title: Association between endothelial function (assessed on reactive hyperemia peripheral arterial tonometry) and obstructive sleep apnea, visceral fat accumulation, and serum adiponectin.
abstract: BACKGROUND
  Visceral obesity, low adiponectin, and severe obstructive sleep apnea (OSA) are associated with cardiovascular diseases, but the interactions among these factors on endothelial dysfunction are not well known.
  
  
  RESULTS
  Endothelial function in 133 patients after polysomnography was evaluated as reactive hyperemia index (RHI) on reactive hyperemia peripheral arterial tonometry. Visceral obesity was defined as visceral fat area ≥100 cm(2)on computed tomography. RHI was significantly correlated with apnea hypopnea index (AHI), visceral fat area, and serum adiponectin (r=-0.24, P=0.0055, r=-0.19, P=0.031, and r=0.20, P=0.019, respectively). RHI in patients with visceral obesity was significantly decreased in the presence of severe OSA (AHI ≥30; P=0.042). On multivariate regression analysis, only severe OSA remained as an independent predictive factor of RHI (P=0.024, R(2)=5.4%). RHI in patients with severe OSA (n=44) was significantly improved after 3 months of continuous positive airway pressure (CPAP) treatment (1.78±0.40 before CPAP vs. 2.00±0.53 after CPAP, P=0.013), similarly to those with AHI <30 (P=0.45).
  
  
  CONCLUSIONS
  Severe OSA, but not visceral fat area or serum adiponectin, was independently associated with endothelial function according to RHI. In addition, impaired endothelial function was reversible following 3 months of CPAP treatment.
authors: Department of Respiratory Medicine, Graduate School of Medicine, Kyoto University.
authors: Masanori
authors: M
authors: Azuma
authors: Yuichi
authors: Y
authors: Chihara
authors: Chikara
authors: C
authors: Yoshimura
authors: Kimihiko
authors: K
authors: Murase
authors: Satoshi
authors: S
authors: Hamada
authors: Ryo
authors: R
authors: Tachikawa
authors: Takeshi
authors: T
authors: Matsumoto
authors: Morito
authors: M
authors: Inouchi
authors: Kiminobu
authors: K
authors: Tanizawa
authors: Tomohiro
authors: T
authors: Handa
authors: Toru
authors: T
authors: Oga
authors: Michiaki
authors: M
authors: Mishima
authors: Kazuo
authors: K
authors: Chin
mesh_terms: D052242:Adiponectin / Q000097:blood*; D000328:Adult; D000368:Aged; D015897:Comorbidity; D045422:Continuous Positive Airway Pressure; D050171:Dyslipidemias / Q000453:epidemiology; D004730:Endothelium, Vascular / Q000503:physiopathology*; D005260:Female; D006801:Humans; D006940:Hyperemia / Q000503:physiopathology; D006943:Hyperglycemia / Q000453:epidemiology; D006973:Hypertension / Q000453:epidemiology; D050152:Intra-Abdominal Fat / Q000000981:diagnostic imaging; D008297:Male; D008365:Manometry; D024821:Metabolic Syndrome / Q000453:epidemiology; D008875:Middle Aged; D061330:Multidetector Computed Tomography; D017286:Polysomnography; D012307:Risk Factors; D020181:Sleep Apnea, Obstructive / Q000503:physiopathology* / Q000628:therapy; D050151:Subcutaneous Fat / Q000000981:diagnostic imaging; D016896:Treatment Outcome
chemical_list: C499918:ADIPOQ protein, human; D052242:Adiponectin