Obstructive sleep apnea syndrome is associated with some components of metabolic syndrome in nonobese adults

Lin, Qi‐Chang; Zhang, Xiaobin; Chen, Gongping; Huang, Dou-Yu; Din, Hai-Bo; Tang, Ai-Zhong

doi:10.1007/s11325-011-0544-7

Cited by 77 publications

(64 citation statements)

References 36 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%

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

Bonsignore¹,

Esquinas²,

Barceló³

et al. 2011

Eur Respir J

107

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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%

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

Bonsignore¹,

Esquinas²,

Barceló³

et al. 2011

Eur Respir J

107

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“…93 Another study demonstrated that non-obese OSA subjects had metabolic abnormalities associated with dyslipidaemia and hypertension. 43 Thus, the coexistence of metabolic syndrome and OSA may have detrimental effects on cardiovascular risk and glycaemia. The extent to which OSA has direct effects on components of the metabolic syndrome was found to be dependent on the severity of OSA 93 and was correlated with insulin resistance and inflammatory markers.…”

Section: Metabolic Syndromementioning

confidence: 99%

Sleep-disordered breathing, type 2 diabetes and the metabolic syndrome

Seetho

Wilding

2014

Chron Respir Dis

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Sleep-disordered breathing (SDB) encompasses a spectrum of conditions that can lead to altered sleep homeostasis. In particular, obstructive sleep apnoea (OSA) is the most common form of SDB and is associated with adverse cardiometabolic manifestations including hypertension, metabolic syndrome and type 2 diabetes, ultimately increasing the risk of cardiovascular disease. The pathophysiological basis of these associations may relate to repeated intermittent hypoxia and fragmented sleep episodes that characterize OSA which drive further mechanisms with adverse metabolic and cardiovascular consequences. The associations of OSA with type 2 diabetes and the metabolic syndrome have been described in studies ranging from epidemiological and observational studies to controlled trials investigating the effects of OSA therapy with continuous positive airway pressure (CPAP). In recent years, there have been rising prevalence rates of diabetes and obesity worldwide. Given the established links between SDB (in particular OSA) with both conditions, understanding the potential influence of OSA on the components of the metabolic syndrome and diabetes and the underlying mechanisms by which such interactions may contribute to metabolic dysregulation are important in order to effectively and holistically manage patients with SDB, type 2 diabetes or the metabolic syndrome. In this article, we review the literature describing the associations, the possible underlying pathophysiological mechanisms linking these conditions and the effects of interventions including CPAP treatment and weight loss.

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“…45 AHI correlated positively with triglyceride levels and negatively with HDL levels but not with total cholesterol or LDL. 45 The association between OSA/AHI and triglyceride levels was also evident in non-obese patients 34 suggesting that relationship is independent of obesity and possibly more related to IR. However, despite these findings, a good evidence of causality between OSA and hyperlipidaemia is lacking, although mechanistically it is plausible that chronic intermittent hypoxia might lead to hyperlipidaemia via the generation of stearoylcoenzyme A desaturase-1 and oxidative stress, peroxidation of lipids and sympathetic activation.…”

Section: Obstructive Sleep Apnoea and Lipids In General Population Stmentioning

confidence: 97%

“…7,10,11 Obesity is obviously a major confounder but the association between OSA and IR was also found in lean individuals, suggesting that the relationship is independent of obesity. 33,34 One study examined the effect of OSA on IR longitudinally; over 11-year follow-up OSA, AHI, oxygen desaturation index (ODI) and minimal oxygen saturations overnight were independently associated with IR after adjustment for age, baseline BMI, hypertension, BMI change over follow-up and CPAP treatment. 35 CPAP was shown to lower IR (improve insulin sensitivity) in several studies and metaanalysis, [36][37][38] particularly when CPAP usage was >4 hours per night.…”

Section: Obstructive Sleep Apnoea and Insulin Resistancementioning

confidence: 99%

Obstructive Sleep Apnoea and Vascular Disease in Patients with Type 2 Diabetes

Tahrani¹

2015

US Endocrinology

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Obstructive sleep apnoea (OSA) is common and is associated with many vascular risk factors, such as hypertension, insulin resistance, albuminuria, dyslipidaemia, increased inflammation and endothelial dysfunction. Epidemiological studies have shown that OSA is associated with increased cardiovascular disease (CVD) and that continuous positive airway pressure (CPAP) might reduce CVD events in patients with OSA. In addition, OSA has also been shown to be associated with albuminuria, chronic kidney disease, a wide range of ocular diseases and peripheral neuropathy. Considering that CVD and microvascular complications are major contributors to the morbidity, mortality and the economic burden of diabetes and that OSA is common in patients with type 2 diabetes (T2D), it is important to understand the role of OSA in the development and/or progression of vascular disease in patients with T2D and to explore the impact of CPAP on diabetes-related vascular outcomes. The purpose of this article is to review the evidence for the relationship and impact of OSA on vascular disease and vascular risk factors particularly in patients with T2D. KeywordsType 2 diabetes, obstructive sleep apnoea, vascular disease, vascular risk Diabetes-related macro-and microvascular complications contribute significantly to the increased morbidity, mortality, worsened quality of life and social and financial burden observed in patients with diabetes. [1][2][3][4][5] Hence, reducing the development and/or the progression of these complications is one of the main aims of treatment in patients with diabetes.Over the last 2 decades, strategies resulting in the improvements of glycaemic control, blood pressure (BP) and lipids and the use of renin angiotensin aldosterone inhibitors, resulted in reductions in cardiovascular disease (CVD) in patients with diabetes, but there was little impact on diabetic microvascular complications. 6 Nonetheless, both CVD and microvascular complications remain common and a better understanding of the pathogenesis of these complications is needed in order to identify new treatment strategies.Obstructive sleep apnoea (OSA) is common in patients with type 2 diabetes (T2D) (up to 86 % prevalence), which is not surprising considering that increasing age and obesity are common risk factors to both conditions. 7,8 OSA is characterised by upper airway instability during sleep that results in recurrent upper airway obstruction resulting in either complete or partial cessation of airflow (i.e. apnoea and hypopnoea, respectively). 9The recurrent obstructions of the upper airway usually result in recurrent oxygen desaturations/re-saturations, cyclical changes in intrathoracic pressure (as the patient attempts to breath against a blocked airway) and recurrent micro arousals that cause sleep fragmentation and reduction in slow wave and rapid eye movement (REM) sleep and result in termination of the apnoea/hypopnoea episodes. 9Several large epidemiological studies and randomised controlled trials (RCTs) have shown that OSA was ...

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Obstructive sleep apnea syndrome is associated with some components of metabolic syndrome in nonobese adults

Abstract: Our finding was consistent with previous studies that OSA was independently associated with dyslipidemia, hypertension, and at least two of metabolic abnormalities in nonobese patients.

Cited by 77 publications

References 36 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-disordered breathing, type 2 diabetes and the metabolic syndrome

Obstructive Sleep Apnoea and Vascular Disease in Patients with Type 2 Diabetes

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