Obstructive Sleep Apnea, Inflammation, and the Metabolic Syndrome

Calvin, Andrew D.; Albuquerque, Felipe N.; López-Jiménez, Francisco; Somers, Virend K.

doi:10.1089/met.2008.0093

Cited by 110 publications

(78 citation statements)

References 122 publications

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“…Presently there are a couple of sets of defining criteria for metabolic syndrome set out by two different sources-the International Diabetes Federation and the revised National Cholesterol Education Program (NCEP). 9,[22][23][24][25] These are very similar and they identify individuals with a given set of symptoms as having metabolic syndrome. In the study conducted NCEP criteria has been used to ascertain metabolic syndrome among the subjects.…”

Section: Discussionmentioning

confidence: 99%

“…This can lead to a combination of hypopneas, or reduction in airflow associated with a fall in oxygen saturation, or apneas, or complete cessation of airflow. 9 OSA severity is usually determined as follows: AHI 5-15 indicates mild, 15-30 moderate and over 30 severe OSAS. The oxygen saturation index (ODI 4%) describes the number of at least 4% drops in blood oxygen levels per hour of sleep.…”

Section: Introductionmentioning

confidence: 99%

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Prevalence of obstructive sleep apnoea in metabolic syndrome

Dubey¹,

Rajput²,

Suhag³

et al. 2017

Int J Adv Med

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Background: The prevalence of both OSA and metabolic syndrome is increasing worldwide, in part linked to the epidemic of obesity. Beyond their epidemiologic relationship, growing evidence suggests that OSA may be causally related to metabolic syndrome. We are only beginning to understand the potential mechanisms underlying the OSA-metabolic syndrome interaction. Objectives were to study the clinical prevalence of obstructive sleep apnoea in metabolic syndrome; and to find risk factors associated with obstructive sleep apnoea (OSA).Methods: 50 patients attending various OPDs of a tertiary care research and referral hospital and found to have metabolic syndrome on the basis of NCEP criteria were selected. These patients were subjected to overnight polysomnography. Parameters such as apnea-hypopnoea index (AHI), respiratory efforts related arousals (RERA), minimum SpO2, pulse rate, blood pressure, and ECG were monitored throughout the study.Results: Central obesity was found in 34 patients, xanthelasmas in 12 patients and xanthomas in 08 patients. Pitting type of pedal oedema was noted in 14 patients. Epworth sleepiness score (ESS) was calculated in all the patients by interviewing them before the polysomnography. Most of the patients have ESS Score more than 11.03 out of 50 patients were found to have AHI<5.20 patients were found to have moderate AHI (AHI 15-30) whereas 22 were found to have severe AHI.Conclusions: Polysomnography provides a valuable tool to access non symptomatic sleep disordered breathing at an early stage in patients with metabolic syndrome.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Prevalence of obstructive sleep apnoea in metabolic syndrome

Dubey¹,

Rajput²,

Suhag³

et al. 2017

Int J Adv Med

View full text Add to dashboard Cite

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“…Other associated conditions are increased inflammation, vascular dysfunction, non-alcoholic fatty liver disease (NAFLD), polycystic ovary syndrome, sleep apnea and some types of cancer and dementia. 16,17,18,19,20,21,22,23,24 Obesity is commonly viewed as the cause of metabolic syndrome. However, while obesity is highly correlated with the condition, we (and others) suggest that it is the expansion of adipose stores beyond a person's individual storage capacity, 25,26 driven by and in conjunction with hyperinsulinaemia because of the overconsumption of processed dietary carbohydrates in the setting of a Western diet -so prevalent in modern society -that drives this disease process.…”

Section: Metabolic Syndrome As Pre-diabetesmentioning

confidence: 99%

A low-carbohydrate survey: Evidence for sustainable metabolic syndrome reversal

Cucuzzella

Tondt

Dockter

et al. 2017

JMH

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Background: Metabolic syndrome has become a significant problem, with the American Diabetes Association estimating the cost of diabetes and pre-diabetes in the United States alone to be $322 billion per year. Numerous clinical trials have demonstrated the efficacy of low-carbohydrate diets in reversing metabolic syndrome and its associated disorders.Aim: This study was designed to examine how voluntary adherents to a low-carbohydrate diet rate its effectiveness and sustainability using an online survey.Setting and methods: The 57-question survey was administered online and shared internationally via social media and ‘low-carb’ communities. Where appropriate, chi-squared tests and paired t-tests were used to analyse the responses.Results: There were 1580 respondents. The majority of respondents had consumed less than 100 g of carbohydrates per day for over a year, typically for reasons of weight loss or disease management. There was a reported decrease in waist circumference and weight with a simultaneous decrease in hunger and increase in energy level. Of those who provided laboratory values, the majority saw improvements in their HbA1c, blood glucose measurements, and lipid panel results. There was a reduction in usage of various medications, and 25% reported medication cost savings, with average monthly savings of $288 for those respondents. In particular, the usage of pain relievers and anti-inflammatories dropped with a simultaneous decreased rating of pain and increase in mobility.Conclusion: We conclude that low-carbohydrate diets are a sustainable method of metabolic syndrome reversal in a community setting.

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“…This would support the hypothesis that a chronic increase over time in inflammation could be the cause of the SAHS. In fact, it has been described that there is generally an association to SAHS in patients with an increased in TNF-α, and those that have a polymorphism of it (-308A) [27]. The earlier RA treatment is initiated, the greater is the likelihood that the inflammatory condition can be controlled, thus reducing the structural damage [28].…”

Section: Discussionmentioning

confidence: 99%

Severity of the Apnea-Hypopnea Sleep Syndrome in Patients with Rheumatoid Arthritis and Spondyloarthropathies. Modulation of the Sleep Apnea Index with Anti-TNF-? Inhibitors

Moreira¹

2015

J Arthritis

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IntroductionThere is greater cardiovascular risk (CV) in those having chronic inflammatory diseases such as rheumatoid arthritis (RA) or spondyloarthropathies (SpA) than in the general population. This risk is not only explained by the association of the traditional risk factors of arterial hypertension (AHT), dyslipidemia, diabetes mellitus (DM) and smoking [1]. In this sense, early endothelial dysfunction and accelerated atherosclerotic process [2] have been described in these diseases and may be related to the same inflammatory process and be mediated by the tumor necrosis factor alpha (TNF-α) and interleukin 6 (IL-6) [3]. Sleep apnea-hypopnea syndrome (SAHS) has a 3-4% [4] prevalence in Western countries and is also associated to the metabolic syndrome and other CV risk factors [5]. SAHS per se constitutes an independent CV risk factor in male subjects and young subjects with this disease [6].Sleep abnormalities are common in RA [7,8] and SAHS has been attributed as being a factor that contributes to CV mortality in patients with RA [9]. There seems to be a systemic inflammatory component in the etiopathogeny of SAHS, although the mechanism is little known. The repeated episodes of hypoxia and reoxygenation cause oxidative stress that may play an important role in the associated systemic inflammatory process [10]. This would entail an increase in the expression of TNF-α.Association of inflammatory pathophysiology and an evolution occurring with more CV complications observed in RA as well as SpA and SAHS acquire greater conceptual support when we observe the response to the treatment. Thus, when SAHS is treated with continuing positive air pressure, a reduction is observed in blood pressure, triglycerides and glycated hemoglobin [11]. Furthermore, it has been stated that treatment with anti-TNF-α in patients with RA and sleep disorders improves sleep quality [12]. However, at present, there are still few studies that evaluate the severity of SAHS in patients with RA or SpA, the increase of CV risk that this association implies and the possible modulation of the nighttime anoxia-hypoxia episodes with treatment with anti TNF-α drugs. This study has aimed to evaluate the severity of SAHS in patients with RA or SpA and to verify the behavior of the apnea-hypopnea index (AHI) in patients with and without anti-TNF-α treatment. AbstractObjective: To evaluate severity of the sleep apnea-hypopnea syndrome (SAHS) in patients with rheumatoid arthritis (RA) and spondyloarthropathies (SpA). To study the behavior of the apnea-hypopnea index (AHI) in patients treated with anti-TNF-α. Materials and methods:An observational, retrospective study was conducted in patients with RA and SpA (study group) and with osteoarthritis (control group) who have SAHS symptoms. AHI (expressed in median and 25-75 percentiles), mean oxygen saturation (SaO 2 ) and information on associated cardiovascular risk factors (CVRF) were collected. This information was also collected in the anti-TNF-α treated study group. Results:The study group (75 ...

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Obstructive Sleep Apnea, Inflammation, and the Metabolic Syndrome

Cited by 110 publications

References 122 publications

Prevalence of obstructive sleep apnoea in metabolic syndrome

Prevalence of obstructive sleep apnoea in metabolic syndrome

A low-carbohydrate survey: Evidence for sustainable metabolic syndrome reversal

Severity of the Apnea-Hypopnea Sleep Syndrome in Patients with Rheumatoid Arthritis and Spondyloarthropathies. Modulation of the Sleep Apnea Index with Anti-TNF-? Inhibitors

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