Autonomic Markers of Impaired Glucose Metabolism: Effects of Sleep-Disordered Breathing

Wang, Wenli; Redline, Susan; Khoo, Michael C. K.

doi:10.1177/193229681200600521

Cited by 10 publications

(3 citation statements)

References 50 publications

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“…This is consistent with a previous study that subjects with impaired glucose metabolism, regardless of the presence of OSAS, had suppressed heart rate baroreflex [12]. This suggests that insulin resistance has stronger negative impact on the cardiac autonomic function thanOSAS.…”

Section: Discussionsupporting

confidence: 93%

Markers of altered cardiovascular autonomic function in overweight children

Chalacheva

Khoo

2015

2015 8th Biomedical Engineering International Conference (BMEiCON)

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Autonomic dysfunction is known to be associated with sleep apnea and insulin resistance. With the growing prevalence of obesity, the common factor among subjects with sleep apnea and insulin resistance, we sought to determine how autonomic cardiovascular function is affected by the independent and combined effects of sleep apnea and insulin resistance at the early stage of these syndromes. In this study, we investigated the autonomic function of overweight-to-obese children with either sleep apnea or insulin resistance or both during supine and standing postures. Using computational models of heart rate and peripheral vascular resistance variability, we found that children with sleep apnea, regardless of the presence of insulin resistance, had higher peripheral vascular baroreflex gain. Furthermore, children with insulin resistance, regardless of the presence of sleep apnea, had decreased heart rate baroreflex gain from supine to standing, which was opposite to those without insulin resistance. In conclusion, we were able to detect altered autonomic function by sleep apnea and insulin resistance using markers derived from our computational models that based only on non-invasive measurements.

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Section: Discussionsupporting

confidence: 93%

Markers of altered cardiovascular autonomic function in overweight children

Chalacheva

Khoo

2015

2015 8th Biomedical Engineering International Conference (BMEiCON)

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“…We identified 29 additional studies from the hand-search of reference lists of these studies, and added six more articles received by an expert (DG). Therefore, we retrieved 143 articles to conduct a full-text review, and subsequently excluded 26 studies (15–40) (Appendix 2). Thus, a total of 117 articles were selected.…”

Section: Resultsmentioning

confidence: 99%

Biomarkers associated with obstructive sleep apnea: A scoping review

Canto

Pachêco‐Pereira

Aydınöz

et al. 2015

Sleep Medicine Reviews

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Summary The overall validity of biomarkers in the diagnosis of obstructive sleep apnea (OSA) remains unclear. We conducted a scoping review to provide assessments of biomarkers characteristics in the context of obstructive sleep apnea (OSA) and to identify gaps in the literature. A scoping review of studies in humans without age restriction that evaluated the potential diagnostic value of biological markers (blood, exhaled breath condensate, salivary, and urinary) in the OSA diagnosis was undertaken. Retained articles were those focused on the identification of biomarkers in subjects with OSA, the latter being confirmed with a full overnight or home-based polysomnography (PSG). Search strategies for six different databases were developed. The methodology of selected studies was classified using an adaptation of the evidence quality criteria from the American Academy of Pediatrics. Additionally the biomarkers were classified according to their potential clinical application. We identified 572 relevant studies, of which 117 met the inclusion criteria. Eighty-two studies were conducted in adults, 34 studies involved children, and one study had a sample composed of both adults and children. Most of the studies evaluated blood biomarkers. Potential diagnostic biomarkers were found in 9 pediatric studies and in 58 adults studies. Only 9 studies that reported sensitivity and specificity, which varied substantially from 43% to 100%, and from 45% to 100%, respectively. Thus, studies in adults have focused on the investigation of IL-6, TNF-α and hsCRP. There was not a specific biomarker that was tested by a majority of authors in pediatric studies, and combinatorial urine biomarker approaches have shown preliminary promising results. In adults IL-6 and IL-10 seem to have a favorable potential to become a good biomarker to identify OSA.

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“…Using data derived from polysomnograms in a large-scale study of sleep apnea, we have found that BRS PTT is correlated with measures of impaired glucose tolerance, in subjects with or without SDB. 70 This association suggests that these low-cost, noninvasively derived autonomic indices may be useful in practice as biomarkers of abnormal glucose metabolism or autonomic dysfunction.…”

Section: Surrogate Of Continuous Blood Pressurementioning

confidence: 99%

Model-Derived Markers of Autonomic Cardiovascular Dysfunction in Sleep-Disordered Breathing

Khoo

Chalacheva

2016

Sleep Medicine Clinics

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A large body of evidence indicates that sleep-disordered breathing leads to abnormally elevated sympathetic tone and impaired vagal activity, and that these factors in turn promote hypertension and cardiometabolic disease. Thus, low-cost but accurate monitoring of autonomic function is useful for the aggressive management of patients with sleep apnea. However, the mechanistic information that can be derived from conventional noninvasive techniques, such as heart rate variability, is limited by the univariate nature of the underlying analyses. This article reviews the development and application of multivariate dynamic biophysical models that enable the causal dependencies among respiration, blood pressure, heart rate variability and peripheral vascular resistance to be quantified. The markers derived from these “minimal models” can be used in conjunction with heart rate variability to increase the sensitivity with which abnormalities in autonomic cardiovascular control are detected in subjects with sleep-disordered breathing.

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Autonomic Markers of Impaired Glucose Metabolism: Effects of Sleep-Disordered Breathing

Cited by 10 publications

References 50 publications

Markers of altered cardiovascular autonomic function in overweight children

Markers of altered cardiovascular autonomic function in overweight children

Biomarkers associated with obstructive sleep apnea: A scoping review

Model-Derived Markers of Autonomic Cardiovascular Dysfunction in Sleep-Disordered Breathing

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