Translated Titles

Effects of Exercise on Cardiac Dysfunction Induced by the Combination of Obesity and Obstructive Sleep Apnoea: The Role of Myokines




黃森芳(Sen-Fang Huang);陳聰毅(Tsung-I Chen)

Key Words

脂肪激素 ; 發炎反應 ; 纖維化 ; 間歇性低氧 ; adipokine ; inflammation ; cardiac fibrosis ; intermittent hypoxia



Volume or Term/Year and Month of Publication

135期(2015 / 12 / 31)

Page #

67 - 77

Content Language


Chinese Abstract


English Abstract

Obesity and intermittent hypoxia (IH) occurring during obstructive sleep apnoea (OSA) are two independent risk factors for impaired ventricular function; moreover, cardiac dysfunction is exacerbated when the two factors co-occur. Regular exercise provides beneficial effects to attenuate cardiac fibrosis by reducing body fat and preventing adipokine dysregulation. However, it is still unclear whether muscle-derived cytokines (myokines) released during exercise play a role in the prevention of IH-induced cardiac dysfunction. The purpose of this paper was to investigate the influence of myokines on the dysregulation of adipokines and reduction of ventricular dysfunction. The role that myokine plays in the effect of exercise on cardiac function in obese OSA patients was discussed within a literature review. The conclusion of this paper is that in obese individuals, excess adipose mass triggers dysregulation of adipokines, which leads to myocardial inflammation resulting in left ventricular dysfunction. Exercise induces an increase in energy expenditure, and also triggers the release of myokine into circulation by skeletal muscles, accelerating lipid metabolism and inhibiting the release of excess adipokines. This process helps alleviate myocardial inflammation and prevent the impairment of ventricular function. This paper suggests that future studies should investigate the effects of myokine on the lipid metabolism, including how to efficiently reduce fat deposition and alleviate inflammation. In effect, muscle-derived cytokines can be considered an anti-inflammatory medication. This provides support for advocating that regular exercise provides cardioprotective effects against the impairment of cardiac function in obese OSA patients.

Topic Category 社會科學 > 體育學
  1. 陳聰毅(2011)。罹患阻塞型睡眠呼吸中止症對運動能力的影響。中華體育季刊,25(1),1-9。
  2. 陳聰毅、謝茜茹(2011)。運動對阻塞性睡眠呼吸中止症患者心肌氧化傷害的影響。大專體育,112,62-68。
  3. Al-Daghri, N. M.,Alokail, M. S.,Rahman, S.,Amer, O. E.,Al-Attas, O. S.,Alfawaz, H.,Piya, M. K.(2015).Habitual physical activity is associated with circulating irisin in healthy controls but not in subjects with diabetes mellitus type 2.European Journal of Clinical Investigation,45(8),775-781.
  4. Aldrich, M. S.(1989).Automobile accidents in patients with sleep disorders.Sleep,12(6),487-494.
  5. Anastasilakis, A. D.,Polyzos, S. A.,Saridakis, Z. G.,Kynigopoulos, G.,Skouvaklidou, E. C.,Molyvas, D.,Mantzoros, C. S.(2014).Circulating irisin in healthy, young individuals: Day-night rhythm, effects of food intake and exercise, and associations with gender, physical activity, diet, and body composition.Journal of Clinical Endocrinology and Metabolism,99(9),3247-3255.
  6. Aoi, W.,Naito, Y.,Takagi, T.,Tanimura, Y.,Takanami, Y.,Kawai, Y.,Yoshikawa, T.(2013).A novel myokine, secreted protein acidic and rich in cysteine (SPARC), suppresses colon tumorigenesis via regular exercise.Gut,62(6),882-889.
  7. Awad, K. M.,Malhotra, A.,Barnet, J. H.,Quan, S. F.,Peppard, P. E.(2012).Exercise is associated with a reduced incidence of sleep-disordered breathing.American Journal of Medicine,125(5),485-490.
  8. Badran, M.,Golbidi, S.,Devlin, A.,Ayas, N.,Laher, I.(2014).Chronic intermittent hypoxia causes endothelial dysfunction in a mouse model of dietinduced obesity.Sleep Medicine,15(5),596-602.
  9. Baguet, J. P.,Barone-Rochette, G.,Tamisier, R.,Levy, P.,Pépin, J. L.(2012).Mechanisms of cardiac dysfunction in obstructive sleep apnea.Nature Reviews Cardiology,9(12),679-688.
  10. Beitler, J. R.,Awad, K. M.,Bakker, J. P.,Edwards, B. A.,DeYoung, P.,Djonlagic, I.,Malhotra, A.(2014).Obstructive sleep apnea is associated with impaired exercise capacity: A cross-sectional study.Journal of Clinical Sleep Medicine,10(11),1199-1204.
  11. Cavalera, M.,Wang, J.,Frangogiannis, N. G.(2014).Obesity, metabolic dysfunction, and cardiac fibrosis: Pathophysiological pathways, molecular mechanisms, and therapeutic opportunities.Translational Research,164(4),323-335.
  12. Chen, L.,Einbinder, E.,Zhang, Q.,Hasday, J.,Balke, C. W.,Scharf, S. M.(2005).Oxidative stress and left ventricular function with chronic intermittent hypoxia in rats.American Journal of Respiratory and Critical Care Medicine,172(7),915-920.
  13. Eschalier, R.,Rossignol, P.,Kearney-Schwartz, A.,Adamopoulos, C.,Karatzidou, K.,Fay, R.,Zannad, F.(2014).Features of cardiac remodeling, associated with blood pressure and fibrosis biomarkers, are frequent in subjects with abdominal obesity.Hypertension,63(4),740-746.
  14. Essick, E. E.,Ouchi, N.,Wilson, R. M.,Ohashi, K.,Ghobrial, J.,Shibata, R.,Sam, F.(2011).Adiponectin mediates cardioprotection in oxidative stress-induced cardiac myocyte remodeling.American Journal of Physiology: Heart and Circulatory Physiology,301(3),H984-H993.
  15. Evans, C. A.,Selvadurai, H.,Baur, L. A.,Waters, K. A.(2014).Effects of obstructive sleep apnea and obesity on exercise function in children.Sleep,37(6),1103-1110.
  16. Fujita, K.,Maeda, N.,Sonoda, M.,Ohashi, K.,Hibuse, T.,Nishizawa, H.,Funahashi, T.(2008).Adiponectin protects against angiotensin II -Induced cardiac fibrosis through activation of PPARalpha.Arteriosclerosis, Thrombosis, and Vascular Biology,28(5),863-870.
  17. Golbidi, S.,Laher, I.(2014).Exercise induced adipokine changes and the metabolic syndrome.Journal of Diabetes Research,2014
  18. Kaleth, A. S.,Chittenden, T. W.,Hawkins, B. J.,Hargens, T. A.,Guill, S. G.,Zedalis, D.,Herbert, W. G.(2007).Unique cardiopulmonary exercise test responses in overweight middle-aged adults with obstructive sleep apnea.Sleep Medicine,8(2),160-168.
  19. Kerstholt, N.,Ewert, R.,Nauck, M.,Spielhagen, T.,Bollmann, T.,Stubbe, B.,Friedrich, N.(2015).Association of circulating irisin and cardiopulmonary exercise capacity in healthy volunteers: Results of the study of health in Pomerania.BMC Pulmonary Medicine,15,41.
  20. Koyama, R. G.,Esteves, A. M.,Oliveira e Silva, L.,Lira, F. S.,Bittencourt, L. R.,Tufik, S.,de Mello, M. T.(2012).Prevalence of and risk factors for obstructive sleep apnea syndrome in Brazilian railroad workers.Sleep Medicine,13(8),1028-1032.
  21. Lavie, L.,Kraiczi, H.,Hefetz, A.,Ghandour, H.,Perelman, A.,Hedner, J.,Lavie, P.(2002).Plasma vascular endothelial growth factor in sleep apnea syndrome: Effects of nasal continuous positive air pressure treatment.American Journal of Respiratory and Critical Care Medicine,165(12),1624-1628.
  22. Mahajan, R. D.,Patra, S. K.(2013).Irisin, a novel myokine responsible for exercise induced browning of white adipose tissue.Indian Journal of Clinical Biochemistry,28(1),102-103.
  23. Mahajan, R.,Lau, D. H.,Sanders, P.(2015).Impact of obesity on cardiac metabolism, fibrosis, and function.Trends in Cardiovascular Medicine,25(2),119-126.
  24. Olea, E.,Agapito, M. T.,Gallego-Martin, T.,Rocher, A.,Gomez-Niño, A.,Obeso, A.,Yubero, S.(2014).Intermittent hypoxia and diet-induced obesity: Effects on oxidative status, sympathetic tone, plasma glucose and insulin levels, and arterial pressure.Journal of Applied Physiology,117(7),706-719.
  25. Ozeke, O.,Ozer, C.,Gungor, M.,Celenk, M. K.,Dincer, H.,Ilicin, G.(2011).Chronic intermittent hypoxia caused by obstructive sleep apnea may play an important role in explaining the morbidity-mortality paradox of obesity.Medical Hypotheses,76(1),61-63.
  26. Park, A. M.,Nagase, H.,Vinod Kumar, S.,Suzuki, Y. J.(2007).Acute intermittent hypoxia activates myocardial cell survival signaling.American Journal of Physiology: Heart and Circulatory Physiology,292(2),H751-H757.
  27. Pedersen, B. K.,Fischer, C. P.(2007).Beneficial health effects of exercise - The role of IL-6 as a myokine.Trends in Pharmacological Sciences,28(4),152-156.
  28. Quan, S. F.,O'Connor, G. T.,Quan, J. S.,Redline, S.,Resnick, H. E.,Shahar, E.,Sherrill, D. L.(2007).Association of physical activity with sleepdisordered breathing.Sleep and Breathing,11(3),149-157.
  29. Raschke, S.,Eckel, J.(2013).Adipo-myokines: Two sides of the same coin - Mediators of inflammation and mediators of exercise.Mediators of Inflammation,2013
  30. Redinger, R. N.(2007).The pathophysiology of obesity and its clinical manifestations.Jorunal of Gastroenterology and Hepatology,3(11),856-863.
  31. Sakuma, K.,Yamaguchi, A.(2012).Novel intriguing strategies attenuating to sarcopenia.Journal of Aging Research,2012
  32. Schütz, T. C.,Cunha, T. C.,Moura-Guimaraes, T.,Luz, G. P.,Ackel-D'Elia, C.,Alves Eda, S.,Bittencourt, L.(2013).Comparison of the effects of continuous positive airway pressure, oral appliance and exercise training in obstructive sleep apnea syndrome.Clinics,68(8),1168-1174.
  33. Seldin, M. M.,Peterson, J. M.,Byerly, M. S.,Wei, Z.,Wong, G. W.(2012).Myonectin (CTRP15), a novel myokine that links skeletal muscle to systemic lipid homeostasis.Journal of Biological Chemistry,287(15),11968-11980.
  34. Stengel, A.,Hofmann, T.,Goebel-Stengel, M.,Elbelt, U.,Kobelt, P.,Klapp, B. F.(2013).Circulating levels of irisin in patients with anorexia nervosa and different stages of obesity - Correlation with body mass index.Peptides,39,125-130.
  35. Sun, Y.,Yi, W.,Yuan, Y.,Lau, W. B.,Yi, D.,Wang, X.,Ma, X. L.(2013).C1q/tumor necrosis factor-related protein-9, a novel adipocyte-derived cytokine, attenuates adverse remodeling in the ischemic mouse heart via protein kinase A activation.Circulation,128(Suppl 1),S113-S120.
  36. Urdampilleta, A.,Gonzalez-Muniesa, P.,Portillo, M. P.,Martinez, J. A.(2012).Usefulness of combining intermittent hypoxia and physical exercise in the treatment of obesity.Journal of Physiology and Biochemistry,68(2),289-304.
  37. Vanuxem, D.,Badier, M.,Guillot, C.,Delpierre, S.,Jahjah, F.,Vanuxem, P.(1997).Impairment of muscle energy metabolism in patients with sleep apnoea syndrome.Respiratory Medicine,91(9),551-557.
  38. Wåhlin Larsson, B.,Kadi, F.,Ulfberg, J.,Piehl Aulin, K.(2008).Skeletal muscle morphology and aerobic capacity in patients with obstructive sleep apnoea syndrome.Respiration,76(1),21-27.
  39. Walter, T.(2014).Worldwide survey of fitness trends for 2015: What's driving the market?.ACSM'S Health and Fitness Journal,18(6),8-17.
  40. Yin, X.,Zheng, Y.,Liu, Q.,Cai, J.,Cai, L.(2012).Cardiac response to chronic intermittent hypoxia with a transition from adaptation to maladaptation: The role of hydrogen peroxide.Oxidative Medicine and Cellular Longevity,2012
  41. Yin, X.,Zhou, S.,Zheng, Y.,Tan, Y.,Kong, M.,Wang, B.,Cai, L.(2014).Metallothionein as a compensatory component prevents intermittent hypoxia-induced cardiomyopathy in mice.Toxicology and Applied Pharmacology,277(1),58-66.
  42. Zhang, Y.,Liu, J.,Yao, J.,Ji, G.,Qian, L.,Wang, J.,Liu, Y.(2014).Obesity: Pathophysiology and intervention.Nutrients,6(11),5153-5183.
Times Cited
  1. 陳聰毅、王冠捷(2017)。運動誘發鳶尾素對肥胖合併間歇性低氧引起心肌纖維化的影響。大專體育學刊,19(3),272-287。