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Objectives: Obstructive sleep apnea (OSA) is associated with an increased risk of cardiovascular disease (CVD). Several of the proposed mechanisms for the development of CVD in OSA are similar to those proposed for the increased risk of CVD in obesity, so that it is difficult to determine the influence of OSA on these pathogenic mechanisms in obese individuals. The aim of this study was to evaluate the relationship of OSA with endothelial function, oxidative stress, inflammatory biomarkers, metabolic profile, sympathetic nervous system activity, and blood pressure (BP) in obese individuals., Methods: This cross-sectional study included 53 obese adults (28 women). Sleep study was performed with WatchPAT 200 (Itamar Medical, Caesarea, Israel) and the diagnosis of OSA was made when apnea-hypopnea index (AHI) ≥5 events/h (n = 33). All participants underwent evaluation of: body adiposity, BP, plasma catecholamines, high sensitivity C-reactive protein (hs-CRP), adiponectin, malondialdehyde, glucose, insulin, lipid profile, and endothelial function (EndoPAT 2000)., Results: In univariate analysis, participants with OSA compared with those without OSA exhibited higher values of neck circumference, glucose, noradrenaline, and systolic BP. After adjustment for confounders, including adiposity, only glucose and hs-CRP were significantly higher in OSA patients. In correlation analysis, after controlling for confounders, AHI was positively and significantly associated with neck circumference and hs-CRP, while minimum O2 saturation was associated negatively and significantly with neck circumference, insulin and homeostatic model assessment-insulin resistance (HOMA-IR)., Conclusions: The present study suggests that in obese individuals OSA is independently associated with inflammation and insulin resistance, but not with BP, plasma catecholamines and endothelial function., (Copyright © 2015 Elsevier Inc. All rights reserved.)

Objective: The aim of this study was to evaluate high body adiposity and cardiovascular disease (CVD) risk factors prevalence, in renal transplant recipients (RTR), comparing men with women., Methods: In this retrospective cross-sectional study, 102 patients (55 men) who were 49 ± 1.2 y and 114.3 ± 9 mo post-transplant (post-tx) were evaluated. Pretransplant (pre-tx) period data and weight gain during the first year post-tx were obtained from patient charts and post-tx data were collected during a routine visit at nephrology clinic. Body mass index (BMI) ≥ 25 kg/m(2) defined overweight and BMI ≥ 30 kg/m(2) defined obesity., Results: Pre-tx overweight prevalence was low and similar between men and women (26%), whereas only women showed obesity (11%). Post-tx body weight increased significantly in the entire group, leading to an increase in overweight (to 38% in men and 51% in women) and obesity (to 11% in men and 23% in women) prevalence. Post-tx comparisons between men and women showed that women had higher (women versus men; P < 0.05) BMI values (26.7 ± 0.8 versus 24.7 ± 0.5 kg/m(2)), weight gain during first year post-tx (9.2 ± 1.1 versus 5.5 ± 1 kg), abdominal obesity (57% versus 23%) and diabetes (34% versus 16%) prevalence. The associations between adiposity and CVD risk factors showed that pre-tx overweight increased the risk for diabetes in post-tx; pos-tx high BMI and abdominal obesity increased the risk for metabolic syndrome; abdominal obesity increased the risk for dyslipidemia in women., Conclusions: High body adiposity prevalence was high after transplantation and increased the risk for metabolic syndrome, an important CVD risk factor. Women showed higher total body adiposity values, abdominal obesity, and diabetes prevalence than men. Abdominal obesity increased the risk for dyslipidemia in women., (Copyright © 2013 Elsevier Inc. All rights reserved.)

Objective: Obesity is characterized by chronic subclinical inflammation, which is critical to endothelial dysfunction. Weight loss, induced by lifestyle interventions, is associated with a decline in biomarkers of inflammation and endothelial dysfunction. There is little evidence that high dietary calcium intake may reduce inflammation and improve endothelial function. The purpose of this study was to evaluate the effects of weight loss from a high-calcium energy-reduced diet on biomarkers of inflammation, fibrinolysis, and endothelial function in obese individuals., Methods: In this randomized clinical trial, we analyzed the data from 35 obese adults who lost at least 3% of initial body weight, during a period of 16 wk of energy restriction (-800 Kcal/d). Individuals were randomized into the following dietary regimens: (1) a high calcium diet (HCD; 1200-1300 mg/d) or (2) a low-calcium diet (LCD; <500 mg/d)., Results: After 16 wk of intervention subjects on HCD compared with those on LCD exhibited greater reduction in waist circumference and waist-to-hip ratio. Participants on HCD presented a significant reduction in all biomarkers of endothelial dysfunction evaluated in the study (intracellular adhesion molecule-1, vascular cell adhesion molecule 1, and E-Selectin), whereas subjects on LCD showed a significant decrease in intracellular adhesion molecule-1 and E-Selectin. Biomarkers of inflammation and fibrinolysis were reduced in both diets, although without reaching statistical significance. The reduction in all markers of inflammation, fibrinolysis, and endothelial dysfunction was similar in both diets., Conclusion: The findings of this study suggest that increased calcium intake during weight loss has no benefits with respect to biomarkers of inflammation, fibrinolysis, and endothelial function., (Copyright © 2013 Elsevier Inc. All rights reserved.)

Objective: An inverse relation between dietary calcium and adiposity has been found in several epidemiologic studies. Recent evidence has also suggested that a calcium-rich diet may have beneficial effects on insulin resistance and dyslipidemia. This study aimed to evaluate the association of dietary calcium intake with global adiposity, abdominal obesity, and metabolic profile in hypertensive patients., Methods: In this cross-sectional study, 85 hypertensive patients 25 to 70 y old underwent clinical, dietary, anthropometric, and biochemical evaluations. Participants were stratified into the following two groups according to their usual dietary calcium intake: low calcium group (<800 mg/d) and high calcium group (≥800 mg/d)., Results: Fifty-seven participants (11 men and 46 women) were included in the final analyses. Subjects in the low calcium group compared with those in the high calcium group exhibited significantly higher levels of body mass index and percentage of body fat after adjustments for variables that could interfere with those adiposity parameters (P = 0.03 and 0.01, respectively). Patients in the high calcium group had a lower odds ratio for prevalent obesity than those in the low calcium group, even after controlling for potential confounders (P = 0.01). No significant differences were found in abdominal adiposity and metabolic profile between the two groups. Using data from all patients, an inverse and significant association was observed between dietary calcium intake and percentage of body fat, and it remained after controlling for confounders (P = 0.03)., Conclusions: The findings of the present study suggest that, in hypertensive patients, higher dietary calcium intake could be associated with lower global adiposity., (Copyright © 2011 Elsevier Inc. All rights reserved.)

Objective: Recent evidence has suggested obesity as an independent risk factor for chronic kidney disease. However, the temporal relation between body mass index (BMI) and early renal dysfunction is unknown. This study aimed at evaluating whether longitudinal variations in BMI would reflect on changes in estimated glomerular filtration rate (GFR) in hypertensive individuals with excess body weight., Methods: This was a cross-sectional, longitudinal study., Results: Of the 218 participants who attended the first examination, 150 were available for paired final analyses. At the end of follow-up, GFR decreased by 1.024 mL/min for each 1-kg/m(2) increment in BMI (P<0.03). When BMI was analyzed in quartiles, a positive graded relation with GFR changes was observed in quartiles 1 and 2 (individuals who maintained or lost weight), and a negative relation in quartiles 3 and 4 (individuals who gained weight, P=0.05). A significant difference was observed between the smallest and highest BMI quartiles (P=0.01). At the end of follow-up, the 76 participants (51%) who gained weight (+4.6+/-0.4 kg) showed a reduction in GFR (-2.99+/-1.99 mL/min) of borderline significance (P=0.06) and a significant increase in fasting plasma glucose and triacylglycerol levels. Conversely, the 74 participants who maintained or lost weight showed no significant change in GFR and in fasting plasma glucose and triacylglycerol levels, although their blood pressure decreased significantly., Conclusions: Our study showed a significant temporal association between changes in BMI and GFR in overweight and obese hypertensive patients.