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Impact of nocturnal hypoxia on glycaemic control, appetite, gut microbiota and inflammation in adults with type 2 diabetes mellitus: A single-blind cross-over trial

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Title: Impact of nocturnal hypoxia on glycaemic control, appetite, gut microbiota and inflammation in adults with type 2 diabetes mellitus: A single-blind cross-over trial
Authors: Shepherd, AI, James, TJ, Gould, AAM, Mayes, H, Neal, R, Shute, J, Tipton, MJ, Massey, H, Saynor, ZL, Perissiou, M, Montgomery, H, Sturgess, C, Makaronidis, J, Murray, AJ, Grocott, MPW, Cummings, M, Young-Min, S, Rennell-Smyth, J, McNarry, MA, Mackintosh, KA, Dent, H, Robson, SC, Corbett, J
Publisher Information: Wiley
Publication Year: 2024
Collection: Liverpool John Moores University: LJMU Research Online
Subject Terms: TX341 Nutrition. Foods and food supply, QP Physiology, RC Internal medicine
Description: High altitude residents have a lower incidence of type 2 diabetes mellitus (T2DM). Therefore, we examined the effect of repeated overnight normobaric hypoxic exposure on glycaemic control, appetite, gut microbiota and inflammation in adults with T2DM. Thirteen adults with T2DM [glycated haemoglobin (HbA1c): 61.1 ± 14.1 mmol mol−1; aged 64.2 ± 9.4 years; four female] completed a single-blind, randomised, sham-controlled, cross-over study for 10 nights, sleeping when exposed to hypoxia (fractional inspired O2 [(Formula presented.)] = 0.155; ∼2500 m simulated altitude) or normoxic conditions ((Formula presented.) = 0.209) in a randomised order. Outcome measures included: fasted plasma [glucose]; [hypoxia inducible factor-1α]; [interleukin-6]; [tumour necrosis factor-α]; [interleukin-10]; [heat shock protein 70]; [butyric acid]; peak plasma [glucose] and insulin sensitivity following a 2 h oral glucose tolerance test; body composition; appetite indices ([leptin], [acyl ghrelin], [peptide YY], [glucagon-like peptide-1]); and gut microbiota diversity and abundance [16S rRNA amplicon sequencing]. During intervention periods, accelerometers measured physical activity, sleep duration and efficiency, whereas continuous glucose monitors were used to assess estimated HbA1c and glucose management indicator and time in target range. Overnight hypoxia was not associated with changes in any outcome measure (P > 0.05 with small effect sizes) except fasting insulin sensitivity and gut microbiota alpha diversity, which exhibited trends (P = 0.10; P = 0.08 respectively) for a medium beneficial effect (d = 0.49; d = 0.59 respectively). Ten nights of overnight moderate hypoxic exposure did not significantly affect glycaemic control, gut microbiome, appetite, or inflammation in adults with T2DM. However, the intervention was well tolerated and a medium effect-size for improved insulin sensitivity and reduced alpha diversity warrants further investigation. (Figure presented.). Key points: Living at altitude lowers the incidence of ...
Document Type: article in journal/newspaper
File Description: text
Language: English
ISSN: 0022-3751
Relation: https://researchonline.ljmu.ac.uk/id/eprint/25112/1/Impact%20of%20nocturnal%20hypoxia%20on%20glycaemic%20control%20appetite%20gut%20microbiota%20and%20inflammation%20in%20adults%20with%20type%202%20diabetes%20mellitus.pdf; Shepherd, AI ORCID logoorcid:0000-0001-6392-7944 , James, TJ ORCID logoorcid:0000-0003-1470-9400 , Gould, AAM, Mayes, H, Neal, R ORCID logoorcid:0000-0003-2065-0011 , Shute, J, Tipton, MJ ORCID logoorcid:0000-0002-7928-8451 , Massey, H ORCID logoorcid:0000-0002-7542-513X , Saynor, ZL, Perissiou, M ORCID logoorcid:0000-0002-3974-2250 , Montgomery, H, Sturgess, C, Makaronidis, J, Murray, AJ, Grocott, MPW, Cummings, M, Young-Min, S ORCID logoorcid:0000-0001-8270-6207 , Rennell-Smyth, J, McNarry, MA, Mackintosh, KA, Dent, H, Robson, SC and Corbett, J (2024) Impact of nocturnal hypoxia on glycaemic control, appetite, gut microbiota and inflammation in adults with type 2 diabetes mellitus: A single-blind cross-over trial. Journal of Physiology, 602 (21). pp. 5835-5854. ISSN 0022-3751
DOI: 10.1113/jp285322
Availability: https://researchonline.ljmu.ac.uk/id/eprint/25112/
https://researchonline.ljmu.ac.uk/id/eprint/25112/1/Impact%20of%20nocturnal%20hypoxia%20on%20glycaemic%20control%20appetite%20gut%20microbiota%20and%20inflammation%20in%20adults%20with%20type%202%20diabetes%20mellitus.pdf
https://doi.org/10.1113/jp285322
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  Data: Impact of nocturnal hypoxia on glycaemic control, appetite, gut microbiota and inflammation in adults with type 2 diabetes mellitus: A single-blind cross-over trial
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  Data: High altitude residents have a lower incidence of type 2 diabetes mellitus (T2DM). Therefore, we examined the effect of repeated overnight normobaric hypoxic exposure on glycaemic control, appetite, gut microbiota and inflammation in adults with T2DM. Thirteen adults with T2DM [glycated haemoglobin (HbA1c): 61.1 ± 14.1 mmol mol−1; aged 64.2 ± 9.4 years; four female] completed a single-blind, randomised, sham-controlled, cross-over study for 10 nights, sleeping when exposed to hypoxia (fractional inspired O2 [(Formula presented.)] = 0.155; ∼2500 m simulated altitude) or normoxic conditions ((Formula presented.) = 0.209) in a randomised order. Outcome measures included: fasted plasma [glucose]; [hypoxia inducible factor-1α]; [interleukin-6]; [tumour necrosis factor-α]; [interleukin-10]; [heat shock protein 70]; [butyric acid]; peak plasma [glucose] and insulin sensitivity following a 2 h oral glucose tolerance test; body composition; appetite indices ([leptin], [acyl ghrelin], [peptide YY], [glucagon-like peptide-1]); and gut microbiota diversity and abundance [16S rRNA amplicon sequencing]. During intervention periods, accelerometers measured physical activity, sleep duration and efficiency, whereas continuous glucose monitors were used to assess estimated HbA1c and glucose management indicator and time in target range. Overnight hypoxia was not associated with changes in any outcome measure (P > 0.05 with small effect sizes) except fasting insulin sensitivity and gut microbiota alpha diversity, which exhibited trends (P = 0.10; P = 0.08 respectively) for a medium beneficial effect (d = 0.49; d = 0.59 respectively). Ten nights of overnight moderate hypoxic exposure did not significantly affect glycaemic control, gut microbiome, appetite, or inflammation in adults with T2DM. However, the intervention was well tolerated and a medium effect-size for improved insulin sensitivity and reduced alpha diversity warrants further investigation. (Figure presented.). Key points: Living at altitude lowers the incidence of ...
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  Data: https://researchonline.ljmu.ac.uk/id/eprint/25112/1/Impact%20of%20nocturnal%20hypoxia%20on%20glycaemic%20control%20appetite%20gut%20microbiota%20and%20inflammation%20in%20adults%20with%20type%202%20diabetes%20mellitus.pdf; Shepherd, AI ORCID logoorcid:0000-0001-6392-7944 , James, TJ ORCID logoorcid:0000-0003-1470-9400 , Gould, AAM, Mayes, H, Neal, R ORCID logoorcid:0000-0003-2065-0011 , Shute, J, Tipton, MJ ORCID logoorcid:0000-0002-7928-8451 , Massey, H ORCID logoorcid:0000-0002-7542-513X , Saynor, ZL, Perissiou, M ORCID logoorcid:0000-0002-3974-2250 , Montgomery, H, Sturgess, C, Makaronidis, J, Murray, AJ, Grocott, MPW, Cummings, M, Young-Min, S ORCID logoorcid:0000-0001-8270-6207 , Rennell-Smyth, J, McNarry, MA, Mackintosh, KA, Dent, H, Robson, SC and Corbett, J (2024) Impact of nocturnal hypoxia on glycaemic control, appetite, gut microbiota and inflammation in adults with type 2 diabetes mellitus: A single-blind cross-over trial. Journal of Physiology, 602 (21). pp. 5835-5854. ISSN 0022-3751
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