Obstructive sleep apnea and dyslipidemia: evidence and underlying mechanism.
BACKGROUND
Over the past half century, evidence has been accumulating on the emergence of obstructive sleep apnea (OSA), the most prevalent sleep-disordered breathing, as a major risk factor for cardiovascular disease. A significant body of research has been focused on elucidating the complex interplay between OSA and cardiovascular risk factors, including dyslipidemia, obesity, hypertension, and diabetes mellitus that portend increased morbidity and mortality in susceptible individuals.


CONCLUSIONS
Although a clear causal relationship of OSA and dyslipidemia is yet to be demonstrated, there is increasing evidence that chronic intermittent hypoxia, a major component of OSA, is independently associated and possibly the root cause of the dyslipidemia via the generation of stearoyl-coenzyme A desaturase-1 and reactive oxygen species, peroxidation of lipids, and sympathetic system dysfunction. The aim of this review is to highlight the relationship between OSA and dyslipidemia in the development of atherosclerosis and present the pathophysiologic mechanisms linking its association to clinical disease. Issues relating to epidemiology, confounding factors, significant gaps in research and future directions are also discussed.
Department of Medicine, SUNY Downstate Medical Center (Box 1199), Brooklyn Health Disparities Center, 450 Clarkson Avenue, Brooklyn, NY, 11203-2098, USA.
Ajibola Monsur
AM
Adedayo
Oladipupo
O
Olafiranye
David
D
Smith
Alethea
A
Hill
Ferdinand
F
Zizi
Clinton
C
Brown
Girardin
G
Jean-Louis
D000818:Animals; D050197:Atherosclerosis / Q000503:physiopathology; D008076:Cholesterol, HDL / Q000097:blood; D015897:Comorbidity; D004195:Disease Models, Animal; D050171:Dyslipidemias / Q000175:diagnosis / Q000503:physiopathology*; D006801:Humans; D000860:Hypoxia / Q000175:diagnosis / Q000503:physiopathology; D015227:Lipid Peroxidation / Q000502:physiology; D018384:Oxidative Stress / Q000502:physiology; D051381:Rats; D017382:Reactive Oxygen Species / Q000378:metabolism; D012307:Risk Factors; D020181:Sleep Apnea, Obstructive / Q000175:diagnosis / Q000503:physiopathology*; D013230:Stearoyl-CoA Desaturase / Q000378:metabolism; D013564:Sympathetic Nervous System / Q000503:physiopathology
D008076:Cholesterol, HDL; D017382:Reactive Oxygen Species; D013230:Stearoyl-CoA Desaturase