions:
- Obesity per se is not associated with increased muscle sympathetic nerve activity.
- Occult obstructive sleep apnea is a significant contributor to elevated MSNA in obese individuals.
- OSA, not obesity alone, appears to drive increased sympathetic outflow to muscle vasculature.
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