Background: Patients with metabolic syndrome (MS) tend to suffer from comorbidities, and are often simultaneously affected by obesity, dysglycemia, hypertension, and dyslipidemia. This syndrome can be reversed if it is timely diagnosed and treated with a combination of risk factors-reducing lifestyle changes and a tailored pharmacological plan. Interval hypoxic-hyperoxic training (IHHT) has been shown as an effective program in reducing cardiovascular risk factors in patients with MS even in the absence of exercise. However, the influence of IHHT on the lipid profile and inflammation in this clinical population remains relatively unknown. Methods: A prospective, single-center, randomized controlled trial was conducted on 65 (33 men) patients with MS aged 29-74 years, who were randomly allocated to the IHHT or control (sham) experimental groups. The IHHT group completed a 3-week, 5 days/week intermittent exposure to hypoxia and hyperoxia. The control (sham) group followed the same protocol but was breathing room air instead. The primary endpoints were the lipid profile (concentrations of total cholesterol [TC], low-density lipoprotein [LDL], high-density lipoprotein [HDL], and triglycerides [TG]) and the inflammatory factors such as high-sensitivity C-reactive protein (hs-CRP), galectin-3, heat shock proteins (Hsp70). The secondary endpoints were alanine aminotransferase (ALT), aspartate aminotransferase (AST), N-terminal pro-hormone of brain natriuretic peptide level (NTproBNP), transforming growth factor beta-1 (TGF-beta1), heart-type fatty acid-binding protein (H-FABP), and nitric oxide synthase 2 (NOS2). Results: There were no differences between the two groups but the different baseline values have affected these results. The IHHT group demonstrated pre-post decrease in total cholesterol (p = 0.001), LDL (p = 0.001), and TG levels (p = 0.001). We have also found a decrease in the CRP-hs (p = 0.015) and Hsp70 (p = 0.006) in IHHT-group after intervention, and a significant decrease in pre-post (delta) differences of NTproBNP (p < 0.0001) in the IHHT group compared to the control group. In addition, the patients of the IHHT group showed a statistically significant decrease in pre-post differences of ALT and AST levels in comparison with the control group (p = 0.001). No significant IHHT complications or serious adverse events were observed. Conclusions: The IHHT appears to improve lipid profile and anti-inflammatory status. It is a safe, well-tolerated procedure, and could be recommended as an auxiliary treatment in patients suffering from MS, however, the experiment results were limited by the baseline group differences. Clinical Trial Registration:ClinicalTrials.gov, identifier [NCT04791397]. Evaluation of the effect of IHHT on vascular stiffness and elasticity of the liver tissue in patients with MS.

中文翻译：

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间歇性低氧-高氧暴露对代谢综合征患者血脂和炎症的影响。

背景：代谢综合征 (MS) 患者往往患有合并症，并且经常同时受到肥胖、血糖异常、高血压和血脂异常的影响。如果及时诊断并结合减少风险因素的生活方式改变和量身定制的药理学计划，这种综合征可以逆转。间歇性缺氧-高氧训练 (IHHT) 已被证明是一种有效的计划，即使在没有运动的情况下，也能降低 MS 患者的心血管危险因素。然而，IHHT 对这一临床人群的血脂和炎症的影响仍然相对未知。方法：一项前瞻性、单中心、随机对照试验对 65 名（33 名男性）29-74 岁的 MS 患者进行，他们被随机分配到 IHHT 或对照（假）实验组。IHHT 组完成了 3 周、5 天/周的间歇性缺氧和高氧暴露。对照组（假）遵循相同的方案，但改为呼吸室内空气。主要终点是血脂（总胆固醇 [TC]、低密度脂蛋白 [LDL]、高密度脂蛋白 [HDL] 和甘油三酯 [TG] 的浓度）和炎症因子，如高敏 C 反应性蛋白 (hs-CRP)、半乳糖凝集素-3、热休克蛋白 (Hsp70)。次要终点是丙氨酸氨基转移酶 (ALT)、天冬氨酸氨基转移酶 (AST)、脑钠肽 N 端激素原水平 (NTproBNP)、转化生长因子β-1 (TGF-β1)、心脏型脂肪酸结合蛋白 (H-FABP) 和一氧化氮合酶 2 (NOS2)。结果：两组之间没有差异，但不同的基线值影响了这些结果。IHHT 组表现出总胆固醇 (p = 0.001)、低密度脂蛋白 (p = 0.001) 和 TG 水平 (p = 0.001) 的前后降低。我们还发现干预后 IHHT 组的 CRP-hs (p = 0.015) 和 Hsp70 (p = 0.006) 降低，NTproBNP (p < 0.0001) 的前后 (​​delta) 差异显着降低IHHT 组与对照组相比。此外，与对照组相比，IHHT 组患者的 ALT 和 AST 水平前后差异有统计学意义的降低（p = 0.001）。没有观察到显着的 IHHT 并发症或严重的不良事件。结论：IHHT 似乎可以改善血脂状况和抗炎状态。这是一个保险箱，耐受性良好的手术，可推荐作为 MS 患者的辅助治疗，但实验结果受基线组差异的限制。临床试验注册：ClinicalTrials.gov，标识符 [NCT04791397]。评估 IHHT 对 MS 患者肝组织血管硬度和弹性的影响。