Impact Of Obstructive Sleep Apnea On Metabolic Dysfunction In Severe Obesity

2011 ◽  
Author(s):  
Mercè Gasa ◽  
Neus Salord ◽  
Ana Maria Fortuna ◽  
Mercè Mayos ◽  
Nuria Vilarrasa ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Severe Obesity ◽  
Metabolic Dysfunction ◽  
Obstructive Sleep

scholarly journals Translational approaches to understanding metabolic dysfunction and cardiovascular consequences of obstructive sleep apnea

2015 ◽  
Vol 309 (7) ◽  
pp. H1101-H1111 ◽  
Author(s):  
Luciano F. Drager ◽  
Vsevolod Y. Polotsky ◽  
Christopher P. O'Donnell ◽  
Sergio L. Cravo ◽  
Geraldo Lorenzi-Filho ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Cardiovascular Risk ◽  
Sleep Apnea ◽  
Animal Models ◽  
Metabolic Dysfunction ◽  
Significant Progress ◽  
Glucose And Lipid Metabolism ◽  
Obstructive Sleep ◽  
Underlying Mechanisms ◽  
Made In

Obstructive sleep apnea (OSA) is known to be independently associated with several cardiovascular diseases including hypertension, myocardial infarction, and stroke. To determine how OSA can increase cardiovascular risk, animal models have been developed to explore the underlying mechanisms and the cellular and end-organ targets of the predominant pathophysiological disturbance in OSA–intermittent hypoxia. Despite several limitations in translating data from animal models to the clinical arena, significant progress has been made in our understanding of how OSA confers increased cardiovascular risk. It is clear now that the hypoxic stress associated with OSA can elicit a broad spectrum of pathological systemic events including sympathetic activation, systemic inflammation, impaired glucose and lipid metabolism, and endothelial dysfunction, among others. This review provides an update of the basic, clinical, and translational advances in our understanding of the metabolic dysfunction and cardiovascular consequences of OSA and highlights the most recent findings and perspectives in the field.

scholarly journals The Prevalence and Severity of Obstructive Sleep Apnea in Severe Obesity: The Impact of Ethnicity

2013 ◽  
Vol 09 (09) ◽  
pp. 853-858 ◽  
Author(s):  
Wen Bun Leong ◽  
Teresa Arora ◽  
David Jenkinson ◽  
Ajit Thomas ◽  
Vikas Punamiya ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Severe Obesity ◽  
Obstructive Sleep ◽  
The Impact

scholarly journals Effects of acute intermittent hypoxia on glucose metabolism in awake healthy volunteers

2009 ◽  
Vol 106 (5) ◽  
pp. 1538-1544 ◽  
Author(s):  
Mariam Louis ◽  
Naresh M. Punjabi
Keyword(s):  
Obstructive Sleep Apnea ◽  
Insulin Secretion ◽  
Sleep Apnea ◽  
Insulin Sensitivity ◽  
Glucose Metabolism ◽  
Healthy Volunteers ◽  
Intermittent Hypoxia ◽  
Metabolic Dysfunction ◽  
Glucose Effectiveness ◽  
Obstructive Sleep

Accumulating evidence suggests that obstructive sleep apnea is associated with alterations in glucose metabolism. Although the pathophysiology of metabolic dysfunction in obstructive sleep apnea is not well understood, studies of murine models indicate that intermittent hypoxemia has an important contribution. However, corroborating data on the metabolic effects of intermittent hypoxia on glucose metabolism in humans are not available. Thus the primary aim of this study was to characterize the acute effects of intermittent hypoxia on glucose metabolism. Thirteen healthy volunteers were subjected to 5 h of intermittent hypoxia or normoxia during wakefulness in a randomized order on two separate days. The intravenous glucose tolerance test (IVGTT) was used to assess insulin-dependent and insulin-independent measures of glucose disposal. The IVGTT data were analyzed using the minimal model to determine insulin sensitivity (SI) and glucose effectiveness (SG). Drops in oxyhemoglobin saturation were induced during wakefulness at an average rate of 24.3 events/h. Compared with the normoxia condition, intermittent hypoxia was associated with a decrease in SI [4.1 vs. 3.4 (mU/l)−1·min−1; P = 0.0179] and SG (1.9 vs. 1.3 min−1×10−2, P = 0.0065). Despite worsening insulin sensitivity with intermittent hypoxia, pancreatic insulin secretion was comparable between the two conditions. Heart rate variability analysis showed the intermittent hypoxia was associated with a shift in sympathovagal balance toward an increase in sympathetic nervous system activity. The average R-R interval on the electrocardiogram was 919.0 ms during the normoxia condition and 874.4 ms during the intermittent hypoxia condition ( P < 0.04). Serum cortisol levels after intermittent hypoxia and normoxia were similar. Hypoxic stress in obstructive sleep apnea may increase the predisposition for metabolic dysfunction by impairing insulin sensitivity, glucose effectiveness, and insulin secretion.

scholarly journals Obstructive Sleep Apnea, Insulin Resistance, and Steatohepatitis in Severe Obesity

2009 ◽  
Vol 179 (3) ◽  
pp. 228-234 ◽  
Author(s):  
Vsevolod Y. Polotsky ◽  
Susheel P. Patil ◽  
Vladimir Savransky ◽  
Alison Laffan ◽  
Shannon Fonti ◽  
...  
Keyword(s):  
Insulin Resistance ◽  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Severe Obesity ◽  
Obstructive Sleep

scholarly journals Metabolic dysfunction in obstructive sleep apnea: A critical examination of underlying mechanisms

2014 ◽  
Vol 13 (1) ◽  
pp. 2-17 ◽  
Author(s):  
Omar A Mesarwi ◽  
Ellora V Sharma ◽  
Jonathan C Jun ◽  
Vsevolod Y Polotsky
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Critical Examination ◽  
Metabolic Dysfunction ◽  
Obstructive Sleep ◽  
Underlying Mechanisms

scholarly journals Obstructive sleep apnea and pulmonary function in patients with severe obesity before and after bariatric surgery: a randomized clinical trial

2014 ◽  
Vol 9 ◽  
Author(s):  
Isabella C. Aguiar ◽  
Wilson R. Freitas jr. ◽  
Israel R. Santos ◽  
Nadua Apostolico ◽  
Sergio R. Nacif ◽  
...  
Keyword(s):  
Bariatric Surgery ◽  
Clinical Trial ◽  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Waist Circumference ◽  
Pulmonary Function ◽  
Randomized Clinical Trial ◽  
Severe Obesity ◽  
Obstructive Sleep ◽  
Before And After

Background: The increasing prevalence of obesity in both developed and developing countries is one of the most serious public health problems and has led to a global epidemic. Obesity is one of the greatest risk factors of obstructive sleep apnea (OSA), which is found in 60 to 70% of obese patients mainly due to the buildup of fat tissue in the upper portion of the thorax and neck. The aim of the present randomized clinical trial is to assess daytime sleepiness, sleep architecture and pulmonary function in patients with severe obesity before and after bariatric surgery. Methods: This randomized, controlled trial, was designed, conducted, and reported in accordance with the standards of The CONSORT (Consolidated Standards of Reporting Trials) Statement. Patients were divided into a bariatric surgery group and control group. The clinical evaluation was performed at the Sleep Laboratory of the Nove de JulhoUniversity (Sao Paulo, Brazil) and consisted of the collection of clinical data, weight, height, body mass index (BMI), measurements of neck and abdomen circumferences, spirometry, maximum ventilatory pressure measurements, standard overnight polysomnography (PSG) and the administration of the Berlin Questionnaire and Epworth Sleepiness Scale. Results: Fifty-two patients participated in the present study and performed PSG. Out of these, 16 underwent bariatric surgery. After surgery, mean BMI decreased from 48.15 ± 8.58 to 36.91 ± 6.67 Kg/m2. Significant differences were found between the preoperative and postoperative periods regarding neck (p < 0.001) and waist circumference (p < 0.001), maximum inspiratory pressure (p = 0.002 and p = 0.004) and maximum expiratory pressure (p = 0.001 and p = 0.002) for women and men, respectively, as well as sleep stage N3 (p < 0.001), REM sleep (p = 0.049) and the apnea-hypopnea index (p = 0.008). Conclusions: Bariatric surgery effectively reduces neck and waist circumference, increases maximum ventilatory pressures, enhances sleep architecture and reduces respiratory sleep disorders, specifically obstructive sleep apnea, in patients with severe obesity. Trial registration: The protocol for this study was registered with the World Health Organization (Universal Trial Number: U1111-1121-8873) and Brazilian Registry of Clinical Trials – ReBEC (RBR-9k9hhv).

scholarly journals The Potential Association between Obstructive Sleep Apnea and Diabetic Retinopathy in Severe Obesity—The Role of Hypoxemia

PLoS ONE ◽  
2013 ◽  
Vol 8 (11) ◽  
pp. e79521 ◽  
Author(s):  
Dev Banerjee ◽  
Wen Bun Leong ◽  
Teresa Arora ◽  
Melissa Nolen ◽  
Vikas Punamiya ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Diabetic Retinopathy ◽  
Sleep Apnea ◽  
Severe Obesity ◽  
Potential Association ◽  
Obstructive Sleep
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