Sleep-Wake Disorders Unit, Soroka University Medical Center, Beer-Sheva, Israel.
Shraga Segal Department of Microbiology, Immunology and Genetics, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
Sleep. 2019 Dec 24;42(12). doi: 10.1093/sleep/zsz176.
Treatment of obstructive sleep apnea increases obesity risk by an unclear mechanism. Here, we explored the effects of upper airway obstruction and its removal on respiratory homeostasis, energy expenditure, and feeding hormones during the sleep/wake cycle from weaning to adulthood.
The tracheas of 22-day-old rats were narrowed, and obstruction removal was performed on post-surgery day 14. Energy expenditure, ventilation, and hormone-regulated feeding were analyzed during 49 days before and after obstruction.
Energy expenditure increased and body temperature decreased in upper airway obstruction and was only partially recovered in obstruction removal despite normalization of airway resistance. Increased energy expenditure was associated with upregulation of ventilation. Decreased body temperature was associated with decreased brown adipose tissue uncoupling protein 1 level, suppressed energy expenditure response to norepinephrine, and decreased leptin level. Upper airway obstructed animals added less body weight, in spite of an increase in food intake, due to elevated hypothalamic orexin and neuropeptide Y and plasma ghrelin. Animals who underwent obstruction removal fed more due to an increase in hypothalamic neuropeptide Y and plasma ghrelin.
The need to maintain respiratory homeostasis is associated with persistent abnormal energy metabolism and hormonal regulation of feeding. Surgical treatment per se may not be sufficient to correct energy homeostasis, and endocrine regulation of feeding may have a larger effect on weight change.
阻塞性睡眠呼吸暂停的治疗通过一种不明机制增加肥胖风险。在这里，我们探索了在上呼吸道阻塞及其解除期间，从断奶到成年期睡眠/觉醒周期内对呼吸稳态、能量消耗和进食激素的影响。
在 22 天大的大鼠的气管中进行缩窄，并在手术后第 14 天进行阻塞解除。在阻塞之前和之后的 49 天内分析能量消耗、通气和激素调节的进食。
在上呼吸道阻塞中，能量消耗增加，体温降低，尽管气道阻力正常化，但仅部分恢复。增加的能量消耗与通气的上调有关。体温降低与棕色脂肪组织解偶联蛋白 1 水平降低、去甲肾上腺素刺激能量消耗的反应降低和瘦素水平降低有关。尽管进食增加，但上呼吸道阻塞的动物体重增加较少，这是由于下丘脑食欲素和神经肽 Y 升高以及血浆 ghrelin 升高所致。接受阻塞解除的动物进食更多，这是由于下丘脑神经肽 Y 和血浆 ghrelin 增加所致。
维持呼吸稳态的需要与持续异常的能量代谢和进食的激素调节有关。手术治疗本身可能不足以纠正能量稳态，而进食的内分泌调节可能对体重变化有更大的影响。
