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Randomized Controlled Trial
. 2009 Aug 24;4(8):e6733.
doi: 10.1371/journal.pone.0006733.

Endothelial dysfunction and specific inflammation in obesity hypoventilation syndrome

Jean-Christian Borel  1 , Pascale Roux-Lombard, Renaud Tamisier, Claire Arnaud, Denis Monneret, Nathalie Arnol, Jean-Philippe Baguet, Patrick Levy, Jean-Louis Pepin
Affiliations
Randomized Controlled Trial

Endothelial dysfunction and specific inflammation in obesity hypoventilation syndrome

Jean-Christian Borel et al. PLoS One. .

Abstract

Background: Obesity hypoventilation syndrome (OHS) is associated with increased cardiovascular morbidity. What moderate chronic hypoventilation adds to obesity on systemic inflammation and endothelial dysfunction remains unknown.

Question: To compare inflammatory status and endothelial function in OHS versus eucapnic obese patients.

Methodology: 14 OHS and 39 eucapnic obese patients matched for BMI and age were compared. Diurnal blood gazes, overnight polysomnography and endothelial function, measured by reactive hyperemia peripheral arterial tonometry (RH-PAT), were assessed. Inflammatory (Leptin, RANTES, MCP-1, IL-6, IL-8, TNFalpha, Resistin) and anti-inflammatory (adiponectin, IL-1Ra) cytokines were measured by multiplex beads immunoassays.

Principal findings: OHS exhibited a higher PaCO(2), a lower forced vital capacity (FVC) and tended to have a lower PaO(2) than eucapnic obese patients. (HS)-CRP, RANTES levels and glycated haemoglobin (HbA1c) were significantly increased in OHS (respectively 11.1+/-10.9 vs. 5.7+/-5.5 mg x l(-1) for (HS)-CRP, 55.9+/-55.3 vs 23.3+/-15.8 ng/ml for RANTES and 7.3+/-4.3 vs 6.1+/-1.7 for HbA1c). Serum adiponectin was reduced in OHS (7606+/-2977 vs 13,660+/-7854 ng/ml). Endothelial function was significantly more impaired in OHS (RH-PAT index: 0.22+/-0.06 vs 0.51+/-0.11).

Conclusions: Compared to eucapnic obesity, OHS is associated with a specific increase in the pro-atherosclerotic RANTES chemokine, a decrease in the anti-inflammatory adipokine adiponectin and impaired endothelial function. These three conditions are known to be strongly associated with an increased cardiovascular risk.

Trial registration: ClinicalTrials.gov NCT00603096.

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Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. Comparison between Obesity Hypoventilation Syndrome (OHS) compared to eucapnic obese patients in RH-PAT, Sleep time spent with SpO2<90%, FVC (% predicted value), glycated haemoglobin, serum levels of RANTES, Adiponectin and MCP1.
TST: total sleep time.
See this image and copyright information in PMC

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