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

Bonsignore, Maria R.; Esquinas, Cristina; Barceló, Antònia; Sánchez‐de‐la‐Torre, Manuel; Paternò, Alessandra; Durán-Cantolla, Joaquín; Marı́n, José Marı́a; Barbé, Ferrán

doi:10.1183/09031936.00151110

Cited by 107 publications

(102 citation statements)

References 43 publications

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“…The number of MetS criteria is defined as the metabolic index and can be used as an indicator of severity of metabolic abnormalities. Patients with severe OSA showed a significantly higher metabolic index compared to patients with mild-to-moderate OSA [45], and this finding has been also confirmed in patients primarily identified for the presence of MetS [46] or morbid obesity [47]. An independent role of OSA on metabolic abnormalities is not strongly supported by randomised controlled trials rigorously testing the effect of CPAP on metabolism in OSA patients.…”

Section: Osa Visceral Fat and The Metabolic Syndromementioning

confidence: 78%

“…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%

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Sleep apnoea and metabolic dysfunction

Bonsignore¹,

Borel²,

Machan³

et al. 2013

European Respiratory Review

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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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Section: Osa Visceral Fat and The Metabolic Syndromementioning

confidence: 78%

Section: Osa Visceral Fat and The Metabolic Syndromementioning

confidence: 99%

Sleep apnoea and metabolic dysfunction

Bonsignore¹,

Borel²,

Machan³

et al. 2013

European Respiratory Review

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“…Its prevalence in obstructive sleep apnea patients has been reported to reach the levels of 47% [37]. Early reports suggested that resistin is associated with obesity and insulin resistance in rodents.…”

Section: Discussionmentioning

confidence: 99%

Resistin and Cardiac Remodeling in Patients with Obstructive Sleep Apnea

Cherneva¹

2014

J Pulm Respir Med

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“…In the clinical setting, it has been estimated that at least half of patients with OSA fulfil the criteria for the metabolic syndrome [5]. Furthermore, the prevalence of metabolic syndrome increases with OSA severity [5,6]. An independent dose-response relationship has been demonstrated between OSA severity and the features of metabolic syndrome, including visceral adiposity [7], hypertension [8], metabolic dyslipidaemia [6] and impaired glucose metabolism [9,10].…”

mentioning

confidence: 99%

“…Besides OSA-related variables, comorbid conditions including hypertension and metabolic dysfunction play an important role in the development of cardiovascular diseases in OSA patients [4]. In the clinical setting, it has been estimated that at least half of patients with OSA fulfil the criteria for the metabolic syndrome [5]. Furthermore, the prevalence of metabolic syndrome increases with OSA severity [5,6].…”

mentioning

confidence: 99%

Effects of sleep apnoea therapy on blood pressure and metabolism: a CPAP sex gap?

et al. 2017

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Obstructive sleep apnoea (OSA) is a highly prevalent disease characterised by recurrent episodes of complete or partial upper airway obstruction during sleep, leading to intermittent hypoxia and sleep fragmentation. Most recent estimates of OSA prevalence suggest that 13% of men and 6% of women have clinically significant OSA [1, 2]. There is evidence from population-based and clinic-based cohort studies that moderate-to-severe OSA is independently associated with an increased incidence of cardiovascular events [3,4]. Besides OSA-related variables, comorbid conditions including hypertension and metabolic dysfunction play an important role in the development of cardiovascular diseases in OSA patients [4]. In the clinical setting, it has been estimated that at least half of patients with OSA fulfil the criteria for the metabolic syndrome [5]. Furthermore, the prevalence of metabolic syndrome increases with OSA severity [5,6]. An independent dose-response relationship has been demonstrated between OSA severity and the features of metabolic syndrome, including visceral adiposity [7], hypertension [8], metabolic dyslipidaemia [6] and impaired glucose metabolism [9,10]. Considering cardiovascular prevention as a therapeutic objective in OSA patients, it is crucial to determine whether OSA therapy can lead to clinically relevant improvements in blood pressure, and glucose and lipid metabolism.Most previous randomised controlled trials (RCTs) evaluating the impact of continuous positive airway pressure (CPAP) therapy on health outcomes were performed in unselected, predominantly male OSA patients. It is increasingly recognised that there is a between-sex difference in the clinical manifestations of OSA, with women more frequently experiencing symptoms of depression and anxiety, and less frequently complaining of excessive daytime sleepiness [11][12][13]. Sex differences have also been observed in cardiovascular outcomes, with more severe endothelial dysfunction [14], and higher risks of coronary heart disease and stroke in women [15]. Epidemiological data have shown that OSA in females is related to obesity, hypertension and diabetes but not to daytime sleepiness [11]. Altogether, these findings highlight the need for adequately powered RCTs examining sex differences in CPAP treatment response with particular focus on blood pressure and metabolic profile.

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

Cited by 107 publications

References 43 publications

Sleep apnoea and metabolic dysfunction

Sleep apnoea and metabolic dysfunction

Resistin and Cardiac Remodeling in Patients with Obstructive Sleep Apnea

Effects of sleep apnoea therapy on blood pressure and metabolism: a CPAP sex gap?

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