Interactions Between Pregnancy, Obstructive Sleep Apnea, and Gestational Diabetes Mellitus

Reutrakul, Sirimon; Zaidi, Nausheen; Wroblewski, Kristen; Kay, Helen H.; Ismail, Mahmoud; Ehrmann, David A.; Cauter, Eve Van

doi:10.1210/jc.2013-2348

Cited by 78 publications

(72 citation statements)

References 33 publications

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“…Snoring in pregnant women leads to recurrent arousals from sleep to reestablish upper airway patency and has been associated with glucose intolerance and gestational diabetes risk (42). However, it is still not clear how sleep perturbations during pregnancy may affect the developmental trajectories in the offspring and its epigenome.…”

Section: Discussionmentioning

confidence: 99%

“…Among the disorders that impose additional disruption of sleep integrity during pregnancy, sleep-disordered breathing is particularly prevalent and has emerged as a contributor to gestational diabetes mellitus, preeclampsia, as well as adverse perinatal outcomes (28,42). However, the impact of poor sleep quality and continuity during pregnancy could transcend the gestational period and adversely affect children, even late in life (7).…”

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confidence: 99%

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Early-life physical activity reverses metabolic and Foxo1 epigenetic misregulation induced by gestational sleep disturbance

Mutskov

Wang

Carreras

et al. 2015

American Journal of Physiology-Regulatory, Integrative and Comp

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life physical activity reverses metabolic and Foxo1 epigenetic misregulation induced by gestational sleep disturbance. Am J Physiol Regul Integr Comp Physiol 308: R419 -R430, 2015. First published January 7, 2015 doi:10.1152/ajpregu.00426.2014.-Sleep disorders are highly prevalent during late pregnancy and can impose adverse effects, such as preeclampsia and diabetes. However, the consequences of sleep fragmentation (SF) on offspring metabolism and epigenomic signatures are unclear. We report that physical activity during early life, but not later, reversed the increased body weight, altered glucose and lipid homeostasis, and increased visceral adipose tissue in offspring of mice subjected to gestational SF (SFo). The reversibility of this phenotype may reflect epigenetic mechanisms induced by SF during gestation. Accordingly, we found that the metabolic master switch Foxo1 was epigenetically misregulated in SFo livers in a temporally regulated fashion. Temporal Foxo1 analysis and its gluconeogenetic targets revealed that the epigenetic abnormalities of Foxo1 precede the metabolic syndrome phenotype. Importantly, regular physical activity early, but not later in life, reversed Foxo1 epigenetic misregulation and altered the metabolic phenotype in gestationally SF-exposed offspring. Thus, we have identified a restricted postnatal period during which lifestyle interventions may reverse the Foxo1 epigenetically mediated risk for metabolic dysfunction later in the life, as induced by gestational sleep disorders. epigenetics; Foxo1 gene; offspring metabolism effect; pregnancy sleep disruption; reverse epigenetic effects; physical activity THE TERM "EPIGENETICS" REFERS to DNA and histone modifications and noncoding RNA, which result in heritable changes in gene expression among the next generation without a change in the DNA sequence (5,17,29). The environment, such as diet and early life experiences, can influence the epigenome. Epigenetic abnormalities have been found to be causative factors in cancer, as well as contributing factors in autoimmune diseases, metabolic pathways, and aging. Disruption of the balance of epigenetic networks can lead to inappropriately heightened expression or silencing of genes, resulting in "epigenetic diseases". In contrast to genetic events, the potential reversibility of epigenetic states offers exciting opportunities for new therapeutic targets (9, 19).Sleep disorders are highly prevalent among pregnant women in late gestation and are characterized by increased awakenings during the night and sleep maintenance insomnia, which are potentially fraught with adverse pregnancy outcomes (13,21,38,45). Among the disorders that impose additional disruption of sleep integrity during pregnancy, sleep-disordered breathing is particularly prevalent and has emerged as a contributor to gestational diabetes mellitus, preeclampsia, as well as adverse perinatal outcomes (28, 42). However, the impact of poor sleep quality and continuity during pregnancy could transcend the gestational period and adve...

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Early-life physical activity reverses metabolic and Foxo1 epigenetic misregulation induced by gestational sleep disturbance

Mutskov

Wang

Carreras

et al. 2015

American Journal of Physiology-Regulatory, Integrative and Comp

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“…Ez a hatás valószínűleg annak tudható be, hogy az ösztrogén indukálja az intracelluláris progeszteronreceptorokat [32]. Ezt az elméletet támasztja alá Reutrakul és mtsai megfi gyelése, miszerint egészséges várandós nők AHI-ja szignifi kánsabban magasabb volt a nem vá-randós társaikéhoz képest [33]. Egy másik ok lehet, hogy a progeszteron befolyásolja a légutak kollapszibilitását és növeli a M. genioglossus aktivitását.…”

Section: öSszefoglaló Közleményunclassified

Obstructive sleep apnea in women

et al. 2014

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A különböző alvászavarok prevalenciája és klinikai-tüneti megnyilvánulása eltérő lehet a férfi ak és a nők körében. Az utóbbi évek kutatásai hívták fel a fi gyelmet az obstruktív alvási apnoe gyakori előfordulására nők körében is, mivel a férfi akkal ellentétben, főként az atípusos tünetek miatt (mint a reggeli fejfájás, depresszióra jellemző tünetek, nappali fáradtság) az esetek nagy részében nem diagnosztizálják ezt a betegséget. Mindkét nemnél nagy jelentősége van az alvászavarok korai felismerésének és kezelésének, az életminőség, társbetegségek és a mortalitás szempontjából. Orv. Hetil., 2014, 155(52), 2067-2073 Kulcsszavak: obstruktív alvási apnoe, nemek közötti különbség, életminőség, depresszió Obstructive sleep apnea in womenThe prevalence of sleep disturbances and their symptomatic manifestations may be different in men and women. Women with obstructive sleep apnea are less likely to be diagnosed with sleep apnea compared to men, probably due to atypical symptoms such as morning headaches, symptoms of depression and daytime fatigue. There is a great importance of diagnosis and treatment of sleep disorders regarding quality of life, co-morbidity and mortality in both genders. Keywords ÖSSZEFOGLALÓ KÖZLEMÉNYRövidítések AHI = (apnea-hypopnea index) apnoe-hypopnoe index; CPAP = (continous positive airway pressure) folyamatos pozitív nyomású légzéstámogatás; ESS = (Epworth Sleepiness Scale) Epworth Álmossági Skála; MBS = (metabolic syndrome) metabolikus szindróma; OSA = (obstructive sleep apnea) obstruktív alvási apnoe; OSAS = (obstructive sleep apnea syndrome) obstruktív alvási apnoe szindróma Az elmúlt néhány évtizedben egyre nagyobb fi gyelem övezi az alvászavarok problémakörét, és a kutatások egy része a nemek közti különbségeket elemzi. A nők és a férfi ak körében bár ugyanazon alvás-és ébrenléti zavarok fordulnak elő, ezek megnyilvánulásai, tünetei, egészség-ügyi következményei, kihatásai a mindennapi életre elté-rő módon és mértékben jelentkeznek. Jelen tanulmá-nyunkban az alvási apnoét tekintjük át. Defi nícióAz obstruktív alvási apnoe (OSA) az alvás alatti légzésza-varok leggyakoribb formája. Jellemző rá a felső légutak alvás alatti ismétlődő, részleges vagy teljes elzáródása, ami azt eredményezi, hogy az egyre fokozódó belégzési erőfeszítés (effort) ellenére hypopnoe, illetve apnoe alakul ki [1]. Hypopnoénak nevezzük a légutak részleges

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“…About of 75% of mothers develop some sleep disorder in pregnancy [4], such as poor sleep quality and decreased sleep duration. In addition, pregnant mothers have an increased risk of obstructive sleep apnoea (OSA) [5]. In addition, these sleep disorders are correlated with glucose intolerance, gestational diabetes mellitus, gestational hypertension and preeclampsia [5].…”

Section: Sleep Quality As a Confounding Factor Of Maternal Weight Andmentioning

confidence: 99%

Sleep quality as a confounding factor of maternal weight and preschool wheezing

Nozoe

Polesel²,

Boin³

et al. 2014

Eur Respir J

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Interactions Between Pregnancy, Obstructive Sleep Apnea, and Gestational Diabetes Mellitus

Abstract: Pregnancy is associated with sleep disturbances. Sleep is more disturbed in GDM than in P-NGT women. There is a strong association between GDM and OSA.

Cited by 78 publications

References 33 publications

Early-life physical activity reverses metabolic and Foxo1 epigenetic misregulation induced by gestational sleep disturbance

Early-life physical activity reverses metabolic and Foxo1 epigenetic misregulation induced by gestational sleep disturbance

Obstructive sleep apnea in women

Sleep quality as a confounding factor of maternal weight and preschool wheezing

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