Gender Differences in Comorbidities and Sleep Patterns of Obese Patients with Obstructive Sleep Apnea

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Objective: The aim of the study was to compare the comorbidities and sleep patterns most commonly associated with each gender in obstructive sleep apnea (OSA). Methods: This was a cross-sectional study of obese individuals with OSA. The polysomnographies were carried out in a sleep laboratory environment, using a 15-channel polysomnography setup. Airflow was measured using a nasal pressure cannula/thermistor combination. A standard handbook was used for interpretation of PSG findings. Results: A total of 284 subjects were included in the study, (147 females). The mean age, body mass index and neck circumference were similar between females and males (p = 0.9579, p < 0.0001, and p < 0.0001, respectively). On polysomnography, females exhibited longer latency to REM sleep (146.50 ± 85.93 vs. 122.3 ± 68.28, p = 0.0210) and a higher percentage of delta sleep (10.09 ± 7.48 vs. 7.55 ± 6.57, p = 0.0037); males had more frequent microarousals (38.37 ± 27.44 vs. 28.07 ± 21.23, p = 0.0017) and a higher AHI score (30.56 ± 27.52 vs. 17.31 ± 21.23, p < 0.0001). The comorbidities most commonly associated with female gender were diabetes (29% vs. 9.49%, p = 0.0132), hypothyroidism (20% vs. 2.19%, p < 0.0001), and depression (81.63% vs. 51.22%, p < 0.0001). Male gender was associated with myocardial infarction (6.57% vs. 1.38%, p = 0.0245) and alcohol intake (33.88% vs. 11.34%, p < 0.0001). Obese males with OSA have a larger neck circumference and higher AHI and arousal indices than females. Conclusions: There are genderdifferences both in the sleep patterns and in the comorbidities of patients with OSA. Men had a larger neck circumference, higher apnea and sleep fragmentation scores, were more likely to consume alcohol, and were more likely to have a history of myocardial infarction than women.

Cite this paper

Valadares, R. , Sousa, K. , Espindola, M. , dos Santos, C. and Viegas, C. (2015) Gender Differences in Comorbidities and Sleep Patterns of Obese Patients with Obstructive Sleep Apnea. World Journal of Neuroscience, 5, 49-57. doi: 10.4236/wjns.2015.51006.

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Progressive Obesity in Female Rats from Synergistic Interactions between Drugs and Whole Body Application of Weak, Physiologically Patterned Magnetic Fields

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http://www.scirp.org/journal/PaperInformation.aspx?PaperID=47406#.VMiWVizQrzE

ABSTRACT

Prepubescent female rats treated with the atypical neuroleptic acepromazine but not ketamine, prazosin, or doxepin, after lithium/pilocarpine-induced seizures gradually became obese over their lifetimes if spontaneous seizures developed. Mild increases in weight gain were induced when prepuberal females were given pilocarpine and acepromazine while being exposed briefly (1.5 hr) to a frequency-modulated magnetic field known to induce seizures. Weekly (1.5 hr) exposures to physiologically-patterned magnetic fields over 36 wks had no effect on weight gain while continuous periseizure exposure to 50 Hz fields above about 1 μT facilitated mild weight gains and protracted aggression. Perinatal exposure to a very weak, a 7 Hz magnetic field or a nitric oxide inhibitor retarded the weight gain induced by the obesity procedure. These results indicate that synergisms during a single episode between neuronal electrical lability and pharmacological states can initiate a process of weight gain that progresses to extreme obesity. We suggest that at least a component of the global “epidemic of obesity” could be related to a synergism between the insidious emergence of amplitude modulations within biologically compatible electromagnetic frequencies from the proliferation of communication systems and the pervasive utilization of pharmacology to treat transient disorders of ontogeny within the human population.

Cite this paper

St-Pierre, L. and Persinger, M. (2014) Progressive Obesity in Female Rats from Synergistic Interactions between Drugs and Whole Body Application of Weak, Physiologically Patterned Magnetic Fields. Journal of Behavioral and Brain Science, 4, 268-283. doi: 10.4236/jbbs.2014.46028.

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Optimal Adiposity Measurement and Risk Stratification in Established Ischaemic Stroke

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http://www.scirp.org/journal/PaperInformation.aspx?PaperID=52767#.VKNXlcnQrzE

ABSTRACT

Background: Prevention strategies post-stroke should target risk factor reduction which includes consideration of weight, diet and lipoprotein profiles. Limited data informs the optimal adiposity measurement post-stroke to target those at highest recurrent risk. This study aims to identify adiposity measurement/s post-stroke that best predict cardiovascular and co-morbid risk. Subjects and Methods: 142 stroke patients (100 males, 42 females; mean age 63 years) participated. Adiposity and metabolic profiles included BMI, waist circumference, waist to height ratio (WHR), triglyceride levels and hypertriglyceridemic waist. The predictive ability of these measures with indices of cardiovascular risk (Cardiovascular Risk Score) and co-morbidity (Charlson’s co-morbidity index) were examined. Results: In hierarchical multiple regression models, age and gender controlled, waist (p = 0.002), triglyceride levels (p = 0.006), BMI and WHR (p = 0.014), uniquely and significantly contributed to the variance in cardiovascular risk, in their models. Only one combination of measures (waist and triglyceride levels) improved the predictive ability of waist in cardiovascular risk stratification (p = 0.001). In men, waist (p = 0.013) and in women triglyceride levels (p = 0.012) performed as the best predictors of cardiovascular risk respectively. No combination of measures was superior to triglyceride levels in women or waist circumference measures in men in predicting cardiovascular risk. With Charlson’s co-morbidity index as the dependent variable, triglyceride levels significantly contributed to variance of the model with age and gender influences controlled (p = 0.047). No combination of measures improved the predictive ability of triglyceride levels for co-morbidity. Conclusion: Waist circumference and triglyceride levels should form a minimum dataset for adiposity when considering cardiovascular and comorbid risk post-stroke.

Cite this paper

Lennon, O. and Blake, C. (2014) Optimal Adiposity Measurement and Risk Stratification in Established Ischaemic Stroke. World Journal of Cardiovascular Diseases, 4, 655-665. doi: 10.4236/wjcd.2014.413077.

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Does Surgery Benefit Postmenopausal Overweight Women with Pelvic Floor Dysfunction?

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http://www.scirp.org/journal/PaperInformation.aspx?PaperID=48961#.VJjgPcCAM4

ABSTRACT

Introduction: Pelvic floor muscle function of 30 overweight postmenopausal women prior to and after colporrhahpy was monitored in this study. Material and Methods: Patients diagnosed with cystokele or combined cystorectokele was involved. 1 mg oral estriol and local estriol cream were administered for 30 days preoperatively. Pelvic floor muscle function was monitored by surface electromyography 1 month before (1st) 1 day prior to surgery (2nd), and six weeks after the surgery (3rd measurement). Body composition parameters (intra- and extracellular water and body fat) were also measured. Results: The ability to relax significantly improved (p = 0.03) in the preoperative period (between 1st and 2nd occasions). Six weeks after surgery a non-significant (p = 0.054) decrease in average muscle activity was detected when compared with values obtained before the surgery. Muscle-activity declined significantly from the first to the last measurements (p = 0.005). Conclusion: Our results confirm that postmenopausal obese women who undergo anterior or posterior colporrhaphy need a follow-up concerning pelvic floor muscle function and suggest that physiotherapy started the earliest possible may aid in preserving postoperative functionality on the long run.

Cite this paper

Hock, M. , Domány, B. , Bódis, J. and Garai, J. (2014) Does Surgery Benefit Postmenopausal Overweight Women with Pelvic Floor Dysfunction?. Open Journal of Therapy and Rehabilitation, 2, 114-119. doi: 10.4236/ojtr.2014.23016.

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http://dx.doi.org/10.1111/j.1479-828X.2005.00415.x                                                                eww141223lx

Negative Emotions and Defence Mechanisms in Obese People

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http://www.scirp.org/journal/PaperInformation.aspx?PaperID=51693#.VHUisGfHRK0

ABSTRACT

Previous investigations, using an effective non-invasive procedure of short-term experimental stress, proved that Obese vs. Normal Women develop about double the intensity of negative emotions (anxiety, anger, sadness) when under stress (Bonaiuto et al., 1993). A high production of negative emotions as a reaction to many everyday life stressors forces people to resort to psychological defense mechanisms. In the case of Obese Persons, these include oral regression (“neonatal regression”) and somatization, together with repression and denial. The latter components are part of the so-called Lifestyle Defense Mechanisms, studied by Grossarth-Maticek (1980). In the rigorous revision and classification carried out by Spielberger (1988) and Spielberger & Reheiser (2000, 2009), these factors were defined as “Need for Harmony” (N/H) and “Rationality/Emotional Defensiveness” (R/ED). In order to develop further appropriate indications, more than seven hundred Italian adults were examined by also recording the Body Mass Index (BMI) and using some evaluation tools, including the LDM Inventory. Significantly higher N/H scores were found in Obese Persons when compared with Overweight, Normal weight and Underweight ones. Other personological differences included significantly higher frequencies of the Type B Behaviour Pattern and higher average levels of Hyperphagic tendencies among the obese people. A development of this study involved more than one thousand participants and provided a confirmation of the influence of these defence mechanisms and personality structures as co-factors in determining obesity.

Cite this paper

Biasi, V. & Bonaiuto, P. (2014). Negative Emotions and Defence Mechanisms in Obese People. Psychology, 5, 1979-1988. doi: 10.4236/psych.2014.518201.

References

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Study of Serum Cholesterol Level in Adult Obese Population of Karachi, Pakistan

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http://www.scirp.org/journal/PaperInformation.aspx?PaperID=51222#.VFwbkGfHRK0

ABSTRACT

Background: The present study was planned to investigate the level of cholesterol in obese/non-obese (normal) individuals according to their body mass index (BMI) and age in different population residing in Karachi. Aim: Comparison of serum cholesterol values of obese with normal subjects and comparison of BMI of obese and normal individuals. Methods: Selection of obese subjects was according to the WHO (1998) criteria. A total of 40 subjects 18 – 55 years of age participated in the study, among which 30 subjects (Mean Age = 29.47 ± 1.99) were obese (Mean BMI = 35.41 ± 0.878) and 10 were controls with Mean age = 21.00 ± 0.547 and BMI = 19.96 ± 0.432. An overnight fasting blood sample was obtained and serum total Cholesterol (T-CH) level was estimated. Results: Obese persons having Mean T-CH = 202.6 ± 14.3 and controls having Mean T-CH = 173.3 ± 14.0. The data were further divided into males and females. Obese females were 11 with their BMI 31.836 ± 0.21, mean age ranged at 28.73 ± 4.04 and T-CH 191.8 ± 21.8, while that of control females were 6 in number with their BMI ranged at 19.183 ± 0.507, age 21.000 ± 0.894 and Cholester 148.7 ± 16.0 in controls. Total numbers of obese males were 19 with their BMI ranged at 37.49 ± 1.14, age ranged at 29.89 ± 2.19 and cholesterol level ranged at 208.89 ± 19.1. Control males were 4 in number with their BMI ranged at 21.125 ± 0.075, age 21.250 ± 0.479 and their T-CH 128.7 ± 8.72. Conclusion: The results of current study have reflected that BMI and total cholesterol concentration are higher in obese subjects.

Cite this paper

Mushtaq, R. , Mushtaq, R. , Akram, A. , Khwaja, S. and Ahmed, S. (2014) Study of Serum Cholesterol Level in Adult Obese Population of Karachi, Pakistan. Open Journal of Endocrine and Metabolic Diseases, 4, 238-243. doi: 10.4236/ojemd.2014.411024.

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Obesity Appears to Impact Male Fertility by Degrading Overall Semen Quality Rather Than Individual Semen Parameters

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http://www.scirp.org/journal/PaperInformation.aspx?PaperID=51190#.VFrRjmfHRK0

ABSTRACT

Obesity has become a well-recognized medical issue. However its exact role in male infertility remains unclear. The objective of the current study was to determine if an increase inBMIis associated with an increase in semen parameter abnormalities and if this relationship was influenced by other patient activities. Charts were reviewed for one hundred and thirty-three male patients who had also undergone a complete initial office face to face interview, as part of an infertility evaluation and a semen analysis. As part of standard patient care, all patients answered a detailed questionnaire regarding demographics, exposures, medical and reproductive history as part of their infertility evaluation. Patients were grouped according toBMIas normal (20 – 24 kg/m2), overweight (25 – 30 kg/m2), or obese (>30 kg/m2). Semen analysis parameters analyzed included: morphology, volume, concentration, percent motility, and agglutination. While some parameters suggested trends, results were similar between the normal, overweight, and obeseBMI, for concentration (P= 0.18), volume (P = 0.845), motility (P = 0.06); % Positive agglutination: 12%, 7%, 7% (P = 0.668) and % normal morphology (P = 0.083). Unlike a number of previous studies, results indicate that there is no statistically significant association betweenBMIand any of the individual semen parameters tested. Raw data suggested a trend for decreasing concentration with increasingBMI. Further, data also suggested equal numbers of oligospermics in each group. However, when the data looked at globally rather than on the effects on individually parameters (total number of normal motile sperm cells—NMS), functional sperm cells decreased with increasing BMI. None of these factors appeared to be affected by other patient factors. Collectively these data suggest that obesity has a multifactorial effect on male fertility; possibly due to relationships with the hormone cascade, body composition and potentially testis temperature regulation. Further study will be needed to confirm such relationships.

Cite this paper

Petty, J. , Jabara, S. , Prien, S. and Penrose, L. (2014) Obesity Appears to Impact Male Fertility by Degrading Overall Semen Quality Rather Than Individual Semen Parameters. Open Journal of Obstetrics and Gynecology, 4, 917-923. doi: 10.4236/ojog.2014.415129.

References

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http://dx.doi.org/10.1016/j.fertnstert.2007.06.046
[13] Winters, S.J., Wang, C., Abdelrahaman, E., et al. (2006) Inhibin-B Levels in Healthy Young Adult Men and Prepubertal Boys: Is Obesity the Cause for the Contemporary Decline in Sperm Count Because of Fewer Sertoli Cells? Journal of Andrology, 27, 560-564. http://dx.doi.org/10.2164/jandrol.05193
[14] Aggerholm, A.S., Thulstrup, A.M., Toft, G., et al. (2008) Is Overweight a Risk Factor for Reduced Semen Quality and Altered Serum Sex Hormone Profile? Fertility and Sterility, 90, 619-626. http://dx.doi.org/10.1016/j.fertnstert.2007.07.1292
[15] Eisenberg, M.L., Kim, S., Chen, Z., et al. (2014) The Relationship between Male BMI and Waist Circumference on Semen Quality: Data from the LIFE Study. Human Reproduction, 29, 193-200. http://dx.doi.org/10.1093/humrep/det428
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[17] Sánchez-Garrido, M.A., Ruiz-Pino, F., Manfredi-Lozano, M., et al. (2014) Obesity-Induced Hypogonadism in the Male: Premature Reproductive Neuroendocrine Senescence and Contribution of Kiss1-Mediated Mechanisms. Endocrinology, 155, 1067-1079. http://dx.doi.org/10.1210/en.2013-1584
[18] Fui, M.N., Dupuis, P. and Grossmann, M. (2014) Lowered Testosterone in Male Obesity: Mechanisms, Morbidity and Management. Asian Journal of Andrology, 16, 223-231.
http://dx.doi.org/10.4103/1008-682X.122365                                                                            eww141106lx