Obstructive sleep apnoea is associated with risk factors comprising the metabolic syndrome

Akahoshi, Toshiki; Uematsu, Akihito; Akashiba, Tsuneto; Nagaoka, Kenichi; Kiyofuji, Kouji; Kawahara, Shinya; Hattori, Tomohiro; Kaneita, Yoshitaka; Yoshizawa, Tsuyoshi; Takahashi, N.; Uchiyama, Makoto; Hashimoto, Shigeo

doi:10.1111/j.1440-1843.2010.01818.x

Cited by 37 publications

(31 citation statements)

References 33 publications

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“…If the same results were to be shown in humans with OSA, the patients without any metabolic syndrome component may represent a low-risk subgroup, with obvious consequences regarding treatment. Some studies, however, found metabolic abnormalities in non-obese OSA patients, although a diagnosis of metabolic syndrome was not fulfilled [19,28,37]. Conversely, both morbidly obese patients [38] and patients with the metabolic syndrome [26] showed worse metabolic variables associated with severe OSA compared with subjects without OSA.…”

Section: Prevalence Of the Metabolic Syndromementioning

confidence: 99%

“…Clinical studies in OSA patients have reported variable prevalence of the metabolic syndrome according to NCEP-ATP III criteria, with values ranging between 23% and 87% [14][15][16][17][18][19]. The largest published series (819 Japanese patients) found prevalence of the metabolic syndrome to be 49.5% in males and 32% in females [15].…”

Section: Prevalence Of the Metabolic Syndromementioning

confidence: 99%

“…Prevalence of the metabolic syndrome in OSA patients according to the NCEP-ATP III definition was found to range between 23% and 87% [14][15][16][17][18][19]. Most studies included small numbers of patients and did not assess insulin resistance in conjunction with metabolic syndrome.…”

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confidence: 99%

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Metabolic syndrome, insulin resistance and sleepiness in real-life obstructive sleep apnoea

Bonsignore¹,

Esquinas²,

Barceló³

et al. 2011

Eur Respir J

109

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The metabolic syndrome shows a variable prevalence in obstructive sleep apnoea (OSA), and its association with insulin resistance or excessive daytime sleepiness in OSA is unclear. This study assessed the following in consecutive patients with newly diagnosed OSA: 1) the prevalence of metabolic syndrome; and 2) its association with insulin resistance and daytime sleepiness.Metabolic syndrome (National Cholesterol Education Program Adult Treatment Panel (NCEP-ATP) III criteria), insulin resistance (Homeostatic Model Assessment (HOMA) index, n5288) and daytime sleepiness (Epworth Sleepiness Scale) were assessed in 529 OSA patients.The prevalence of metabolic syndrome was 51.2%, which increased with OSA severity. Each metabolic syndrome component correlated with apnoea/hypopnoea index, but only blood pressure retained significance after correction for confounders. Both obesity and OSA contributed to metabolic abnormalities, with different sex-related patterns, since diagnosis of metabolic syndrome was significantly associated with neck circumference, age, body mass index and lowest arterial oxygen saturation in males, and with age and arousal index in females. The number of metabolic syndrome components increased with HOMA index (p,0.001). Prevalence of sleepiness was the same in patients with and without metabolic syndrome.The metabolic syndrome occurs in about half of ''real-life'' OSA patients, irrespective of daytime sleepiness, and is a reliable marker of insulin resistance.

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Section: Prevalence Of the Metabolic Syndromementioning

confidence: 99%

Section: Prevalence Of the Metabolic Syndromementioning

confidence: 99%

See 1 more Smart Citation

Metabolic syndrome, insulin resistance and sleepiness in real-life obstructive sleep apnoea

Bonsignore¹,

Esquinas²,

Barceló³

et al. 2011

Eur Respir J

109

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“…3). MetS is diagnosed in clinical practice by the NCEP-ATP (National Cholesterol Education ProgrammeAdult Treatment Panel) III criteria, which require the presence of three out of five criteria [36][37][38][39][40][41][42][43][44][45]. The number of MetS criteria is defined as the metabolic index and can be used as an indicator of severity of metabolic abnormalities.…”

Section: Osa Visceral Fat and The Metabolic Syndromementioning

confidence: 99%

Sleep apnoea and metabolic dysfunction

Bonsignore¹,

Borel²,

Machan³

et al. 2013

Eur Respir Rev

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Obstructive sleep apnoea (OSA) is a highly prevalent condition often associated with central obesity. In the past few years, several studies have analysed the potential independent contribution of OSA to the pathogenesis of metabolic abnormalities, including type 2 diabetes, the metabolic syndrome and nonalcoholic fatty liver disease. New perspectives in OSA patient care have been opened by the promotion of lifestyle interventions, such as diet and exercise programmes that could improve both OSA and the metabolic profile. The rich clinical literature on this subject, together with the growing amount of data on pathophysiological mechanisms provided by animal studies using the chronic intermittent hypoxia model, urged the organising Committee of the Sleep and Breathing meeting to organise a session on sleep apnoea and metabolic dysfunction, in collaboration with the European Association for the Study of Diabetes. This review summarises the state-of-the-art lectures presented in the session, more specifically the relationship between OSA and diabetes, the role of OSA in the metabolic consequences of obesity, and the effects of lifestyle interventions on nocturnal respiratory disturbances and the metabolic profile in OSA patients. @ERSpublications Treatment of obesity and metabolic diseases through diet and exercise should be part of OSA management besides CPAP

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“…Se postula que los eventos secundarios a la fragmentación del sueño, la HI y el aumento de la actividad simpática contribuyen a este "desbalance metabólico" aumentando significativamente el riesgo cardiovascular 8 . En un estudio de pacientes con diagnóstico reciente de SM, 68% de ellos presentaba SAOS como comorbilidad 15,16 . En otro estudio, que incluyó a 195 pacientes con patología cardiovascular, el SM fue el principal predictor de la desaturación nocturna 6 .…”

Section: Síndrome Metabólico (Sm)unclassified

Compromiso multisistémico en apnea obstructiva del sueño

Labarca

Descalzi

2014

Rev. méd. Chile

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. El diagnóstico se establece mediante la demostración de eventos obstructivos mediante polisomnografía o la poligrafía respiratoria, la que demuestra el índice de apnea e hipoapnea (AHI), indicador de severidad de SAOS. Un AHI < 5 es normal; leve, 5 a 10; moderado, 15 a 30 y severo > 30 [1][2][3] . La terapia se basa en tratamiento conservador e incluyen la pérdida de peso, higiene del sueño, corrección con terapia postural y manejo de factores como la congestión nasal. En aquellos pacientes con SAOS moderado o severo se recomienda el uso de CPAP (continuous positive airway pressure). Este dispositivo es considerado el tratamiento más efectivo demostrado en varios ensayos clínicos de distribución aleatoria 3,4 . La obstrucción de la vía aérea y la fragmentación del sueño tienen como consecuencia una alteración en los ciclos de hipoxia y reoxigenación.Esta alteración produce isquemia transitoria sobre los tejidos, concepto conocido como hipoxia crónica intermitente (HI) 5,6 . La HI aumenta las concentraciones de radicales libre de oxígeno (ROS) que actúan como mediadores de citoquinas pro-inflamatorias, generando un estado de inflamación sistémica, una mayor activación del sistema simpático, disfunción endotelial, desregulación metabólica y un estado de hipercoagulabilidad, mecanismos identificados como patogénicos en distintos sistemas del organismo en modelos clínicos como experimentales 7 (Figura 1). El objetivo de la presente revisión es describir las consecuencias que tiene SAOS sobre los distintos sistemas, así como los riesgos asociados a la patología y estudios que avalan estas asociaciones. Compromiso metabólico en SAOS ObesidadLa obesidad central es el factor de riesgo más prevalente en SAOS, cerca de 40% de los pacientes

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Obstructive sleep apnoea is associated with risk factors comprising the metabolic syndrome

Abstract: Although Asians are generally less obese than Caucasians, the prevalence of the MS was high among Japanese patients with OSA, and even among non-obese patients, OSA was associated with risk factors for the MS.

Cited by 37 publications

References 33 publications

Metabolic syndrome, insulin resistance and sleepiness in real-life obstructive sleep apnoea

Metabolic syndrome, insulin resistance and sleepiness in real-life obstructive sleep apnoea

Sleep apnoea and metabolic dysfunction

Compromiso multisistémico en apnea obstructiva del sueño

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