title: Obstructive sleep apnoea and metabolic impairment in severe obesity.
abstract: Obstructive sleep apnoea (OSA) seems to worsen metabolism. This effect has not been evaluated in morbid obesity (MO). We hypothesised that the metabolic profile is more impaired in MO patients with OSA than in those without, and investigated whether any specific metabolic dysfunction is related to OSA in MO. A prospective multicentre cross-sectional study was conducted in consecutive subjects before bariatric surgery. OSA was defined as apnoea/hypopnoea index (AHI) ≥15 by overnight polysomnography. Anthropometrical, blood pressure (BP) and fasting blood measurements were obtained the morning after. Metabolic syndrome (MetS) was defined according to National Cholesterol Education Program Adult Treatment Panel III modified criteria. 159 patients were studied: 72% were female and 72% had OSA. MetS prevalence was 70% in OSA versus 36% in non-OSA (p<0.001). As AHI severity increased, metabolic parameters progressively worsened, even in those without type 2 diabetes (DM2). AHI was independently associated with systolic and diastolic BP, triglycerides and the percentage of glycosylated haemoglobin (HbA1c) in the total sample, and with systolic BP, high-density lipoprotein cholesterol and HbA1c in those samples without DM2. OSA increased the adjusted odds ratio of having MetS by 2.8 (95% CI 1.3-6.2; p=0.009). In MO, OSA is associated with major metabolic impairment caused by higher BP and poorer lipid and glucose control, independent of central obesity or DM2.
authors.affiliation: Sleep Unit, Dept of Respiratory Medicine, Hospital Universitari de Bellvitge, Hospitalet de Llobregat, Spain. mgasa@bellvitgehospital.cat
authors.forename: M
authors.initials: M
authors.lastname: Gasa
authors.forename: N
authors.initials: N
authors.lastname: Salord
authors.forename: A M
authors.initials: AM
authors.lastname: Fortuna
authors.forename: M
authors.initials: M
authors.lastname: Mayos
authors.forename: N
authors.initials: N
authors.lastname: Vilarrasa
authors.forename: J
authors.initials: J
authors.lastname: Dorca
authors.forename: J M
authors.initials: JM
authors.lastname: Montserrat
authors.forename: M R
authors.initials: MR
authors.lastname: Bonsignore
authors.forename: C
authors.initials: C
authors.lastname: Monasterio
mesh_terms: D000293:Adolescent; D000328:Adult; D001786:Blood Glucose / Q000032:analysis; D001794:Blood Pressure; D003924:Diabetes Mellitus, Type 2 / Q000150:complications; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D008055:Lipids / Q000097:blood; D008297:Male; D024821:Metabolic Syndrome / Q000150:complications*; D008875:Middle Aged; D009767:Obesity, Morbid / Q000150:complications* / Q000378:metabolism; D010100:Oxygen / Q000097:blood; D017286:Polysomnography; D020181:Sleep Apnea, Obstructive / Q000150:complications* / Q000503:physiopathology; D055815:Young Adult
chemical_list: D001786:Blood Glucose; D006442:Glycated Hemoglobin; D008055:Lipids; D010100:Oxygen