Adiponectin in Patients with Obstructive Sleep Apnea Syndrome: Course and Physiological Relevance

Harsch, I. A.; Wallaschofski, Henri; Koebnick, Corinna; Schahin, Simin Pour; Hahn, Eckhart G.; Ficker, Joachim H.; Lohmann, Tobias

doi:10.1159/000081758

Cited by 56 publications

(43 citation statements)

References 37 publications

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“…Notably, decreased adiponectin levels in OSAHS were attributed to obesity [197]. In line with the data reporting on unchanged adiponectin levels in OSAHS, longterm nCPAP treatment was also shown to be ineffective [200,201]. As noted earlier, adiponectin is primarily released by adipose tissue and decreases in the obese and yet is affected by oxidative stress.…”

Section: Adiponectinsupporting

confidence: 74%

Molecular mechanisms of cardiovascular disease in OSAHS: the oxidative stress link

Lavie¹,

Lavie²

2009

European Respiratory Journal

320

223

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Obstructive sleep apnoea/hypopnoea syndrome (OSAHS) is a highly prevalent breathing disorder in sleep that is an independent risk factor for cardiovascular morbidity and mortality. A large body of evidence, including clinical studies and cell culture and animal models utilising intermittent hypoxia, delineates the central role of oxidative stress in OSAHS as well as in conditions and comorbidities that aggregate with it. Intermittent hypoxia, the hallmark of OSAHS, is implicated in promoting the formation of reactive oxygen species (ROS) and inducing oxidative stress. The ramifications of increased ROS formation are pivotal. ROS can damage biomolecules, alter cellular functions and function as signalling molecules in physiological as well as in pathophysiological conditions. Consequently, they promote inflammation, endothelial dysfunction and cardiovascular morbidity. Oxidative stress is also a crucial component in obesity, sympathetic activation and metabolic disorders such as hypertension, dyslipidaemia and type 2 diabetes/insulin resistance, which aggregate with OSAHS. These conditions and comorbidities could result directly from the oxidative stress that is characteristic of OSAHS or could develop independently. Hence, oxidative stress represents the common underlying link in OSAHS and the conditions and comorbidities that aggregate with it.

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Section: Adiponectinsupporting

confidence: 74%

Molecular mechanisms of cardiovascular disease in OSAHS: the oxidative stress link

Lavie¹,

Lavie²

2009

European Respiratory Journal

320

223

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“…The effects of CPAP treatment may be related to improvement of sleep quality, metabolism, and other factors; therefore, improvement of the drop in adiponectin levels with one-night nCPAP may be due not only to removing hypoxia partly but also to alteration of other OSAHS-related factors. Although we did not investigate the long-term effect of nCPAP treatment in the present study, several reports found no significant changes in serum levels of adiponectin after 3 mo of long-term nCPAP treatment (6,42), suggesting that the lack of a long-lasting change in adiponectin can be explained by the influence of body mass on adiponectin secretion, which was unchanged during nCPAP treatment. Considered together, the results of one-night nCPAP seem different from those of long-term nCPAP treatment.…”

Section: Discussioncontrasting

confidence: 59%

Nocturnal reduction in circulating adiponectin concentrations related to hypoxic stress in severe obstructive sleep apnea-hypopnea syndrome

Nakagawa¹,

Kishida²,

Kihara³

et al. 2008

American Journal of Physiology-Endocrinology and Metabolism

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Previous reports demonstrated that adiponectin has antiatherosclerotic properties. Obstructive sleep apnea-hypopnea syndrome (OSAHS) is reported to exacerbate atherosclerotic diseases. We investigated nocturnal alternation of serum adiponectin levels before sleep and after wake-up in OSAHS patients and the effect of sustained hypoxia on adiponectin in vivo and in vitro. We measured serum adiponectin concentrations in 75 OSAHS patients and 18 control subjects before sleep and after wake-up and examined the effect of one-night nasal continuous positive airway pressure (nCPAP) on adiponectin in 24 severe OSAHS patients. We investigated the effects of hypoxia on adiponectin in mice and cultured adipocytes with a sustained hypoxia model. Circulating adiponectin levels before sleep and after wake-up were lower in severe OSAHS patients than in control subjects [before sleep: 5.9 Ϯ 2.9 vs. 8.8 Ϯ 5.6 g/ml (P Ͻ 0.05); after wake-up: 5.2 Ϯ 2.6 vs. 8.5 Ϯ 5.5 g/ml (P Ͻ 0.01), respectively; means Ϯ SD]. Serum adiponectin levels diminished significantly during sleep in severe OSAHS patients (P Ͻ 0.0001), but one-night nCPAP improved the drop in serum adiponectin levels [Ϫ18.4 Ϯ 13.4% vs. Ϫ10.4 Ϯ 12.4% (P Ͻ 0.05)]. In C57BL/6J mice and 3T3-L1 adipocytes, hypoxic exposure decreased adiponectin concentrations by inhibiting adiponectin regulatory mechanisms at secretion and transcriptional levels. The present study demonstrates nocturnal reduction in circulating adiponectin levels in severe OSAHS. Our experimental studies showed that hypoxic stress induced adiponectin dysregulation at transcriptional and posttranscriptional levels. Hypoxic stress is, at least partly, responsible for the reduction of serum adiponectin in severe OSAHS. Nocturnal reduction in adiponectin in severe OSAHS may be an important risk for cardiovascular events or other OSAHSrelated diseases during sleep. nasal continuous positive airway pressure RECENT STUDIES HAVE DEMONSTRATED that adipose tissue is not only a passive reservoir for energy storage but also produces and secretes a variety of bioactive molecules called adipocytokines, including adiponectin (1a, 20), tumor necrosis factor-␣, leptin, and plasminogen activator inhibitor type 1 (PAI-1) (36). Dysregulated production of adipocytokines is associated with the pathophysiology of obesity-related diseases (1a, 9, 27). The biological functions of adiponectin, which we identified as an adipocytokine in the human adipose cDNA library (20), include improvement of glucose (21) and lipid metabolism (26), prevention of inflammation (31) and atherosclerosis (24), and cardiovascular protection (14,30,38). Serum adiponectin levels are low in visceral obesity (1a), insulin resistance (10), type 2 diabetes (9), and cardiovascular diseases (29). Previous studies demonstrated the possible association between visceral obesity and obstructive sleep apnea-hypopnea syndrome (OSAHS) (39,40). More recent studies reported that obese subjects with OSAHS had hypoadiponectinemia (36,46).In patients with OSAHS, repetitive noctu...

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“…In a recent Japanese study [62], plasma adiponectin levels were not different between mild, moderate and severe OSAS patient groups. The plasma adiponectin levels were correlated with the insulin sensitivity of these patients, as calculated using the Homeostasis Model Assessment, which confirms the results of the present author's study [59]. However, although plasma adiponectin was an independent determinant of insulin sensitivity in OSAS patients, plasma adiponectin was more closely related to obesity than to sleep apnoea.…”

Section: The Role Of Adiponectin In Osassupporting

confidence: 89%

“…In a study by the present author [59] of 30 patients with OSAS, it was possible to demonstrate a small decrease in adiponectin serum levels that returned to baseline levels after 3 months of treatment. In these patients, the insulin sensitivity had significantly improved 2 days and 3 months after the onset of nasal CPAP therapy.…”

Section: The Role Of Adiponectin In Osasmentioning

confidence: 65%

Metabolic disturbances in patients with obstructive sleep apnoea syndrome

Harsch¹

2007

European Respiratory Review

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The metabolic disturbances in patients with obstructive sleep apnoea syndrome (OSAS) include insulin resistance and elevated levels of pro-inflammatory cytokines and vascular adhesion molecules, as well as an elevation of hormones derived from the adipose tissue as leptin. These phenomena might, in part, be an explanation for the excess morbidity and mortality of OSAS patients concerning cardiovascular disease.Several of these factors have been described as being independently associated with OSAS and not only related to its comorbidities, including obesity.A promising approach to studying the metabolic phenomena in these OSAS patients would be to monitor patients before and during the course of continuous positive airway pressure therapy, as nocturnal sleep disturbances are treatable and may revert the impact of OSAS on the metabolic phenomena; however, patients do frequently (and unfortunately) maintain their body weight.Although not confirmed by all investigations, a tendency towards an improvement in some of the above-mentioned metabolic parameters has been reported in several studies in obstructive sleep apnoea syndrome patients and may be reflected by the decreased occurrence of new cardiovascular events, the reduction of systolic blood pressure and the improvement of left ventricular systolic function.

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Adiponectin in Patients with Obstructive Sleep Apnea Syndrome: Course and Physiological Relevance

Cited by 56 publications

References 37 publications

Molecular mechanisms of cardiovascular disease in OSAHS: the oxidative stress link

Molecular mechanisms of cardiovascular disease in OSAHS: the oxidative stress link

Nocturnal reduction in circulating adiponectin concentrations related to hypoxic stress in severe obstructive sleep apnea-hypopnea syndrome

Metabolic disturbances in patients with obstructive sleep apnoea syndrome

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