Relationship between the cardiometabolic syndrome and obstructive sleep apnea.
Obstructive sleep apnea (OSA), characterized by cessation of air flow for a minimum of 10 seconds despite continuous respiratory effort, is a prevalent condition in our society. Recent studies demonstrate that OSA is an independent risk factor for insulin resistance and the cardiometabolic syndrome. Hypoxemia and sleep fragmentation from OSA appear to produce autonomic activation, alterations in neuroendocrine function, and increased amounts of inflammatory cytokines (interleukin 6 and tumor necrosis factor alpha). These variables have important roles in the pathogenesis of insulin resistance and the cardiometabolic syndrome. It can be concluded that insulin sensitivity, a key contributor to the pathogenesis of the cardiometabolic syndrome, is mainly determined by the extent of obesity and, to a lesser extent, by OSA. The authors review OSA and summarize recent discoveries and proposed mechanisms of the causal relationship that OSA has with insulin resistance and the cardiometabolic syndrome independent of many confounding comorbidities.
University of Missouri School of Medicine, Columbia, MO, USA.
Steven R
SR
Schuster
Maher
M
Tabba
Pradeep
P
Sahota
D001341:Autonomic Nervous System / Q000503:physiopathology; D045422:Continuous Positive Airway Pressure; D005947:Glucose / Q000378:metabolism; D006801:Humans; D007333:Insulin Resistance; D015850:Interleukin-6 / Q000378:metabolism; D024821:Metabolic Syndrome / Q000209:etiology* / Q000378:metabolism / Q000503:physiopathology; D012307:Risk Factors; D020181:Sleep Apnea, Obstructive / Q000150:complications* / Q000378:metabolism / Q000503:physiopathology / Q000628:therapy; D014409:Tumor Necrosis Factor-alpha / Q000378:metabolism
C508600:IL6 protein, human; D015850:Interleukin-6; D014409:Tumor Necrosis Factor-alpha; D005947:Glucose