The association of OSA with insulin resistance, inflammation and metabolic syndrome

Peled, Nir; Kassirer, Michael; Shitrit, David; Kogan, Yivgeny; Shlomi, Dekel; Berliner, Abraham S.; Kramer, Mordechai R.

doi:10.1016/j.rmed.2007.02.025

Cited by 108 publications

(83 citation statements)

References 37 publications

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“…Similar data have been obtained in samples of OSA patients (tables 3 and 4) [64][65][66][67][68][69][70][71][72][73][74][75][76][77][78][79][80], with a large prevalence of positive [63,[64][65][66][67][68][69][70][71][72][73][74][75][76][77][78][79] rather than negative [78][79][80] studies. In clinical populations, OSA patients characterised by full-PSG were significantly more likely to have impaired glucose tolerance (IGT) and diabetes than subjects free of OSA syndrome (OSAS) [71].…”

Section: Physiological and Clinical Datasupporting

confidence: 74%

Sleep, sleep-disordered breathing and metabolic consequences

Lévy¹,

Bonsignore²,

Eckel³

2009

European Respiratory Journal

293

187

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Sleep profoundly affects metabolic pathways. In healthy subjects, experimental sleep restriction caused insulin resistance (IR) and increased evening cortisol and sympathetic activation. Increased obesity in subjects reporting short sleep duration leads to speculation that, during recent decades, decreased sleeping time in the general population may have contributed to the increasing prevalence of obesity. Causal inference is difficult due to lack of control for confounders and inconsistent evidence of temporal sequence.In the general population, obstructive sleep apnoea (OSA) is associated with glucose intolerance. OSA severity is also associated with the degree of IR. However, OSA at baseline does not seem to significantly predict the development of diabetes. Prevalence of the metabolic syndrome is higher in patients with OSA than in obese subjects without OSA. Treatment with continuous positive airway pressure seems to improve glucose metabolism both in diabetic and nondiabetic OSA but mainly in nonobese subjects.The relative role of obesity and OSA in the pathogenesis of metabolic alterations is still unclear and is intensively studied in clinical and experimental models. In the intermittent hypoxia model in rodents, strong interactions are likely to occur between haemodynamic alterations, systemic inflammation and metabolic changes, modulated by genetic background. Molecular and cellular mechanisms are currently being investigated.

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Section: Physiological and Clinical Datasupporting

confidence: 74%

Sleep, sleep-disordered breathing and metabolic consequences

Lévy¹,

Bonsignore²,

Eckel³

2009

European Respiratory Journal

293

187

View full text Add to dashboard Cite

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“…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%

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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“…2,3 OSAS has been shown to increase the risk of hypertension, stroke, and cardiovascular disease. [4][5][6] In addition, clinical studies have reported that OSAS increases morbidity from crashes caused by daytime somnolence, and have focused on the diagnosis, treatment, and prevention of OSAS. 2 Obesity, male sex, older age, alcohol use, genetic factors, and a narrowed upper airway are well-known risk factors for OSAS, and smoking may be a risk factor for sleep apnea or snoring.…”

Section: S C I E N T I F I C I N V E S T I G a T I O N Smentioning

confidence: 99%

Smoking Induces Oropharyngeal Narrowing and Increases the Severity of Obstructive Sleep Apnea Syndrome

Kim

Kim²,

Park

et al. 2012

Journal of Clinical Sleep Medicine

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anatomic factor for OSAS. [11][12][13] Pathological conditions such as a redundant or long uvula and enlarged tonsils are thought to be the predominant causes of upper airway collapse during sleep and are indications for surgery to decrease snoring, apnea, and snoring-related cardinal symptoms. The upper airway mucosa can be easily affected by smoking, and longer exposure to smoking may cause abnormal histological changes to the upper airway mucosa. Therefore, evaluation of the uvular changes after exposure to smoking is important for understanding how smoking directly affects the uvular mucosa.This study was designed to determine the relationship between smoking and OSAS. We reviewed the sleep studies of smokers and nonsmokers who were diagnosed with OSAS to Objective: Smoking is a known risk factor for snoring, and is reported to be associated with an increased prevalence of obstructive sleep apnea syndrome (OSAS). The purpose of this was to determine the relationship of smoking to the severity of OSAS and examine what local histological changes in the uvular mucosa of OSAS patients might infl uence this relationship. Study Design and Methods: Fifty-seven OSAS subjects were included and classifi ed according to smoking history and OSAS severity. Twenty-eight subjects were heavy smokers and 29 were nonsmokers; these 57 patients were divided according to moderate or severe OSAS. Histologic changes in the uvular mucosa were evaluated in all subjects as well as smoking duration and OSAS severity. Results: Among smokers, moderate-to-severe OSAS was more common, and apnea, hypopnea, and oxygen desaturation indices were higher. Moreover, smoking duration and OSAS severity were signifi cantly correlated. Increased thickness and edema of the uvular mucosa lamina propria were observed in moderate and severe OSAS patients, and only smokers had signifi cant changes in uvular mucosa histology. Positive staining for calcitonin gene-related peptide (CGRP), a neuroinfl ammatory marker for peripheral nerves, was increased in the uvular mucosa of smokers. Conclusions: Our results suggest that smoking may worsen OSAS through exacerbation of upper airway collapse at the level of the uvula, and that histological changes of the uvular mucosa correlated with smoking might be due to increased CGRP-related neurogenic infl ammation. S C I E N T I F I C I N V E S T I G A T I O N SO bstructive sleep apnea syndrome (OSAS) is a complex, chronic disorder characterized by snoring, periodic apnea, hypoxemia during sleep, and daytime hypersomnolence.1 Its prevalence is 16% to 33% in men and 8% to 19% in women. 2,3 OSAS has been shown to increase the risk of hypertension, stroke, and cardiovascular disease. [4][5][6] In addition, clinical studies have reported that OSAS increases morbidity from crashes caused by daytime somnolence, and have focused on the diagnosis, treatment, and prevention of OSAS. Obesity, male sex, older age, alcohol use, genetic factors, and a narrowed upper airway are well-known risk factors for OSAS, and smoking may be ...

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The association of OSA with insulin resistance, inflammation and metabolic syndrome

Cited by 108 publications

References 37 publications

Sleep, sleep-disordered breathing and metabolic consequences

Sleep, sleep-disordered breathing and metabolic consequences

Sleep apnoea and metabolic dysfunction

Smoking Induces Oropharyngeal Narrowing and Increases the Severity of Obstructive Sleep Apnea Syndrome

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