Sex Influences Endothelial Function in Sleep-Disordered Breathing

Faulx, Michael D.; Larkin, Emma K.; Hoit, Brian D.; Aylor, Joan; Wright, Andrew T.; Redline, Susan

doi:10.1093/sleep/27.6.1113

Cited by 114 publications

(84 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The biological plausibility of SDB as a contributor to the pathogenesis of MetS is supported by data from adult studies showing that SDB-associated sympathetic activation and hypoxemia may lead to the generation of reactive oxygen species, stimulation of various inflammatory cytokines, and endothelial dysfunction (49)(50)(51). Such effects appear to be relevant to pediatric patients with SDB as well, as evidenced by studies showing elevations in inflammatory mediators in children with SDB (27,52,53).…”

Section: Discussionmentioning

confidence: 94%

Association between Metabolic Syndrome and Sleep-disordered Breathing in Adolescents

Redline¹,

Storfer‐Isser²,

Rosen³

et al. 2007

Am J Respir Crit Care Med

Self Cite

265

175

View full text Add to dashboard Cite

Rationale: Metabolic syndrome (MetS) affects 4 to 10% of adolescents. Risk factors include overweight, male sex, and Hispanic ethnicity. Although sleep-disordered breathing (SDB) has been implicated as a risk factor for MetS in adults, its association with SDB in adolescents is unknown. Objectives: To define the association of SDB with MetS in adolescents. Methods: Standardized measurements of SDB, anthropometry and bioassays, were made in 270 adolescents, aged 13.6 ؎ 0.7 years. MetS was identified if threshold levels were exceeded in three of five areas: waist circumference, blood pressure, triglyceride level, high-density lipoprotein cholesterol level, and glucose levels. Measurements and Main Results: Although 70% of children with SDB (apnea-hypopnea index у 5) were overweight and 59% had MetS, 16% of children without SDB had MetS. Twenty-five percent of those with MetS had SDB. After adjusting for age, race, sex, and preterm status, children with SDB had a 6.49 (95% confidence interval, 2.52, 16.70) increased odds of MetS compared with children without SDB. Indices of SDB stress associated with MetS included respiratory event frequency, degree of oxygen desaturation, and sleep efficiency. Analyses of individual metabolic parameters showed that, after adjustment for body mass index, SDB was associated with systolic and diastolic blood pressure, low-density lipoprotein cholesterol, and fasting insulin levels. Conclusions: A majority of adolescents with SDB are overweight and meet criteria for MetS. The close association between MetS and SDB and their putative interacting pathophysiologies suggests a need to develop screening, prevention, and treatment strategies for both disorders in high-risk, overweight adolescents.Keywords: sleep apnea; metabolic syndrome; obesity Metabolic syndrome (MetS) refers to a clustering of abnormalities in glucose and lipid metabolism, believed to result from insulin resistance and/or central obesity. MetS, defined according to criteria established by the Adult Treatment Panel III (ATP III), is estimated to affect more than 20% of United States' adults, who frequently progress to diabetes and are at increased risk for premature cardiovascular disease (1). Approximately 95% of adults with MetS are overweight or obese (2).MetS is also estimated to afflict 4 to 10% of adolescents (3, 4). Similar to adults, overweight children have greater degrees of metabolic dysfunction than normal-weight children, and such abnormalities appear to track over time and predict metabolic dysfunction and cardiovascular risk profiles in adulthood (5, 6). What This Study Adds to the FieldObesity and metabolic syndrome are prevalent in adolescents with modest sleep apnea. Associations of metabolic dysfunction with sleep apnea persisted after considering weight, suggesting that sleep apnea contributes to metabolic dysfunction in children.The rising prevalence of overweight among children and adolescents has been implicated in the 10-fold estimated increased rate of noninsulin diabetes in adolescents, and ha...

show abstract

Section: Discussionmentioning

confidence: 94%

Association between Metabolic Syndrome and Sleep-disordered Breathing in Adolescents

Redline¹,

Storfer‐Isser²,

Rosen³

et al. 2007

Am J Respir Crit Care Med

Self Cite

265

175

View full text Add to dashboard Cite

show abstract

“…8 Our study is in accordance with at least two recent studies. 32,33 In a study involving 1166 patients with OSA, Quintana-Gallego et al 32 found that women were older, more obese and had hypertension more frequently when compared with men. These results raise the possibility that women with sleep-disordered breathing are more vulnerable to related cardiovascular diseases than men.…”

Section: Discussionmentioning

confidence: 99%

“…These results raise the possibility that women with sleep-disordered breathing are more vulnerable to related cardiovascular diseases than men. For instance, Faulx et al 33 studied possible sex influences on endothelial function in 139 patients with OSA. The authors found that AHI was inversely associated with flow-mediated dilation and peak blood flow in women.…”

Section: Discussionmentioning

confidence: 99%

Phenotypic characteristics associated with hypertension in patients with obstructive sleep apnea

et al. 2006

View full text Add to dashboard Cite

Obstructive sleep apnea (OSA) causes secondary hypertension. However, the reasons why the prevalence of hypertension among OSA patients varies widely (35-70%) are not clear. We sought to investigate the phenotypic characteristics of patients with and without hypertension among OSA patients who were matched for disease severity. We studied 152 OSA patients (76 normotensive and 76 hypertensive) diagnosed by polysomnography. Detailed phenotypic characteristics, including laboratorial analysis, were determined in all patients. Univariate analysis followed by multiple logistic regression analysis was used to identify variables that were independently associated with hypertension. The apnea-hypopnea index in normotensive and hypertensive patients was similar (48726 and 48726 events/ h, respectively) as well as minimum arterial oxygen saturation (76710 and 75710%, respectively) and total sleep time with oxyhaemoglobin saturation o90% (25725 and 28726%, respectively). Hypertensive patients were older (57711 vs 47712 years; Po0.001), had a higher body mass index (BMI; 3477 vs 3075 kg/m 2 ; Po0.001), had a higher frequency of women (37 vs 8%; Po0.001), had a higher incidence of diabetes (25 vs 6%; P ¼ 0.002) and a higher family history of hypertension (75 vs 42%; P ¼ 0.01) than did the normotensive patients. Multiple logistic regression analysis indicated that age (P ¼ 0.004), familial history of hypertension (P ¼ 0.004), BMI (P ¼ 0.04) and female sex (P ¼ 0.03) were the independent variables associated with hypertension. We concluded that increasing age and BMI, familial history of hypertension as well as female gender are phenotypic characteristics associated with hypertension among OSA patients with similar disease severity.

show abstract

Section: Endothelial Dysfunctionmentioning

confidence: 99%

“…Faulx et al [11] have studied endothelial function by brachial artery ultrasonography in both genders with OSA and demonstrated that solely moderate-to-severe OSA women had impaired endothelial function when compared with men. On the contrary, no difference among moderate-to-severe OSA and mild-normal OSA men were observed [11]. More recently, another study enrolling middle-aged population found that OSA was associated with impaired vascular function (evaluated by digital peripheral arterial tonometry) only in women, independent of menopausal status [12].…”

Section: Endothelial Dysfunctionmentioning

confidence: 99%

Cardiovascular impact of obstructive sleep apnea: does gender matter?

Jenner

Lorenzi‐Filho

Drager

2014

Expert Review of Cardiovascular Therapy

View full text Add to dashboard Cite

Sex Influences Endothelial Function in Sleep-Disordered Breathing

Abstract: Moderate levels of SBD are associated with impaired conduit and resistance endothelial function in women. Women with SDB may be more vulnerable to early SDB-related cardiovascular disease than are men.

Cited by 114 publications

References 0 publications

Association between Metabolic Syndrome and Sleep-disordered Breathing in Adolescents

Association between Metabolic Syndrome and Sleep-disordered Breathing in Adolescents

Phenotypic characteristics associated with hypertension in patients with obstructive sleep apnea

Cardiovascular impact of obstructive sleep apnea: does gender matter?

Contact Info

Product

Resources

About