Obstructive sleep apnoea and metabolic syndrome in Mediterranean countries

Zito, Annapaola; Steiropoulos, Paschalis; Barceló, Antònia; Marrone, Oreste; Esquinas, Cristina; Buttacavoli, Maria; Barbé, Ferrán; Bonsignore, Maria R.

doi:10.1183/09031936.00120510

Cited by 12 publications

(6 citation statements)

References 10 publications

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“…Our results are similar in mild-moderate OSA, but the prevalence rate of MS was higher in severe OSA, probably due to higher BMI and higher neck circumference. The same prevalence was observed in severe OSA patients in Greece [ 21 ], also with the same BMI and neck circumference. In morbid obese Spanish patients with OSA included in a bariatric surgery program the prevalence of MS was 70% [ 22 ], lower than described in our population.…”

Section: Discussionsupporting

confidence: 75%

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Obstructive Sleep Apnea and Metabolic Syndrome in Spanish Population

Barreiro

Garcia²,

Almagro³

et al. 2013

TORMJ

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Obstructive sleep apnea (OSA) is a clinical picture characterized by repeated episodes of obstruction of the upper airway. OSA is associated with cardiovascular risk factors, some of which are components of metabolic syndrome (MS).Objectives:First, determine the prevalence of MS in patients with OSA visited in sleep clinic. Second, evaluate whether there is an independent association between MS components and the severity of OSA.Methods:Patients with clinical suspicion of OSA were evaluated by polysomnography. Three groups were defined according to apnea hypoapnea index (AHI): no OSA (AHI <5), mild-moderate (AHI≥ 5 ≤30), and severe (AHI> 30). All patients were determined in fasting blood glucose, total cholesterol, HDL cholesterol, triglycerides and insulin. MS was defined according to criteria of National Cholesterol Education Program (NCEP).Results:A total of 141 patients (mean age 54 ± 11 years) were evaluated. According to AIH, 25 subjects had no OSA and 116 had OSA (41mild-moderate and 75 severe). MS prevalence ranged from 43-81% in OSA group. Also, a significant increase in waist circumference, triglycerides, glucose, blood pressure levels, and a decrease in HDL cholesterol levels was observed in more severe OSA patients. All polysomnographic parameters correlated significantly with metabolic abnormalities. After a multiple regression analysis, abdominal obesity (p <0.02), glucose (p <0.01) and HDL cholesterol (p <0.001) were independently associated with OSA.Conclusions:Our findings show high prevalence of MS in OSA, especially in severe group. A significant association between OSA and some of the components of MS was found in Spanish population.

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Section: Discussionsupporting

confidence: 75%

“…The prevalence of MS in OSA patients according to the NCEP ATP III ranges between 23-87% [ 7 , 16 ]. Recently, in a large series of Mediterranean OSA patients the prevalence of MS was between 51.2%-69.8% [ 9 , 21 ]. Also, the number of components of MS increases with OSA severity in the same population [ 9 ].…”

Section: Discussionmentioning

confidence: 99%

Obstructive Sleep Apnea and Metabolic Syndrome in Spanish Population

Barreiro

Garcia²,

Almagro³

et al. 2013

TORMJ

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“…Despite substantial evidence from both epidemiological and clinical studies to suggest an independent link between OSA and MS as a syndromic entity, the issue still remains controversial. The association of the two conditions is very consistent in different ethnic populations, as reported in Caucasian, 4,56–61 Mediterranean 62–68 and Asian 5,69–72 studies (Table 2), and their frequent coexistence has led to the description of ‘Syndrome Z’ 73 . In a study of subjects with newly diagnosed MS, who were expectedly obese, OSA was present in 68% of them, a figure that was similar to that for other established individual components of metabolic syndrome 60 .…”

Section: Osa and Metabolic Syndromesupporting

confidence: 54%

Obesity, obstructive sleep apnoea and metabolic syndrome

2012

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OSA is increasingly recognized as a major health problem in developed countries. Obesity is the most common risk factor in OSA and hence, the prevalence of OSA is undoubtedly rising given the epidemic of obesity. Recent data also suggest that OSA is highly associated with the metabolic syndrome, and it is postulated that OSA contributes to cardiometabolic dysfunction, and subsequently vasculopathy.Current evidence regarding the magnitude of impact on ultimate cardiovascular morbidity or mortality attributable to OSA-induced metabolic dysregulation is scarce. Given the known pathophysiological triggers of intermittent hypoxia and sleep fragmentation in OSA, the potential mechanisms of OSA-obesity-metabolic syndrome interaction involve sympathetic activation, oxidative stress, inflammation and neurohumoral changes. There is accumulating evidence from human and animal/cell models of intermittent hypoxia to map out these mechanistic pathways.In spite of support for an independent role of OSA in the contribution towards metabolic dysfunction, a healthy diet and appropriate lifestyle modifications towards better control of metabolic function are equally important as CPAP treatment in the holistic management of OSA.

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“…Ambrosetti et al studied 89 consecutive OSA patients (AHI ≥ 15) following The US National Cholesterol Education Programme Adult Treatment Panel III (NCEP ATP III) recommendations and found a prevalence of MetS in 53% [ 24 ]. In a large series of Mediterranean OSA patients (AHI>5) the prevalence of MetS was between 50.6%-69.8% [ 25 ], and in OSA patients (AHI>10) the prevalence of MetS was 51.2% [ 26 ]. Moreover, the prevalence rates were reported by clinical studies in Western countries ranging between 30% and 87% [ 27 ].…”

Section: Discussionmentioning

confidence: 99%

The Association between Obstructive Sleep Apnea and Metabolic Markers and Lipid Profiles

Tsai

Shih

et al. 2015

PLoS ONE

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PurposeThe purpose of this study was to investigate the association between apnea-hypopnea index (AHI) and metabolic markers and whether the elevated risk of Metabolic Syndrome (MetS) is related to Obstructive Sleep Apnea (OSA).MethodsThis cross-sectional study recruited 246 male bus drivers from one transportation company in Taiwan. Each participant was evaluated by a polysomnography (PSG) test and by blood lipids examination. Severity of OSA was categorized according to the apnea-hypopnea index (AHI).ResultsThe results showed that a 73.3% prevalence of MetS in OSA (AHI > 15) and a 80.0% prevalence of MetS in severe OSA (AHI > 30) were found. After adjusting for confounding variables, an increased level of Body-Mass Index (BMI) and two non-MetS cardiovascular risk factors, total cholesterol/HDL-C ratio and TG/HDL-C ratio was significantly associated with AHI in subjects with severe OSA. MetS was about three times to be present in subjects with severe OSA, even adjusted for BMI.ConclusionsThe findings showed a high prevalence of MetS in OSA among professional drivers, especially in the severe group category. BMI was the major contributing factor to OSA. However, the present study did not find a sensitive clinical marker of a detrimental metabolic profile in OSA patients.

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Obstructive sleep apnoea and metabolic syndrome in Mediterranean countries

Cited by 12 publications

References 10 publications

Obstructive Sleep Apnea and Metabolic Syndrome in Spanish Population

Obstructive Sleep Apnea and Metabolic Syndrome in Spanish Population

Obesity, obstructive sleep apnoea and metabolic syndrome

The Association between Obstructive Sleep Apnea and Metabolic Markers and Lipid Profiles

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