Page 45 - JCBP-2-1

Journal of Clinical and
Basic Psychosomatics Depressive disorder obstructive sleep apnea hypothalamic inflammation

1. Introduction young, obese male patients and investigate the associations
between hypothalamic inflammation and OSA severity.
Obesity is a major public health concern in China. The
latest statistics (2015–2019) show that more than half of 2. Materials and methods
[1]
adult Chinese residents are obese or overweight . Over
the past 30 years, the prevalence of obesity in China has 2.1. Participant recruitment procedures
increased 2.5 times. This increase corresponds to a rise The participants in this study comprised 62 obese male
[2]
in the prevalence of obstructive sleep apnea (OSA) . patients who underwent elective bariatric surgery at the
Among the group aged 30 – 69 years, the prevalence of Department of Gastrointestinal Surgery, Changzhou
[3]
OSA in China exceeds 240 million . Overweight, Second People’s Hospital, affiliated with Nanjing Medical
especially obesity, is the most significant risk factor for University, between January 2020 and December 2021.
OSA. A 10% of increase in body weight is associated with
a 30% of increase in the apnea-hypopnea index (AHI) . The inclusion criteria were as follows: (i) male
[4]
From a clinical perspective, obesity is strongly associated individuals aged ≥18 and ≤45 years; (ii) body mass index
2
with the incidence and severity of OSA . Bariatric (BMI) ≥28 kg/m ; (iii) completion of at least four years
[5]
surgery alleviates OSA severity, confirming a causal link of schooling; and (iv) no history of serious neurological
between the two . Conversely, OSA has many obesity- diseases.
[6]
promoting effects, such as a reduction in physical activity, The exclusion criteria were as follows: (i) patients
energy metabolism, and motivation. Moreover, there is with excessive obesity preventing completion of cranial
a bidirectional association between obesity and OSA . MRI; (ii) unclear cranial MRI images or severe artifacts;
[7]
On the one hand, insomnia can affect energy intake and (iii) severe vision or hearing impairment; (iv) absence of
expenditure. On the other hand, obesity is a well-known a signed informed consent form; and (v) no history of
risk factor for OSA.
antidepressant therapy.
OSA and depression share similar clinical features, such
The diagnostic criteria for DSM-5 depressive
as poor concentration and fatigue . Obesity exacerbates disorder were determined by a psychiatrist . Based
[8]
[18]
the impact of OSA on depressive disorders, serving as
a mediator for the symptom association between OSA on the diagnosis, patients were divided into two groups:
and depressive disorders . The prevalence of depressive A depressive disorder group (n = 18) and a non-depressive
[9]
disorders is high among obese young adults . However, disorder group (n = 44).
[10]
there is limited research on the clinical characteristics of The diagnostic criteria were jointly determined by a
OSA in obese young patients with depressive disorders . neurologist and a psychiatrist. A deputy chief physician in
[11]
Animal studies have demonstrated that insomnia and the imaging department was responsible for reviewing the
inflammation contribute to increased severity of depressive films and excluding unqualified cases.
disorders, which is consistent with clinical observations .
[12]
In addition, inflammatory mechanisms play an important 2.2. Clinical characteristics
role in both OSA and depressive disorders . Specifically, Data on participant demographics, including age,
[13]
the left hypothalamic inflammation is significantly education, height, and weight, were collected the day
associated with the severity of depressive disorders in obese before surgery. BMI was calculated for each participant
young patients . The relationships between hypothalamic by dividing their weight (in kilograms) by the square
[10]
inflammation and OSA are unclear in this population. of the height (in meters). Biochemical indicators, such
It is well-known that the incidence of OSA in women as blood glucose, blood lipids, and renal function, were
before menopause is significantly lower than that in determined using the ADVIA XPT system. All subjects
men . This difference is associated with lower levels of fasted for a minimum of 8 h before the collection of blood
[14]
inflammation in premenopausal women . However, samples.
[15]
the incidence of OSA in postmenopausal women is
similar to that in men . Age did not affect the level of 2.3. Sleep monitoring
[16]
inflammation in male OSA patients. In addition, the levels Before going to sleep, all patients wore a portable monitor
of inflammatory markers are higher in men with significant (Alice NightOne, Philips, Netherlands). The analysis was
daytime sleepiness than in women . In this study, we conducted by healthcare professionals using Sleepware G3
[17]
exclusively focused on young, obese male patients. software. The monitoring included the assessment of nasal
The primary aim of this study is to explore the airflow (via airflow sensing), respiratory movement (with
correlation between depressive disorders and OSA in one guide), and fingertip oxygen saturation .
[19]

Volume 2 Issue 1 (2024) 2 https://doi.org/10.36922/jcbp.1040