Obesity, obstructive sleep apnoea and metabolic syndrome

Respirology - Tập 17 Số 2 - Trang 223-236 - 2012
Jamie C.M. Lam1, Jcw Mak1, Msm Ip1
1Division of Respiratory Medicine, Department of Medicine, Queen Mary Hospital, The University of Hong Kong, Hong Kong.

Tóm tắt

ABSTRACTOSA is increasingly recognized as a major health problem in developed countries. Obesity is the most common risk factor in OSA and hence, the prevalence of OSA is undoubtedly rising given the epidemic of obesity. Recent data also suggest that OSA is highly associated with the metabolic syndrome, and it is postulated that OSA contributes to cardiometabolic dysfunction, and subsequently vasculopathy.Current evidence regarding the magnitude of impact on ultimate cardiovascular morbidity or mortality attributable to OSA‐induced metabolic dysregulation is scarce. Given the known pathophysiological triggers of intermittent hypoxia and sleep fragmentation in OSA, the potential mechanisms of OSA–obesity–metabolic syndrome interaction involve sympathetic activation, oxidative stress, inflammation and neurohumoral changes. There is accumulating evidence from human and animal/cell models of intermittent hypoxia to map out these mechanistic pathways.In spite of support for an independent role of OSA in the contribution towards metabolic dysfunction, a healthy diet and appropriate lifestyle modifications towards better control of metabolic function are equally important as CPAP treatment in the holistic management of OSA.

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Tài liệu tham khảo

CDC, 2005, State‐specific prevalence of obesity among adults—United States, MMWR Morb. Mortal. Wkly. Rep., 55, 985

10.1161/01.ATV.0000216787.85457.f3

10.1016/S0140-6736(09)60318-4

10.1016/j.ehj.2004.02.021

10.1016/j.rmed.2005.10.003

10.1056/NEJM199304293281704

10.1001/archinte.162.8.893

10.1146/annurev-med-050409-104056

Williams G, 2009, Obesity: Science and Practice, 10.1002/9780470712221

Obesity:preventing and managing the global epidemic. Report of a WHO consultation.World Health Organ Tech Resp Ser2000;894:i–xii 1–253.

10.1016/S0140-6736(03)15268-3

10.1161/HYPERTENSIONAHA.110.156596

10.1093/oxfordjournals.aje.a009158

10.2337/diab.37.12.1595

10.1001/jama.288.21.2709

10.2337/diabetes.51.10.3120

10.1093/aje/kwf145

10.1016/j.hlc.2010.12.005

10.1016/S0140-6736(05)66378-7

Lam JC, 2010, Sleep and the metabolic syndrome, Indian J. Med. Res., 131, 206

10.1016/j.ecl.2004.03.005

10.1056/NEJMoa031049

10.1161/CIRCULATIONAHA.105.169404

10.1038/oby.2006.278

Kissebath AH, 1997, Central obesity: measurement and metabolic effects, Diabet. Rev., 5, 8

10.1038/oby.2006.277

10.1513/pats.200708-137MG

10.1001/jama.284.23.3015

10.1001/archinte.165.20.2408

10.1097/00004872-199917090-00009

10.1152/ajpheart.2000.279.1.H234

10.1016/j.clnu.2008.10.006

10.1016/j.sleep.2004.03.004

10.1038/oby.2010.170

10.1093/sleep/33.8.1075

McClendon DA, 2010, An analysis of popular weight loss diet types in relation to metabolic syndrome therapeutic guidelines. Review, Medsurg Nurs., 19, 17

10.1016/j.surg.2006.08.012

10.1038/sj.ijo.0803363

10.1136/thx.2010.151613

10.1093/sleep/30.6.703

Phillips CL, 2009, Changes in regional adiposity and cardiometabolic function following a weight loss program with Sibutramine in obese men with obstructive sleep apnea, J. Clin. Sleep Med., 5, 416, 10.5664/jcsm.27595

10.1038/sj.ijo.0802960

10.1080/13813450802364627

10.1210/jc.83.6.1853

Grunstein RR, 1993, Snoring and sleep apnea in men: association with central obesity and hypertension, Int. J. Obes. Relat. Metab. Disord., 17, 533

10.1164/ajrccm.165.5.2201001b

10.1016/j.smrv.2005.01.006

10.1016/j.jaci.2005.02.023

10.1017/S0007114508971282

10.1038/nature05485

10.1161/01.RES.0000163635.62927.34

Lavie L, 2003, Obstructive sleep apnea syndrome‐an oxidative stress disorder, Sleep Med. Rev., 7, 33, 10.1053/smrv.2002.0261

10.1053/gast.2001.25540

10.1172/JCI200422422

10.1093/sleep/31.1.121

10.1186/1475-2840-5-22

10.5664/jcsm.26910

Nieto FJ, 2009, Sleep disordered breathing and metabolic syndrome, WMJ, 108, 263

10.1179/acb.2009.051

10.1111/j.1559-4572.2008.00046.x

10.1093/sleep/33.9.1193

10.2459/01.JCM.0000250873.01649.41

10.1016/j.rmed.2007.02.025

Tkacova R, 2008, Cardiovascular risk and insulin resistance in patients with obstructive sleep apnea, Med. Sci. Monit., 14, CR438

Papanas N, 2010, Predictors of obstructive sleep apnea in males with metabolic syndrome, Vasc. Health Risk Manag., 6, 281

10.1183/09031936.00050410

10.1183/09031936.00120510

10.1183/09031936.00198810

10.1291/hypres.29.315

10.1291/hypres.29.433

10.1111/j.1440-1843.2010.01818.x

10.2169/internalmedicine.47.0694

Wilcox I, 1998, ‘Syndrome Z’: the interaction of sleep apnea, vascular risk factors and heart disease, Thorax, 3, S25

10.1378/chest.06-1807

10.1164/rccm.200602-270OC

Sharma SK, 2010, Are metabolic syndrome, obstructive sleep apnea, syndrome Z sequential?—a hypothesis, Indian J. Med. Res., 131, 455

10.1016/j.atherosclerosis.2009.08.016

Mota PC, 2010, APAP impact on metabolic syndrome in obstructive sleep apnea patients, Sleep Breath.

10.1159/000243552

10.1164/ajrccm.165.7.2104126

10.1034/j.1399-3003.2000.16d13.x

10.1378/chest.127.5.1674

10.1378/chest.124.4.1386

10.1164/rccm.200905-0671OC

10.1002/jcp.21537

10.1152/physrev.00044.2005

10.1016/j.pcad.2008.08.003

10.1007/s00125-009-1616-0

10.1093/sleep/29.6.777

10.2337/diacare.26.3.702

10.1164/rccm.200504-637OC

10.1152/japplphysiol.91523.2008

10.1113/jphysiol.2003.048173

10.1164/rccm.200610-1527OC

10.1113/jphysiol.2007.143586

10.1111/j.1600-079X.2008.00662.x

10.1016/j.freeradbiomed.2008.11.026

10.1186/1476-5926-10-1

10.1152/japplphysiol.01081.2006

10.1152/physiolgenomics.00082.2007

10.1164/rccm.201012-2033OC

10.1164/rccm.200702-238OC

10.1164/rccm.200612-1771OC

10.1177/0884533609351532

10.1016/j.resp.2011.03.015

10.1089/met.2008.0093

10.1016/j.jsmc.2007.04.003

10.1152/japplphysiol.00492.2011

10.1016/j.resp.2006.06.004

10.1093/sleep/30.6.723

10.1007/s11325-007-0106-1

10.1007/s11325-005-0046-6

10.1161/CIRCULATIONAHA.105.556746

10.1016/j.bbrc.2006.03.015

10.1007/s10456-009-9131-y

Libby P, 2005, Inflammation and atheroslcerosis, Circulation, 105, 1135, 10.1161/hc0902.104353

10.1007/s00125-009-1486-5

10.1161/01.CIR.0000018948.95175.03

10.1093/sleep/30.8.991

10.1378/chest.08-1798

10.1378/chest.08-1431

10.1136/thx.2008.097931

10.2337/diabetes.51.6.1884

10.1016/j.bbrc.2004.08.145

10.1161/01.CIR.100.25.2473

10.1161/01.ATV.0000048856.22331.50

10.1001/jama.291.14.1730

10.1111/j.1365-2265.2005.02407.x

10.1038/oby.2005.24

10.1093/sleep/31.12.1721

10.1016/S0014-5793(01)02960-X

10.1089/met.2009.0019

10.1159/000227800

10.1136/thx.2006.074351

10.1055/s-2008-1078738

10.1378/chest.118.3.569

10.1056/NEJM199602013340503

10.1139/H08-079

10.1210/jcem.85.3.6484

10.1152/ajpheart.2000.279.1.H234

10.1378/chest.118.3.580

10.2169/internalmedicine.47.1035

10.1159/000086254

10.1136/thorax.57.5.429

10.1358/dnp.2005.18.7.939346

10.1161/hh0901.090975

10.1161/01.CIR.100.7.706

10.1183/09031936.03.00010103

10.1074/jbc.M413788200

10.1210/endo.141.9.7637

10.1097/00041433-200204000-00005

Furuhashi M, 2008, Adipocyte/macrophage fatty acid‐binding proteins contribute to metabolic deterioration through actions in both macrophages and adipocytes in mice, J. Clin. Invest., 118, 2640

10.1038/89076

10.1073/pnas.0602178103

10.1183/09031936.50075408

10.1016/j.ijcard.2010.04.027

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Respirology

Tập 17 Số 2

223-236

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