scholarly journals Maximal exercise capacity in patients with obstructive sleep apnoea syndrome: a systematic review and meta-analysis

2018 ◽  
Vol 51 (6) ◽  
pp. 1702697 ◽  
Author(s):  
Monique Mendelson ◽  
Mathieu Marillier ◽  
Sébastien Bailly ◽  
Patrice Flore ◽  
Jean-Christian Borel ◽  
...  

Maximal aerobic capacity is a strong health predictor and peak oxygen consumption (V′O2peak) is considered a reflection of total body health. No systematic reviews or meta-analyses to date have synthesised the existing data regardingV′O2peakin patients with obstructive sleep apnoea (OSA).A systematic review of English and French articles using PubMed/MEDLINE and Embase included studies assessingV′O2peakin OSA patients either in mL·kg−1·min−1compared with controls or in % predicted. Two independent reviewers analysed the studies, extracted the data and assessed the quality of evidence.MeanV′O2peakexpressed in mL·kg−1·min−1was significantly lower in patients with OSA than in controls (mean difference −2.7 mL·kg−1·min−1; p<0.001; n=850). This reduction inV′O2peakwas found to be larger in non-obese patients (body mass index <30 kg·m−2). MeanV′O2peak% pred was 89.9% in OSA patients (n=643).OSA patients have reduced maximal aerobic capacity, which can be associated with increased cardiovascular risks and reduced survival in certain patient subgroups. Maximal exercise testing can be useful to characterise functional limitation and to evaluate health status in OSA patients.

2014 ◽  
Vol 23 (3) ◽  
pp. 291-299 ◽  
Author(s):  
Giovanni Tarantino ◽  
Vincenzo Citro ◽  
Carmine Finelli

Non-alcoholic fatty liver disease (NAFLD) and obstructive sleep apnoea syndrome (OSAS) are common conditions, frequently encountered in patients with obesity and/or metabolic syndrome. NAFLD and OSAS are complex diseases that involve an interaction of several intertwined factors. Several lines of evidence lend credence to an immune system derangement in these patients, i.e. the low grade chronic inflammation status, reckoned to be the most important factor in causing and maintaining these two illnesses. Furthermore, it is emphasized the main role of spleen involvement, as a novel mechanism. In this review the contribution of the visceral adiposity in both NAFLD and OSAS is stressed as well as the role of intermittent hypoxia. Finally, a post on the prevention of systemic inflammation is made.Abbreviations: ALT: alanine aminotransferase; BMI: body mass index; CCR2: chemokine (C-C motif) receptor 2; CRP: C-reactive protein; CPAP: continuous positive airway pressure; FFA: free fatty acid; IGF-I: insulin-like growth factor; IR: insulin resistance; IL-6: interleukin-6; IH: intermittent hypoxia; IKK-β: IκB kinase β; LPS: lipopolysaccharide; MCP-1: monocyte chemoattractant protein-1; NAFLD: non-alcoholic fatty liver disease; NASH: nonalcoholic steatohepatitis; NEFA: non-esterified fatty acid; NF-κB: nuclear factor-κB; OSAS: obstructive sleep apnoea syndrome; PAI-1: plasminogen activator inhibitor-1; ROS: reactive oxygen species; TNF-α: tumor necrosis factor-α; T2D: type 2 diabetes.


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