Publications by authors named "Sébastien Celle"

39 Publications

OSAHS phenotypes after night sleep recordings: How to get to precision medicine in 2021.

Sleep 2021 Jun 18. Epub 2021 Jun 18.

Clinical Physiology, Visas Center, University Hospital, Saint-Etienne, France.

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http://dx.doi.org/10.1093/sleep/zsab154DOI Listing
June 2021

Role of Gender and Physical Activity Level on Cardiovascular Risk Factors and Biomarkers of Oxidative Stress in the Elderly.

Oxid Med Cell Longev 2020 19;2020:1315471. Epub 2020 Jun 19.

Laboratoire Interuniversitaire de Biologie de la Motricité (LIBM) EA7424, Team « Vascular Biology and Red Blood Cell », Univ Lyon, Université Claude Bernard Lyon 1, Villeurbanne, France.

Background: Cardiovascular diseases remain as the leading cause of morbidity and mortality in industrialized countries. Ageing and gender strongly modulate the risk to develop cardiovascular diseases but very few studies have investigated the impact of gender on cardiovascular diseases in the elderly, which represents a growing population. The purpose of this study was to test the impact of gender and physical activity level on several biochemical and clinical markers of cardiovascular risk in elderly individuals.

Methods: Elderly individuals (318 women (75.8 ± 1.2 years-old) and 227 men (75.8 ± 1.1 years-old)) were recruited. Physical activity was measured by a questionnaire. Metabolic syndrome was defined using the National Cholesterol Education Program Expert Panel's definition. Polysomnography and digital tonometry were used to detect obstructive sleep apnea and assess vascular reactivity, respectively. Blood was sampled to measure several oxidative stress markers and adhesion molecules.

Results: The frequency of cardiovascular diseases was significantly higher in men (16.4%) than in women (6.1%) ( < 0.001). Body mass index (25.0 ± 4.3 vs. 25.8 ± 3.13 kg.m) and glycaemia (94.9 ± 16.5 vs. 101.5 ± 22.6 mg.dL) were lower, and High Density Lipoprotein (HDL) (74.6 ± 17.8 vs. 65.0 ± 17.2 mg.dL) was higher in women compared to men ( < 0.05). Oxidative stress was lower in women than in men (uric acid: 52.05 ± 13.78 vs. 59.84 ± 13.58, advanced oxidation protein products: 223 ± 94 vs. 246 ± 101 mol.L, malondialdehyde: 22.44 ± 6.81 vs. 23.88 ± 9.74 nmol.L). Physical activity was not associated with lower cardiovascular risk factors in both genders. Multivariate analyses showed an independent effect of gender on acid uric ( = 0.182; = 0.020), advanced oxidation protein products ( = 0.257; < 0.001), and HDL concentration ( = -0.182; = 0.026).

Conclusion: These findings suggest that biochemical cardiovascular risk factors are lower in women than men which could explain the lower cardiovascular disease proportion observed in women in the elderly.
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http://dx.doi.org/10.1155/2020/1315471DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7321518PMC
May 2021

Sera of elderly obstructive sleep apnea patients alter blood-brain barrier integrity in vitro: a pilot study.

Sci Rep 2020 07 9;10(1):11309. Epub 2020 Jul 9.

Clinical Physiology, University Hospital (CHU), Saint-Étienne, France.

Obstructive sleep apnea syndrome (OSAS) is characterized by repeated episodes of hypoxia during the night. The severity of the disorder can be evaluated using an apnea-hypopnea index (AHI). The physiological consequences are mainly cardiovascular and neuronal dysfunctions. One hypothesis to explain such associated neurological disorders is disruption of the blood-brain barrier (BBB), which protects the brain from endovascular cytotoxic compounds. We selected two subgroups of volunteers from the PROOF cohort study (France), a group of patients suffering newly diagnosed severe OSAS (AHI > 30/h) and a group showing no sleep apnea (AHI < 5/h). We exposed a human in vitro BBB model of endothelial cells (HBEC-5i) with sera of patients with and without OSAS. After exposure, we measured the apparent BBB permeability as well as tight junction and ABC transporter expression using whole cell ELISA. We showed that after incubation with sera from OSAS patients, there was a loss of integrity in the human in vitro BBB model; this was reflected by an increase in permeability (43%; p < 0.001) and correlated with a 50% and 40% decrease in tight junction protein expression of ZO-1 and claudin-5, respectively. At the same time, we observed an upregulation in Pgp protein expression (52%) and functionality, and a downregulation in BCRP expression (52%). Our results demonstrated that severe BBB disorder after exposure to sera from OSAS patients was reflected by an opening of the BBB.
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http://dx.doi.org/10.1038/s41598-020-68374-8DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7347951PMC
July 2020

Even a Previous Light-Active Physical Activity at Work Still Reduces Late Myocardial Infarction and Stroke in Retired Adults Aged>65 Years by 32%: The PROOF Cohort Study.

Front Public Health 2019 19;7:51. Epub 2019 Mar 19.

UJM-Saint-Etienne Autonomic Nervous System Research Laboratory, EA 4607 SNA-EPIS, Univ. Lyon, Saint-Etienne, France.

Work may contribute significantly to daily physical activity (PA) and sedentary behavior (SB). Physical inactivity and SB at work might be two major risk factors for premature morbidity. Therefore, the aim of this research was to describe self-reported past PA and SB at work and during leisure time within the PROOF cohort subjects, and to determine consequences of PA and SB on late health of these now retired workers. The PROOF cohort study was used to prospectively allow assessment of the predictive value of PA and SB at work and during leisure time among a healthy retired French population, with regard to cardiovascular and cerebrovascular events. PA (MET-h/week) and SB (h/d) were assessed using the Population Physical Activity Questionnaire (POPAQ) and the modified Global Physical Activity Questionnaire (GPAQ). Odds ratios (ORs with 95% CIs) for cardiovascular and cerebrovascular events were associated with each level of PA at work: light (<3 METs), moderate (3-5.9 METs), vigorous (≥6 METs) and were compared to SB at work. Out of the 1011 65-year-old subjects initially included, the 15-year follow-up has been currently completed for 688 (68%) subjects; 89 deaths (all-cause mortality, 9%) and 91 fatal and non-fatal cardiovascular and cerebrovascular events (9%), were reported. An active work (light, moderate, or vigorous intensity) was associated with a 21% reduced risk of cardiovascular (myocardial infarction) and cerebrovascular events (stroke) (OR = 0.79, 95% CI: 0.32-0.91, < 0.02) compared to sedentary work. This relationship was already significant for light intensity work (32%; i.e., OR = 0.68, 95% CI: 0.31-0.87, < 0.02). There is strong causal evidence linking PA and SB at work with late cardiovascular and cerebrovascular disease. All in all, the risk for onset of myocardial infarction and stroke was lower among those who had a previous active work compared to those with previous sedentary work. Even previous light active work produced substantial health benefits. www.ClinicalTrials.gov, identifier: NCT00759304.
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http://dx.doi.org/10.3389/fpubh.2019.00051DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6433790PMC
March 2019

Sleep apnoea in the asymptomatic elderly: a real issue for the brain?

Eur Respir J 2018 06 14;51(6). Epub 2018 Jun 14.

Centre Hospitalier Universitaire de Saint-Etienne, Physiologie clinique et de l'exercice, Saint-Étienne, France.

The link between sleep apnoea and brain structure is unclear; although dysfunction of the hippocampus, middle temporal gyrus and brainstem/cerebellum have been observed previously. However, this link has been little explored in elderly subjects. The aim of this study was to explore the link between sleep apnoea and the brain in an elderly population.226 asymptomatic elderly subjects (age mean±sd 75.3±0.9 years, range 72.3-77.8 years) from the PROOF (Evaluation of Ageing, Autonomic Nervous System Activity and Cardiovascular Events) cohort study were explored using linear voxel-based or cortical thickness with apnoea/hypopnoea index (AHI; mean±sd 15.9±11.5 events·h, range 6-63.6 events·h) as a covariate of main interest. The brain volumes of 20 control subjects, 18 apnoeic (AHI >29 events·h) treated patients and 20 apnoeic untreated patients from this population were compared using voxel-based morphometry, cortical thickness or surface-based analyses.AHI was not associated with any change in local brain volume, cortical thickness or cortex surface. Control subjects, apnoeic treated and untreated patients were not different in terms of local brain volume, cortical thickness or surface.In a specific population of asymptomatic elderly healthy subjects, sleep apnoea does not seem to be associated with a change in local brain volume or in cortical thickness.
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http://dx.doi.org/10.1183/13993003.02450-2017DOI Listing
June 2018

Use of Vitamin K Antagonists and Brain Morphological Changes in Older Adults: An Exposed/Unexposed Voxel-Based Morphometric Study.

Dement Geriatr Cogn Disord 2018 27;45(1-2):18-26. Epub 2018 Feb 27.

Department of Geriatric Medicine and Memory Clinic, Angers University Hospital, UPRES EA 4638, University of Angers, Angers, France.

Background: Vitamin K antagonists (VKAs) are commonly used for their role in haemostasis by interfering with the vitamin K cycle. Since vitamin K also participates in brain physiology, this voxel-based morphometric study aimed to determine whether the duration of exposure to VKAs correlated with focal brain volume reduction in older adults.

Methods: In this exposed/unexposed (1: 2) study nested within the GAIT (Gait and Alzheimer Interactions Tracking) cohort, 18 participants exposed to VKA (mean age 75 ± 5 years; 33.3% female; mean exposure 2,122 ± 1,799 days) and 36 matched participants using no VKA (mean age 75 ± 5 years; 33.3% female) underwent MRI scanning of the brain. Cortical grey and white matter volumes were automatically segmented using statistical parametric mapping. Age, gender, educational level, history of atrial fibrillation, type of MRI, and total intracranial volume were included as covariables.

Results: The duration of exposure to VKA correlated inversely across the whole brain with the subvolumes of two clusters in the grey matter (right frontal inferior operculum and right precuneus) and one cluster in the white matter (left middle frontal gyrus). In contrast, the grade of white matter hyperintensities did not differ according to the use of VKA.

Conclusion: We found focal atrophies in older adults exposed to VKA. These findings provide new insights elucidating the effects of VKAs on brain health and function in older adults.
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http://dx.doi.org/10.1159/000485793DOI Listing
October 2018

Elderly Patients with Ongoing Migraine Show Reduced Gray Matter Volume in Second Somatosensory Cortex.

J Oral Facial Pain Headache Winter 2018;32(1):67–74. Epub 2017 Dec 15.

Aims: To identify structural changes in gray matter in suspected migraine generators (the hypothalamus and/or brainstem nuclei) and pain pathways and to evaluate whether structural changes in migraine are definitive or resolve with age.

Methods: Voxel-based morphometry (VBM) was used to assess differences in gray matter between 39 healthy controls (HC), 25 episodic migraine (EM) subjects, and 37 subjects with a history of migraine (HM). In addition, morphometric changes were specifically investigated in suspected migraine generators and/or pain pathways. For statistical analyses, t tests between the groups were performed, and a correction for multiple comparisons was used.

Results: Whole-brain analysis did not reveal any gray or white matter changes. However, when the analysis was limited to the pain matrix, a lower gray matter volume was observed in the left second somatosensory (SII) cortex in EM subjects compared to HC subjects. This volume was significantly reduced in the EM group compared to the HC group and to the HM group, but not in the HM group compared to the HC group.

Conclusion: Morphometric abnormalities in the SII in subjects with ongoing migraine but not in subjects with a resolved migrainous disease are likely to characterize a migrainous state rather than be a marker of brain susceptibility to migraine.
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http://dx.doi.org/10.11607/ofph.1866DOI Listing
April 2018

Serum lipid profile, sleep-disordered breathing and blood pressure in the elderly: a 10-year follow-up of the PROOF-SYNAPSE cohort.

Sleep Med 2017 Nov 18;39:14-22. Epub 2017 Sep 18.

Clinical and Exercise Physiology Laboratory, University Hospital of Saint-Etienne, Saint-Etienne, France.

Objectives: Dyslipidemia, sleep-disordered breathing (SDB) and hypertension are comorbid factors evidenced in adults, but poorly studied in old people. This study aimed to examine the long-term evolution of the serum lipid profile, and its relationships with SDB and blood pressure (BP) in the elderly.

Methods: A ten-year follow-up of the prospective Prognostic Indicator of Cardiovascular and Cerebrovascular Events (PROOF) and the Autonomic Nervous System Activity, Aging and Sleep Apnea/Hypopnea (SYNAPSE) cohort, which initially included 1011 elderly subjects from the general population, and who were untreated by continuous positive airway pressure (CPAP). Serum lipid profile, respiratory polygraphy for SDB and ambulatory blood pressure monitoring were performed.

Results: A total of 266 subjects (male/female 150/116; age 66.2 ± 0.8 years) were reassessed after 9.6 ± 0.7 years (age 75.8 ± 1.2 years). The prevalence of high-risk dyslipidemia decreased from 61.3 to 44.4%, and hypertension from 57.9 to 27.4%. The nocturnal oxygen desaturation index increased (mean + 2.3 ± 6.7 events/hour; p < 0.001), while the mean SaO and minimal SaO decreased. These variations (Δ) of oxygen desaturation worsened whether or not elderly subjects took anti-hypertensive and lipid-lowering treatments, and were not associated with serum lipid variations. The decrease in diurnal diastolic BP was independently associated with aging, and with the lowering of the waist/hip ratio (ΔW/H) and low-density lipoprotein cholesterol (LDL-C)/high-density lipoprotein cholesterol (HDL-C) ratio, while the decrease in diurnal systolic BP only depended on aging and ΔW/H.

Conclusions: The results suggested that the observed worsening of nocturnal oxygen desaturation after 10 years in the elderly was independent of the change in circulating lipids, and not influenced by lipid-lowering treatments. However, the variation in blood pressure remained associated with aging, waist/hip and LDL-C/HDL-C ratios.

Trial Registry: NCT00759304 and NCT00766584 at clinicaltrials.gov.
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http://dx.doi.org/10.1016/j.sleep.2017.07.028DOI Listing
November 2017

HRVanalysis: A Free Software for Analyzing Cardiac Autonomic Activity.

Front Physiol 2016 22;7:557. Epub 2016 Nov 22.

NeuroPain Unit, Lyon Neuroscience Research Centre, Institut National de la Santé et de la Recherche Médicale U 1028/Centre National de la Recherche Scientifique UMR 5292, University of Lyon Lyon, France.

Since the pioneering studies of the 1960s, heart rate variability (HRV) has become an increasingly used non-invasive tool for examining cardiac autonomic functions and dysfunctions in various populations and conditions. Many calculation methods have been developed to address these issues, each with their strengths and weaknesses. Although, its interpretation may remain difficult, this technique provides, from a non-invasive approach, reliable physiological information that was previously inaccessible, in many fields including death and health prediction, training and overtraining, cardiac and respiratory rehabilitation, sleep-disordered breathing, large cohort follow-ups, children's autonomic status, anesthesia, or neurophysiological studies. In this context, we developed , a software to analyse HRV, used and improved for over 20 years and, thus, designed to meet laboratory requirements. The main strength of is its wide application scope. In addition to standard analysis over short and long periods of RR intervals, the software allows time-frequency analysis using wavelet transform as well as analysis of autonomic nervous system status on surrounding scored events and on preselected labeled areas. Moreover, the interface is designed for easy study of large cohorts, including batch mode signal processing to avoid running repetitive operations. Results are displayed as figures or saved in TXT files directly employable in statistical softwares. Recordings can arise from RR or EKG files of different types such as cardiofrequencemeters, holters EKG, polygraphs, and data acquisition systems. can be downloaded freely from the Web page at: https://anslabtools.univ-st-etienne.fr is meticulously maintained and developed for in-house laboratory use. In this article, after a brief description of the context, we present an overall view of HRV analysis and we describe the methodological approach of the different techniques provided by the software.
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http://dx.doi.org/10.3389/fphys.2016.00557DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5118625PMC
November 2016

Anatomic Correlation of the Mini-Mental State Examination: A Voxel-Based Morphometric Study in Older Adults.

PLoS One 2016 14;11(10):e0162889. Epub 2016 Oct 14.

Department of Neuroscience, Division of Geriatric Medicine and Memory Clinic, Angers University Hospital, UPRES EA 4638, University of Angers, UNAM, Angers, France.

The clinical utility of the Mini-Mental State Examination (MMSE) and its shorter version (SMMSE) is still debated. There is a need to better understand the neuroanatomical correlates of these cognitive tests. The objective of this cross-sectional study was to determine whether lower MMSE and SMMSE scores correlated with focal brain volume reduction in older adults. Participants from the GAIT study (n = 207; mean, 70.9±5.9 years; 57% female; mean MMSE 26.2±3.9; mean SMMSE 5.1±1.1) were evaluated using the MMSE and SMMSE and received a 1.5-Tesla MRI scan of the brain. Cortical gray and white matter subvolumes were automatically segmented using Statistical Parametric Mapping. Age, gender, education level, and total intracranial volume were included as potential confounders. We found correlations between the MMSE score and specific cortical regions of the limbic system including the hippocampus, amygdala, cingulate gyrus, and parahippocampal gyrus, independently of the diagnostic category (i.e., mild cognitive impairment or Alzheimer disease or controls). Regarding correlations with the SMMSE score, only one cluster in the left hippocampus was identified, which overlapped with the cluster that was positively correlated with the MMSE score. There were no correlations with the volume of white matter. In conclusion, worse MMSE and SMMSE scores were associated with gray matter atrophy mainly in the limbic system. This finding highlights that atrophy of specific brain regions are related to performance on the MMSE and the SMMSE tests, and provides new insights into the cognitive function probed by these tests.
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http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0162889PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5065203PMC
June 2017

Supra-Epiglottic Upper Airway Volume in Elderly Patients with Obstructive Sleep Apnea Hypopnea Syndrome.

PLoS One 2016 23;11(6):e0157720. Epub 2016 Jun 23.

EA 4607 SNA EPIS, Clinical Physiology and VISAS Center, Pole NOL, CHU and Faculty of Medicine of Saint-Etienne, University Jean Monnet Saint-Etienne, COMUE Lyon Saint-Etienne, France.

Objective: Small upper airway measurements areas and high body mass index are recognized risk factors for obstructive sleep apnea syndrome (OSAS) in non-elderly populations; however, there is limited information regarding elderly patients. We evaluated whether upper airway volume is associated with OSAS and OSAS treated with continuous positive airway pressure (CPAP) treatment and whether BMI is correlated with upper airway volume and measurements in elderly subjects.

Methods: In 60 volunteers aged 75.58±0.9 years: 20 OSAS, 20 OSAS chronically treated with CPAP, and 20 controls, semi-automatic segmentation, retropalatal distance and transverse diameter of the supra-epiglottic upper airway were evaluated using 3DT1-weighted magnetic resonance imaging. Anteroposterior to transverse diameter ratio was defined as retropalatar diameter/transverse diameter.

Results: There were no significant differences in supra-epiglottic upper airway volume between OSAS, CPAP treated patients, and controls. There were significant differences in retropalatal distance and anteroposterior to transverse diameter ratio between OSAS, CPAP treated patients, and controls (P = 0.008 and P<0.0001 respectively). There was a significant correlation between body mass index and retropalatal distance (P<0.05) but not with supra-epiglottic upper airway volume.

Conclusion: In elderly subjects, OSAS and body mass index are not associated with changes in supra-epiglottic upper airway volume but are associated with modification of pharynx shape.
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http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0157720PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4919063PMC
July 2017

Incidental findings on brain magnetic resonance imaging in the elderly:the PROOF study.

Brain Imaging Behav 2017 02;11(1):293-299

Clinical Physiology-VISAS Center, EA-4607-SNA-EPIS, CHU Saint-Etienne, COMUE-Lyon-St-Etienne, Saint Etienne, F-42055, France.

To prospectively evaluate the prevalence of incidental findings on standardized brain MRI scans in a cohort of elderly subjects. All participants provided written informed consent to participate in this prospective study, which was approved by the institutional review board and was HIPAA compliant. There were 503 subjects (75.3 ± 0.9 years of age, 58 % women) who received brain MRIs on a 1.5-T scanner using a standard acquisition protocol. All scans were reviewed by an experienced neuroradiologist. Incidental findings were stratified as follows: 1, no incidental findings; 2, incidental findings without clinical significance; 3, incidental findings with clinical significance or requiring clinical follow-up. Incidental findings were identified in 77.9 % of subjects. Among 392 scans that exhibited incidental findings, 494 abnormalities were identified. The most common findings in our study were cysts (45.9 % of subjects) and ear, nose, and throat (ENT) lesions (24.8 %) followed by stroke lesions (6.6 %) and neoplasms (3.8 %). There were 472 incidental findings that lacked clinical significance (group 2), and 22 incidental findings that required follow-up evaluation (group 3). Incidental findings on brain MRIs were commonly observed in this cohort of elderly subjects, but clinical follow-up was rarely indicated.
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http://dx.doi.org/10.1007/s11682-016-9519-4DOI Listing
February 2017

Hippocampus volume and subjective sleepiness in older people with sleep-disordered breathing: a preliminary report.

J Sleep Res 2016 Apr 14;25(2):190-3. Epub 2015 Dec 14.

Service de Physiologie Clinique et de l'Exercice (Pôle Hospitalier NOL), Faculté de Médecine Jacques Lisfranc, CHU Nord, Université Jean Monnet, Saint-Etienne, France.

Unlabelled: Sleep-disordered breathing (SDB) is associated with excessive daytime sleepiness (EDS) and explained by sleep fragmentation and hypoxaemia, both contributing to brain morphology abnormalities. Recent data on middle-aged SDB patients suggest a link between hippocampus volume (HV) and EDS. We tested this hypothesis in a group of SDB older subjects. A total of 232 healthy participants aged 75 ± 0.9 years were examined. Subjective EDS was assessed by the Epworth Sleep Questionnaire (ESS), with a mean score of 5.6 ± 3.5. Volumetric segmentation of the right (RHV) and left HV (LHV) were measured using FreeSurfer software. All subjects underwent extensive cognitive testing to exclude neurological disease, as well as ambulatory polygraphy to assess SDB status. Sleepy subjects showed a lower HV. In a correlation analysis, RHV (r = -0.162, P = 0.01) and LHV (r = -170, P = 0.05) were correlated negatively with ESS and not associated with respiratory data. Multiple regression analysis did not reveal any effect of age, gender, SDB severity and hypoxia. ESS was the only factor possibly explaining the lower RHV (P = -0.03) and LHV (P = -0.04). In older people with SDB, the subjective EDS was associated with lower HV. This morphological finding should be considered on the pathogenesis of sleepiness in SDB patients.

Clinical Trial Registration: NCT 00759304 and NCT 00766584.
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http://dx.doi.org/10.1111/jsr.12367DOI Listing
April 2016

Identification and comparison of the predictors of maximal inspiratory force and handgrip in a healthy elderly population. The proof study.

Clin Nutr 2016 08 22;35(4):963-7. Epub 2015 Jul 22.

Service de Physiologie Clinique et de l'Exercice, CHU St Etienne, France; Laboratoire SNA-EPIS, Université J Monnet, France.

Background: A severe weakness of peripheral muscles occurs in half of the persons aged 80 years or older. The common factors between muscle depletion and reduced respiratory strength have not yet been established.

Objective: In the subjects of the Proof cohort, we aimed to identify, among body composition, pulmonary function and energy expenditure parameters, the predictors of maximal inspiratory pressure (MIP) as an index of respiratory muscle strength and handgrip (HG) as an index of peripheral muscle strength.

Subjects And Methods: In 375 healthy elderly subjects aged 72 ± 1 years, fat mass (FM) and fat free mass (FFM) were assessed by DEXA, the last being also indexed to height (FFMI). Spirometry was performed and daily energy expenditure (DEE) was estimated by a questionnaire. After three years, MIP and HG of the dominant arm were determined and the predicting value of pulmonary function tests, body composition and DEE on these parameters was tested.

Results: Mean MIP and HG were 77 ± 26% and 106 ± 19% of the predicted value (%pred) with 90 (24%) and 30 (8%) subjects below standards, respectively. There was a significant but weak correlation between MIP%pred and HG%pred (r = 0.175, p < 0.001). Logistic regression showed that low MIP was predicted by trunk FFM and FFMI in women, and DEE in men. Low HG was predicted by trunk FM in men only.

Conclusions: The predictors of a reduction of MIP in the elderly differ from those of HG, suggesting a differential regulation of respiratory muscle and arm strength.
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http://dx.doi.org/10.1016/j.clnu.2015.07.016DOI Listing
August 2016

Desperately seeking grey matter volume changes in sleep apnea: A methodological review of magnetic resonance brain voxel-based morphometry studies.

Sleep Med Rev 2016 Feb 19;25:112-20. Epub 2015 Mar 19.

Inserm, U836, F-38000 Grenoble, France; Université Grenoble Alpes, GIN, F-38000 Grenoble, France.

Cognitive impairment related to obstructive sleep apnea might be explained by subtle changes in brain anatomy. This has been mainly investigated using magnetic resonance brain scans coupled with a voxel-based morphometry analysis. However, this approach is prone to several methodological pitfalls that may explain the large discrepancy in the results reported in the literature. We critically reviewed twelve papers addressing grey matter volume modifications in association with obstructive sleep apnea. Finally, based on strict methodological criteria, only three studies reported robust, but conflicting, results. No clear evidence has emerged and exploring brain alteration due to obstructive sleep apnea should thus be considered as an open field. We provide recommendations for designing additional robust voxel-based morphometry studies, notably the use of larger cohorts, which is the only way to solve the underpowered issue and the underestimated role of confounders in neuroimaging studies.
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http://dx.doi.org/10.1016/j.smrv.2015.03.001DOI Listing
February 2016

Sleep-related breathing disorders and gait variability: a cross-sectional preliminary study.

BMC Pulm Med 2014 Aug 23;14:140. Epub 2014 Aug 23.

Department of Neuroscience, Division of Geriatric Medicine, UPRES EA 4638, UNAM, Angers University Hospital, 49933 Angers, Cedex 9, France.

Background: Sleep-related breathing disorders (SRBDs) provoke cognitive and structural brain disorders. Because these disorders have been associated with unsafe gait characterized by an increase in stride-to-stride variability of stride time (STV), we hypothesised that SRBDs could be associated with an increased STV. The aim of this study was to examine the association between SRBDs and STV in French healthy older community-dwellers.

Methods: A total of 49 participants (mean age 69.6 ± 0.8 years; 65.2% female) were included in this cross-sectional study. All participants, who were free of clinically diagnosed SRBDs before their inclusion, had a nocturnal unattended home-sleep assessment. There were separated in three group based on apnea + hypopnea index (AHI): AHI <15 defining the absence of SRBD, AHI between 15-30 defining mild SRBD, and AHI >30 defining moderate-to-severe SRBD. Coefficient of variation of stride time, which is a measure of STV, was recorded while usual walking using SMTEC® footswitches system. Digit span score was used as a measure of executive performance. Age, gender, body mass index (BMI), number of drugs daily taken, vision, proprioception, history of falls, depression symptoms, global cognitive functioning were also recorded.

Results: STV and BMI were higher in participants with mild SRBDs (P = 0.031 and P = 0.020) and moderate-to-severe SRBDs (P = 0.004 and P = 0.002) compared to non-SRBDs. STV positively correlated with AHI (P = 0.036). Lower (i.e., better) STV was associated with the absence of SRBDs (P = 0.021), while greater (i.e., worse) STV was associated with moderate-to-severe SRBD (P < 0.045) but not with mild SRBD (P > 0.06).

Conclusion: Our results show a positive association between STV and SRBDs, with moderate-to-severe SRBD being associated with greater gait variability. This association opens new perspectives for understanding gait disorders in older adults with SRBDs and opens the door to treatments options since SRBDs are potential treatable factors.
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http://dx.doi.org/10.1186/1471-2466-14-140DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4146548PMC
August 2014

Sleep-related autonomic overactivity in a general elderly population and its relationship to cardiovascular regulation.

Heart Vessels 2016 Jan 24;31(1):46-51. Epub 2014 Aug 24.

Faculté de Médecine Jacques Lisfranc, Service de Physiologie et de l'Exercice, EA 4607 SNA EPIS, CHU Nord, Université Jean Monnet, Saint-Etienne PRES de Lyon, France.

Alteration in cardiac autonomic activity during sleep is a common feature of sleep disorders. Diurnal sympathetic overactivity is a possible consequence and could contribute to future cardiovascular complications. The aim of this study is to assess the relationship between cardiac autonomic activity during sleep and diurnal autonomic cardiovascular control. In a large cohort (n = 1011) of subjects aged 65 years old (± 0.4) free of cardiac and cerebrovascular events and of sleep-related breathing disorders, we evaluated (cross-sectional study) the prevalence of unexpected alteration in sleep-related autonomic overactivity according to the presence of a cyclical nocturnal heart rate variability [quantified using the relative power spectral density of the very low-frequency band of the heart rate increment (VLFi%) from ECG Holter monitoring]. We tested its relationship with diurnal ambulatory blood pressure and spontaneous baroreflex sensitivity (sBRS). An abnormal cardiac autonomic activity during sleep was retained in 34.4% of this population according to a VLFi% >4. Using multiple logistic regression analysis, the severity of the autonomic alteration was mainly correlated after adjustment with lower sBRS (p = 0.01; OR: 0.94; 95% CI: 0.90-0.98). Diurnal baroreflex control alteration is associated with sleep-related autonomic overactivity elderly. Such alteration may contribute to the increased incidence of cardiovascular complications in sleep disorders.
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http://dx.doi.org/10.1007/s00380-014-0573-9DOI Listing
January 2016

Metabolic syndrome is associated with poor memory and executive performance in elderly community residents: the PROOF study.

Am J Geriatr Psychiatry 2014 Nov 25;22(11):1096-104. Epub 2014 Jan 25.

EA SNA-EPIS, PRES Lyon, Saint Etienne, France; Clinical and Exercise Physiology Laboratory, University Hospital of Saint-Etienne, Saint Etienne, France.

Objective: Aging is associated with a loss of cognitive performance and an increasing occurrence of cardiovascular events. Moreover, cardiovascular risk factors are linked to cognitive impairment and dementia. Whereas individual components of metabolic syndrome (Met S) have been reported to be linked to cognitive decline and dementia, there are very few studies on Met S as a whole. The present study aims to assess the relationship between Met S and its components and cognitive functioning in a cohort of elderly non-demented community residents.

Design: Population-based cohort study (PROOF study). Cross-sectional analysis.

Participants: Dementia-free community-dwellers aged 65.

Measures: The PROOF participants underwent an extensive neuropsychological battery at baseline. Summary cognitive measures including memory, attention, and executive performance were created by converting the individual test results to Z scores and computing the average scores within each domain. Each of the three cognitive scores was individually compared between groups as a function of Met S. The cognitive scores and the covariates which were significant in univariate analyses were then included in logistic regression models.

Results: A significant association was observed between the presence of metabolic syndrome, poor memory, and executive function even after adjusting for confounding factors (memory: odds ratio: 1.77, p = 0.008; executive functions: odds ratio: 1.91, p = 0.002).

Conclusions: Our study showed that in a sample of elderly community dwellers, Met S was associated with poor memory and executive performance. These results underline the importance of detecting and managing metabolic syndrome components to prevent cognitive impairment and dementia.
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http://dx.doi.org/10.1016/j.jagp.2014.01.005DOI Listing
November 2014

Leukoaraiosis and ambulatory blood pressure load in a healthy elderly cohort study: the PROOF study.

Int J Cardiol 2014 Mar 23;172(1):59-63. Epub 2013 Nov 23.

Service de Physiologie Clinique et de l'Exercice, Pôle NOL, CHU Nord, 42055 Saint-Étienne, France; EA 4607 SNA-EPIS, Faculté de Médecine Jacques Lisfranc, Université Jean Monnet, PRES Université de Lyon42023 Saint-Étienne, France. Electronic address:

Background: Old age and hypertension are consistently reported to be the main risk factors of leukoaraiosis. The association between white matter lesions (WMLs) and other cardiovascular risk factors (CVRF) remains controversial. We evaluated the association between CVRF and WMLs in a cohort study and determined the blood pressure variables that could predict WML severity.

Methods: 830 subjects (65+/-1 years of age, 60% women) from the PROOF study, with a reliable ABPM and brain MRI, were included. The exclusion criteria included prior myocardial infarction, stroke, heart failure, atrial fibrillation, type 1 diabetes mellitus, and pacing. White matter changes on MRI were defined as hyperintensities >5mm on FLAIR images. We used the total degree of WML (range: 0-30) by adding the region-specific scores of both hemispheres.

Results: Linear regression analyses demonstrated a significant relationship between total leukoaraiosis score and 24h systolic blood pressure (SBP), 24h diastolic BP, daytime SBP and DBP and nighttime SBP. No significant relationship was found between leukoaraiosis score and clinical SBP, clinical DBP, or nocturnal DIP. There was also no significant relationship between leukoaraiosis and other recognized cardiovascular risk factors. Based on a ROC curve analysis, we identified the optimal threshold separating high-risk WML patients for a mean 24h SBP above 123 mmHg (p<0.05).

Conclusions: Even moderate increases in 24h SBP promote arteriolar fragility of the cerebral white matter in a population aged 65. The prognostic implications of such abnormalities in asymptomatic and moderate cardiovascular risk populations remain to be evaluated.
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http://dx.doi.org/10.1016/j.ijcard.2013.11.052DOI Listing
March 2014

Blood pressure levels and brain volume reduction: a systematic review and meta-analysis.

J Hypertens 2013 Aug;31(8):1502-16

Division of Geriatric Medicine, Department of Neuroscience, Angers University Hospital, 49933 Angers Cedex 9, France.

Objective: High blood pressure (BP) levels may be associated with brain volume reduction and may contribute to brain atrophy in key brain regions involved in cognition and susceptible to neurodegeneration in Alzheimer's disease. The purpose of this work was to systematically review and quantitatively synthesize the association of BP levels with brain volume reduction in humans.

Methods: An English Medline, Cochrane Library and PsycINFO search was conducted in June 2012 using the Medical Subject Heading terms 'Blood pressure', 'Hypertension', 'Brain mapping' and 'Brain atrophy'.

Results: Of the 609 screened abstracts, 28 studies (4.6%) were included in the qualitative analysis. Twenty-six studies (92.9%) showed a significant association of higher BP levels and/or hypertension with total and/or regional brain volume reduction, the frontal and temporal lobes being particularly affected. In addition, four other studies reported an association between lower BP levels and brain volume reduction. Due to the heterogeneity of methodology and outcomes, random-effects meta-analyses of the mean difference of brain volume could be performed on only seven studies, with a total of 709 cases with hypertension and 1001 controls without hypertension. The findings showed no between-group difference regarding the whole-gray matter volume (summary mean difference = 2.42 cm [95% confidence interval (CI): -2.13 to 6.96]). Conversely, cases with hypertension exhibited lower hippocampus volume compared with controls [summary mean difference = -0.10 cm (95% CI: -0.17 to -0.02)].

Conclusion: These findings provide evidence that high BP levels lead to brain volume reduction, specifically in hippocampus, and may be an important factor that contributes to neurodegeneration in Alzheimer's disease.
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http://dx.doi.org/10.1097/HJH.0b013e32836184b5DOI Listing
August 2013

Higher gait variability is associated with decreased parietal gray matter volume among healthy older adults.

Brain Topogr 2014 Mar 17;27(2):293-5. Epub 2013 May 17.

Department of Neuroscience, Division of Geriatric Medicine, UPRES EA 4638, UNAM, Angers University Hospital, 49933, Angers Cedex 9, France,

The objectives of this study were to examine the association of stride time variability (STV) with gray and white matter volumes in healthy older adults, and to determine the specific location of any parenchymal loss associated with higher STV. A total of 71 participants (mean age 69.0 ± 0.8 years; 59.7 % female) were included in this study. All participants had a 1.0 Tesla 3D T1-weighted MRI of the brain to measure gray and white matter volumes. STV was measured at steady-state self-selected walking speed using an electronic footswitch system. We found an association between higher STV and lower gray matter volume in the right parietal lobe (e.g., angular gyrus, Brodmann area 39, cluster corrected pFWE = 0.035). There were no significant associations between STV and higher gray matter volume or change in white matter volume. To the best of our knowledge this study is the first to identify a significant association of higher STV with lower right parietal gray matter volume in healthy older adults.
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http://dx.doi.org/10.1007/s10548-013-0293-yDOI Listing
March 2014

Relation of central fat mass to obstructive sleep apnea in the elderly.

Sleep 2013 Apr 1;36(4):501-7. Epub 2013 Apr 1.

Health Research Unit, High School of Health, University of Applied Sciences Western Switzerland, Lausanne, Switzerland.

Study Objectives: Obesity is a recognized risk factor for obstructive sleep apnea syndrome (OSAS). We evaluated whether total trunk and central fat mass (CFM) is associated with OSAS in elderly subjects.

Design: Cross-sectional.

Setting: Body composition assessment by dual-energy X-ray absorbsiometry (DEXA).

Participants: 749 volunteers aged 67.2 ± 0.8 years (59.4% women).

Intervention: All participants underwent evaluation of their body composition by DEXA in parallel with clinical and polygraphic assessments. The presence of OSAS was defined by an apnea plus hypopnea index (AHI) ≥ 15.

Measurements And Results: A total of 44.8% of the population had an AHI < 15, and 55.2% presented OSAS. OSAS subjects were more frequently overweight and had a higher total trunk fat mass and central fat mass (CFM). Correlation analyses revealed that body mass index (r = 0.27, P < 0.001), neck circumference (r = 0.35, P < 0.001), and CFM (r = 0.23, P < 0.001) were significantly related to AHI. Logistic regression analysis indicated that in mild OSAS cases (> 15AHI < 30), BMI (OR: 1.10; 95% CI: 1.03-1.18; P = 0.008), and male gender (OR: 1.49; 95% CI: 1.05-2.12, P = 0.03) were key factors explaining an AHI between 15 and 30. In severe cases (AHI > 30), male gender (OR: 3.65; 95% CI: 2.40-5.55; P < 0.001) and CFM (OR: 1.10; 95% CI: 1.03-1.19; P = 0.009) were significant independent predictors of OSAS.

Clinical Trial Registration: NCT 00759304 and NCT 00766584.

Conclusions: Although central fat mass plays a role in the occurrence of severe OSAS in men older than 65 years of age, its low discriminative sensitivity in mild OSAS cases does not warrant systematic use of DEXA for the diagnosis of OSAS.
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http://dx.doi.org/10.5665/sleep.2532DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3612263PMC
April 2013

Diabetes, impaired fasting glucose, and cognitive decline in a population of elderly community residents.

Aging Clin Exp Res 2012 Aug;24(4):377-83

Centre Mémoire de Ressources et de Recherche, Neurology Unit, University Hospital of Saint-Etienne, Saint-Etienne, France.

Background And Aims: Diabetes and impaired fasting glucose, as well as cognitive impairment, are common in the elderly. Although several cross-sectional studies have demonstrated the influence of diabetes on cognitive impairment, only a few longitudinal studies have assessed the relationship between diabetes, impaired fasting glucose and cognitive decline in non-demented elderly community dwellers, by means of extensive neuropsychological batteries. The present study assesses the relationship between baseline diabetes, impaired fasting glucose (IFG) and 2- year evolution of memory, attention and executive performance in a sample of non-demented elderly subjects.

Methods:

Design: Population-based cohort study [(PROgnostic indicator OF cardiovascular and cerebrovascular events (PROOF)].

Participants: One hundred and sixty-three community dwellers aged 65 years without dementia at recruitment.

Main Outcome Measures: Memory, attention and executive performance.

Results: A significant association was observed between baseline diabetes mellitus and a higher 2-year decline in the Trial Making Test B and Stroop test exploring attention and executive function. This effect remained significant after adjusting for age, gender, education, anxiety and depressive symptoms, as well as other cardiovascular risk factors (F=2.41; p=0.007). Instead, no relationship was observed between IFG and cognitive decline.

Conclusions: Our study showed that, in a sample of elderly non-demented community dwellers, diabetes mellitus (but not IFG) is associated with a higher decline in selective attention and executive functioning. These results emphasize the importance of detecting and man- aging diabetes and impaired fasting glucose, in order to prevent cognitive impairment and dementia.
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http://dx.doi.org/10.1007/BF03325269DOI Listing
August 2012

Association between ambulatory 24-hour blood pressure levels and brain volume reduction: a cross-sectional elderly population-based study.

Hypertension 2012 Nov 8;60(5):1324-31. Epub 2012 Oct 8.

Service de Physiologie Clinique et de l’Exercice, CHU Saint-Etienne, Faculté de Médecine Jacque Lisfranc, EA SNA EPIS 4607, UJM, Saint-Etienne, Pres de LYON, France.

Previous literature has shown mixed results regarding the association between blood pressure levels and brain volume reduction. The objectives of this study were to determine whether high blood pressure levels were associated with focal brain volume reduction and whether high blood pressure-related focal brain volume reduction was associated with a decline in executive function performance. On the basis of a cross-sectional design, 24-hour ambulatory blood pressure measurements, as well as brain morphology from 3-dimensional magnetic resonance images, were assessed among 183 participants (mean, 65 ± 0.6 years; 62.4% women). Average levels of systolic and diastolic blood pressures, as well as dip, pulse pressure, and mean arterial blood pressure, were used as outcomes. Cortical gray and white matter volumes were determined by automatic calculation using Statistical Parametric Mapping segmentation. Folstein's Mini-Mental State Examination, digit span, part B of Trail Making, and Stroop tests were used to assess executive function performance. Sex, use of antihypertensive drugs, duration of hypertension, leukoaraiosis, body mass index, education level, and total brain matter volume were used as potential confounders. A significant blood pressure-related decrease in gray matter volume of the left supplementary motor areas (Brodmann area 6) and of the left superior and middle frontal gyrus (Brodmann area 8) was shown. No significant decrease was found with white matter volume. Blood pressure-related decreases in gray matter volume were significantly associated with a decline in executive function performance. The association of high blood pressure with brain volume reduction may in part explain blood pressure-related cognitive decline leading to dementia.
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http://dx.doi.org/10.1161/HYPERTENSIONAHA.112.193409DOI Listing
November 2012

Contribution of brain imaging to the understanding of gait disorders in Alzheimer's disease: a systematic review.

Am J Alzheimers Dis Other Demen 2012 Sep;27(6):371-80

Division of Geriatric Medicine, Department of Medicine, Parkwood Hospital, St. Joseph's Health Care, London, Ontario, Canada.

Although gait disorders are common in Alzheimer's disease (AD), determining which brain structures and related lesions are specifically involved is a goal yet to be reached. Our objective was to systematically review all published data that examined associations between gait disorders and brain imaging in AD. Of 486 selected studies, 4 observational studies met the selection criteria. The number of participants ranged from 2 to 61 community dwellers (29%-100% female) with prodromal or dementia-stage AD. Quantitative gait disorders (ie, slower gait velocity explained by shorter stride length) were associated with white matter lesions, mainly in the medial frontal lobes and basal ganglia. The nigrostriatal dopamine system was unaffected. Qualitative gait disorders (ie, higher stride length variability) correlated with lower hippocampal volume and function. Gait disorders in AD could be explained by a high burden of age-related subcortical hyperintensities on the frontal-subcortical circuits (nonspecific) together with hippocampal atrophy and hypometabolism (specific).
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http://dx.doi.org/10.1177/1533317512454710DOI Listing
September 2012

At 68 years, unrecognised sleep apnoea is associated with elevated ambulatory blood pressure.

Eur Respir J 2012 Sep 20;40(3):649-56. Epub 2012 Apr 20.

Pole NOL et Service de Physiologie Clinique et de l'Exercice, CHU Nord, EA 4607 SNA EPIS, Faculté de Médecine Jaques Lisfranc, USM, PRES Université de Lyon, Saint-Etienne, France.

After the age of 65 yrs the specific impact of unrecognised sleep-related breathing disorders (SRBD) on 24-h blood pressure (BP) levels remains under debate. We tested the cross-sectional relationship between the severity of obstructive sleep apnoea/hypopnoea (OSAH) and the increase of BP using ambulatory BP monitoring (ABPM) in the PROOF (PROgnostic indicator OF cardiovascular and cerebrovascular events study)-SYNAPSE (Autonomic Nervous System Activity, Aging and Sleep Apnea/Hypopnea study) cohort. 470 subjects (aged 68 yrs) neither treated for hypertension nor diagnosed for SRBD were included. All subjects underwent ABPM, and unattended at-home polygraphic studies. OSAH was defined by an apnoea/hypopnoea index (AHI) >15 · h(-1). The severity of the sleep apnoea was also quantified as the index of dips in oxyhaemoglobin saturation >3% (ODI). Results are expressed in per protocol analysis. Severe OSAH (AHI >30 · h(-1), 17% of subjects) was associated with a significant 5 mmHg increase in both diurnal and nocturnal systolic BP (SBP), and with a nocturnal 3 mmHg increase in diastolic BP (DBP). Systolic (mean SBP >135 mmHg) or diastolic (mean DBP >80 mmHg) hypertension were more frequently encountered in subjects suffering from moderate (AHI 15-30) or severe OSAH. After adjustment, the independent association between severe OSAH and 24-h systolic hypertension remained significant (OR 2.42, 95% CI 1.1-5.4). The relationship was further reinforced when SRBD severity was expressed using ODI >10 · h(-1). The impact of unrecognised SRBD on BP levels also exists at the age of 68 yrs. The hypoxaemic load appears to be the pathophysiological cornerstone for such a relationship.
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http://dx.doi.org/10.1183/09031936.00162710DOI Listing
September 2012

Autonomic activation during sleep and new-onset ambulatory hypertension in the elderly.

Int J Cardiol 2012 Feb 9;155(1):155-9. Epub 2011 Nov 9.

Clinical and Exercise Physiology Laboratory, EA 4607 SNA-EPIS, University Hospital and Jean Monnet University, PRES of Lyon, 42023 Saint-Etienne, France.

Background: Sympathetic "overactivity" during night is a well recognized factor of hypertension development in adults. However, the deleterious effect of nocturnal autonomic activation in elderly remains controversial.

Methods: Subjects, all aged 65 years at baseline, were selected from the PROOF cohort study, a prospective observational cohort of subjects. Exclusion criteria were previous myocardial infarction, stroke, heart failure, type-1 diabetes, atrial fibrillation or anti-arrhythmic drug. Normotensive subjects were selected according to: 24-h ambulatory blood pressure (BP) measurements <135/85 mm Hg, absence of self-report antihypertensive treatment. Autonomic activation during sleep was evaluated from night-time ECG Holter recording. According the %VLFI (Very-Low Frequency component of Interbeat Interval Increment evaluated from heart rate variability analysis). Subjects with new-onset ambulatory hypertension were identified after two years when daytime ambulatory blood pressure was higher than 135/85 mm Hg or when they used an antihypertensive treatment.

Results: Among 428 normotensive subjects at inclusion, 62 (14.5%) were considered as hypertensives after two years. Univariate logistic regression model showed a significant association between abnormal %VLFI (>4%) and new-onset hypertension: OR = 1.78 (1.03-3.07). Male gender, increased body mass index and ambulatory systolic BP were also associated with increased risk of hypertension. After adjustment in the stepwise logistic regression, abnormal %VLFI was associated with an 82% increase in odds of new-onset hypertension, independently of systolic ABPM and body mass index.

Conclusion: Repeated autonomic activation during sleep, whatever the origin of the phenomenon, may trigger hypertension development in the elderly.
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http://dx.doi.org/10.1016/j.ijcard.2011.10.097DOI Listing
February 2012

Obstructive sleep apnea and the metabolic syndrome in an elderly healthy population: the SYNAPSE cohort.

Sleep Breath 2012 Sep 18;16(3):895-902. Epub 2011 Sep 18.

Clinical and Exercise Physiology Laboratory, University Hospital and Jean Monnet University, PRES from Lyon, EA 4607, Saint-Etienne, France.

Background: Obstructive sleep apnea syndrome (OSA) has been recently considered as a cause and a component of the metabolic syndrome (MetS), previous studies showing the presence of OSA in about half of middle-aged patients having MetS. To date, no study has considered the association of OSA and MetS in the elderly. In this study we examine the prevalence of MetS and its strength association among healthy elderly OSA subjects.

Methods: A cohort of 806 subjects aged 68.5 years, participants of a 7-year follow-up study, was examined. All subjects underwent clinical evaluation, blood sample measurements, and an at-home polygraphy. OSA was assessed as an apnea/hypopnea index (AHI) >15, and MetS was diagnosed according to the Adult Treatment Panel III.

Results: In the total group, 9.8% of cases met criteria for MetS with a prevalence similar in men and women. Of the entire group with Mets, 51.3% were women and 48.7% men. OSA was diagnosed in 55.9% of the sample, and among the OSA group, 12.5% had MetS. Oxyhemoglobin desaturation index (ODI, p < 0.0001) and AHI (p = 0.003) were found significantly higher in subjects with MetS than in those without it. Most of MetS components were significantly associated with AHI and ODI, the relationship stronger with ODI. After adjustment for covariables such as obesity, gender, and presence of diabetes, ODI was independently associated with three MetS components, glycemia (p < 0.0001), hypertension (p = 0.002), and triglyceride levels (p = 0.02). Sleepiness, autonomic arousal index, and sleep duration had no effect on the metabolic parameters.

Conclusions: In elderly subjects, the association between OSA and MetS was stronger for hyperglycemia and hypertension. Among factors explaining this association, hypoxemia appears to be the most important factor without any effect of indices of sleep fragmentation, sleep duration, and sleepiness.
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http://dx.doi.org/10.1007/s11325-011-0593-yDOI Listing
September 2012