Hormonal status and the orexin system in obese patients with obstructive sleep apnea syndrome

The aim of research was to estimate the influence of hormone metabolism and sleep apnea on patients with obesity. 76 patients (37 males and 39 females) with obesity were included in this study. After night polysomnography all patients were divided in two groups comparableby age, sex ratio and BMI. The first group consisted of 41 patients with obstructive sleep apnea syndrome (OSAS), the second (controls) – 35 patients without breath disorders during sleep. OSAS is accompanied by the increase in urinary cortisol during the night, high levels ofbasal insulin, disturbances of hepatic production of IGF-1, dysfunction of the pituitary-gonadal axis. Our results show that sleep-related breathing disorders render markedly and negatively affect on hormonal parameters of patients with obesity. As a reliable difference of basalsecretion of orexin A in obese patients with and without OSAS was not revealed (42,0 [14; 99,5] vs. 18,0 [14,5; 124,5] pg/ml; р=0,9), we were not able to show the existence that the existence of OSAS is followed by any special changes of activity of the orexin system.

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Obstructive sleep apnea syndrome in non-obese patients

Sleep And Breathing ◽

10.1007/s11325-021-02412-1 ◽

2021 ◽

Author(s):

Caterina Antonaglia ◽

Giovanna Passuti

Keyword(s):

Obstructive Sleep Apnea ◽

Sleep Apnea ◽

Obstructive Sleep Apnea Syndrome ◽

Sleep Apnea Syndrome ◽

Obese Patients ◽

Obstructive Sleep ◽

Obese Subjects ◽

Apnea Syndrome ◽

Symptoms And Signs

AbstractObstructive sleep apnea syndrome (OSAS) is characterized by symptoms and signs of more than 5 apneas per hour (AHI) at polysomnography or 15 or more apneas per hour without symptoms. In this review, the focus will be a subgroup of patients: adult non-obese subjects with OSA and their specific features. In non-obese OSA patients (patients with BMI < 30 kg/m2), there are specific polysomnographic features which reflect specific pathophysiological traits. Previous authors identified an anatomical factor (cranial anatomical factors, retrognatia, etc.) in OSA non-obese. We have hypothesized that in this subgroup of patients, there could be a non-anatomical pathological prevalent trait. Little evidence exists regarding the role of low arousal threshold. This factor could explain the difficulty in treating OSA in non-obese patients and emphasizes the importance of a specific therapeutic approach for each patient.

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Evaluation of endothelial function and cardiovascular risk in non-obese patients with slight degree of obstructive sleep apnea syndrome

Monaldi Archives for Chest Disease ◽

10.4081/monaldi.2017.822 ◽

2017 ◽

Vol 87 (3) ◽

Author(s):

Fiorella Devito ◽

Annapaola Zito ◽

Silvano Dragonieri ◽

Pierluigi Carratù ◽

Vitaliano N. Quaranta ◽

...

Keyword(s):

Obstructive Sleep Apnea ◽

Cardiovascular Risk ◽

Sleep Apnea ◽

Endothelial Function ◽

Obstructive Sleep Apnea Syndrome ◽

Sleep Apnea Syndrome ◽

Intima Media Thickness ◽

Obese Patients ◽

Obstructive Sleep ◽

Apnea Syndrome

Recently, it has been clearly described an independent relationship between obstructive sleep apnea syndrome (OSAS) and cardiovascular risk, with underlying mechanisms also including endothelial dysfunction. We enrolled 32 consecutive non-obese patients (mean age of 39.5±11.5 years), of which 16 with mild OSAS and 16 snoring without OSAS. Mild OSAS is defined by an AHI index between 5 and 15. We have investigated if whether there was a relationship between mild OSAS, endothelial function and carotid intima-media thickness (C-IMT). The population was divided into two groups: Group 1 (16 simple snorer patients with an average age of 39.4±12.1 years) and Group 2 (16 subjects with mild OSAS with an average age of 39.6±11.2 years). Each group underwent cardiovascular investigation including measurement of flow-mediated dilation (FMD) of the brachial artery and C-IMT. Both groups comprised non-obese subjects. Patients with mild OSAS had serum total cholesterol values statistically significantly higher than simple snores patients (178.6±24.9 vs 159.2±25.3; p=0.038). OSAS patients had also a trend towards higher values of maximum C-IMT compared to simple snorer patients (0.70±0.15 vs 0.65±0.16), although below the level of significance. Between the two groups, no difference was found for FMD values. The present results on mild OSAS strengthen the importance of a diagnosis of OSAS as soon as possible, in order to encourage all primary prevention interventions to correct risk factors responsible for disease progression and the occurrence of cardiovascular diseases, not excluding the use of therapies of non-invasive ventilation even in the early stages of the disease.

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