4. Materials and Methods
hyperoxia, hyperoxic, hypoxia, fibrosis, liver fibrosis stage, steatosis
HYPOXIA, FIBROSIS, HYPOXIC, SECONDARY, STEATOSIS
This prospective, single-center, randomized controlled trial enrolled 65 patients (32 women) with MS. Subjects’ ages ranged from 29 to 74 years. Patients were randomly allocated into groups: the IHHE group and the control group (sham). Patients in the IHHE group received intermittent hypoxic–hyperoxic treatment for 3 weeks, 5 days a week. The control group was simulated with the same protocol, but instead of intermittent hypoxia–hyperoxia, room air (normoxia, 20.9% OThe main endpoints were the evaluation of changes in plasma TMAO levels, the determination and evaluation of changes in TMAO stool samples, and the correlation detection of plasma and stool TMAO levels with other MS parameters. All endpoints were evaluated after three weeks of IHHE training.We selected a number of parameters as secondary endpoints and compared baseline values with those after 3 weeks of exposure: hemodynamic parameters (systolic (SBP) and diastolic (DBP) blood pressure, heart rate (HR)), liver tissue elasticity and fibrosis stage according to liver elastography, lipid spectrum (total cholesterol—TCh, high- and low-density lipoproteins—HDL and LDL, triglycerides), and inflammatory markers (high sensitive C-reactive protein—CRP-hs, N-terminal prohormone brain natriuretic peptide—Ntpro-BNP).The lipid profile and AST/ALT were measured using a Siemens Advia 1800 Biochemical Analyzer (“Siemens Healthcare Diagnostics Inc.”, Newark, DE, USA) and dedicated test kits “Siemens Healthcare Diagnostics Inc.”, USA. High-sensitivity C-reactive protein (CRP-hs, milligram per liter, “Beckman Coulter,” Brea, CA, USA) was measured using Siemens Advia 1800 Biochemical Analyzer (“Siemens Healthcare Diagnostics Inc.”, Newark, DE, USA) by immunoturbidimetry using latex particles. The levels of brain natriuretic peptide N-terminal prohormone (NTproBNP, “Biomedica,” Wien, Austria) were measured using an enzyme-linked immunosorbent assay and a Biochrom Anthos 2020 Jencons Microplate Reader photometer ("Biohrom Ltd.", Cambridge, UK). Weight and height were measured with a Seca gmbh&co.kg scale (Hammer Steindamm 3-25 22089 Hamburg, Germany). The assessment of the functional liver status and liver fibrosis stage and steatosis severity was performed by a noninvasive Vibration-Controlled Transient Elastography (VCTETM) ultrasound method. The measurements were done using the FibroScan 502 Touch (Echosense, Paris, France) device [