Obstructive Sleep Apnea A Cardiometabolic Risk in Obesity and the Metabolic Syndrome

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dc.contributor.authorDrager, Luciano Ferreira
dc.contributor.authorTogeiro, Sonia Maria [UNIFESP]
dc.contributor.authorPolotsky, Vsevolod Y.
dc.contributor.authorLorenzi-Filho, Geraldo
dc.contributor.institutionUniversidade de São Paulo (USP)
dc.contributor.institutionUniversidade Federal de São Paulo (UNIFESP)
dc.contributor.institutionJohns Hopkins Univ
dc.date.accessioned2016-01-24T14:32:07Z
dc.date.available2016-01-24T14:32:07Z
dc.date.issued2013-08-13
dc.description.abstractObstructive sleep apnea (OSA) is an underdiagnosed condition characterized by recurrent episodes of obstruction of the upper airway leading to sleep fragmentation and intermittent hypoxia during sleep. Obesity predisposes to OSA, and the prevalence of OSA is increasing worldwide because of the ongoing epidemic of obesity. Recent evidence has shown that surrogate markers of cardiovascular risk, including sympathetic activation, systemic inflammation, and endothelial dysfunction, are significantly increased in obese patients with OSA versus those without OSA, suggesting that OSA is not simply an epiphenomenon of obesity. Moreover, findings from animal models and patients with OSA show that intermittent hypoxia exacerbates the metabolic dysfunction of obesity, augmenting insulin resistance and nonalcoholic fatty liver disease. in patients with the metabolic syndrome, the prevalence of moderate to severe OSA is very high (similar to 60%). in this population, OSA is independently associated with increased glucose and triglyceride levels as well as markers of inflammation, arterial stiffness, and atherosclerosis. A recent randomized, controlled, crossover study showed that effective treatment of OSA with continuous positive airway pressure for 3 months significantly reduced several components of the metabolic syndrome, including blood pressure, triglyceride levels, and visceral fat. Finally, several cohort studies have consistently shown that OSA is associated with increased cardiovascular mortality, independent of obesity. Taken together, these results support the concept that OSA exacerbates the cardiometabolic risk attributed to obesity and the metabolic syndrome. Recognition and treatment of OSA may decrease the cardiovascular risk in obese patients. (C) 2013 by the American College of Cardiology Foundationen
dc.description.affiliationUniv São Paulo, Sch Med, Heart Inst InCor, São Paulo, Brazil
dc.description.affiliationUniversidade Federal de São Paulo, Dept Psicobiol, Disciplina Med & Biol Sono, São Paulo, Brazil
dc.description.affiliationJohns Hopkins Univ, Sch Med, Dept Med, Div Pulm & Crit Care Med, Baltimore, MD 21205 USA
dc.description.affiliationUnifespUniversidade Federal de São Paulo, Dept Psicobiol, Disciplina Med & Biol Sono, São Paulo, Brazil
dc.description.sourceWeb of Science
dc.format.extent569-576
dc.identifierhttp://dx.doi.org/10.1016/j.jacc.2013.05.045
dc.identifier.citationJournal of the American College of Cardiology. New York: Elsevier B.V., v. 62, n. 7, p. 569-576, 2013.
dc.identifier.doi10.1016/j.jacc.2013.05.045
dc.identifier.fileWOS000323605200002.pdf
dc.identifier.issn0735-1097
dc.identifier.urihttp://repositorio.unifesp.br/handle/11600/36647
dc.identifier.wosWOS:000323605200002
dc.language.isoeng
dc.publisherElsevier B.V.
dc.relation.ispartofJournal of the American College of Cardiology
dc.rightsinfo:eu-repo/semantics/openAccess
dc.rights.licensehttp://www.elsevier.com/about/open-access/open-access-policies/article-posting-policy
dc.subjectcardiovascular risken
dc.subjectmetabolic syndromeen
dc.subjectobesityen
dc.subjectsleep apneaen
dc.titleObstructive Sleep Apnea A Cardiometabolic Risk in Obesity and the Metabolic Syndromeen
dc.typeinfo:eu-repo/semantics/article
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