Effects Of Hypoxic Exposure Sleep Combining Exercise And Diet On Appetite-regulating Hormones In Adolescents With Obesity

Objective: The purpose of the study is to assess the difference between 4 week hypoxic exposure sleep combined with exercise and diet and only exercise and diet intervention in weight loss and appetite-regulating hormones in obese adolescents. Analyze the hypoxic exposure sleep to appetite-regulating hormones of obese adolescents, provide scientific proof to the effect of hypoxic exposure sleep combined with exercise and diet in losing and controlling weight.Method: 35 overweight and obese adolescents(11-15 years old) volunteered to participate in the weight-loss program. They were assigned to two groups according to their will, the control group(n=19) and the experiment group(n=16). Both groups underwent exercise training and diet intervention. The personalized exercise training program was prescribed according to individual fitness levels. The diet modification was designed by a registered dietitian, and the personalized diet plan was formulated based on individual basal metabolic rate to ensure calories and essential nutrient supply while minimizing energy surplus. Sleep condition differentiated between two groups: the control group slept in normal condition and the experiment group spent in a hypoxic room equipped with experiment systems(10 hours per day) for 4 weeks. The hypoxic condition simulated an altitude of 2,700 meters. Before and after the 4-week intervention, adiposity levels and metabolic health-related blood biomarkers(blood glucose and blood lipids profile) were analyzed, and appetite-regulating hormones including ghrelin, PYY, CCK, MCP–1 and GLP-1 were assessed.Results: 1) After intervention, both the control and the experiment groups experienced significant weight loss(indicated by a decrease in body weight, BMI, body fat, waist circumstances/ hip circumstances, Systolic Blood Pressure/ Diastolic Blood Pressure, rest heart rate)(p<0.01). However, the SBP significantly decreases after intervention in control group(p<0.01), but it’s no significant change in experiment group(p>0.05). The decrease of weight and BMI was significantly greater in the experiment group compared with the control group(p<0.05). The decrease of weight and BMI in male subjects of experiment group is significantly greater than that of control group(p<0.05), but it’s no significant difference in female subjects. 2) Accompanying the weight loss, the concentration of plasma Insulin decreased in the control group(p<0.01), but it’s no significant change in experiment group(p>0.05), and the decrease is significant between groups. The concentration of leptin decreased in both groups, and the decrease in control group is significantly greater than experiment group(p<0.05). The concentration of ghrelin in experiment group is significantly increased after intervention(p<0.05), but there is no significant change in control group(p>0.05).The concentration of CCK is significantly decreased in control group(p=0.05), while there is no significant change in experiment group(p>0.05), and the change of CCK is significant between groups(p<0.05). The concentration of MCP-1 decreased in control group and increased in experiment group. 3) For male subjects: the experimental group showed a trend of increase in insulin and PYY, and a trend of decrease in control group, and the change of insulin and PYY after intervention is significantly different between groups(p<0.05); the concentration of CCK decreases in both groups, but the decrease is significantly smaller in experiment group(p<0.05). For female subjects: it’s no significant difference in appetite-regulating hormones after intervention between groups(p>0.05).Conclusions: 1) The two interventions can both significantly decrease the weight, BMI and body fat of obese adolescents, but the intervention of hypoxic exposure sleep combined with exercise and diet is much more helpful in decreasing weight and BMI. 2) Accompanying the weight loss, satiety-signaling hormones decreased, indicates a possible mechanism for the increase in appetite after traditional weight loss program; However, satiety-signaling hormones increased, indicates a possible mechanism for the appetite suppression after the combination of hypoxic exposure sleep and traditional weigh loss program. 3) Hypoxic exposure sleep combines with exercise and diet have different effects on male/female obese adolescent’s appetite-regulating hormones. The weight, BMI, and appetite-regulating hormones(Insulin, PYY, CCK) of male subjects is more easily affected by hypoxic exposure sleep.