Consequences of obstructive sleep apnea on metabolic profile: A Population-Based Survey†

Published on Jun 14, 2012in Obesity 4.04
· DOI :10.1002/oby.20288
Sonia Maria Togeiro15
Estimated H-index: 15
(Federal University of São Paulo),
Glaucia Carneiro10
Estimated H-index: 10
(Federal University of São Paulo)
+ 5 AuthorsSérgio Tufik12
Estimated H-index: 12
(Federal University of São Paulo)
Abstract
Objective: Epidemiologic studies that control for potential confounders are needed to assess the independent associations of obstructive sleep apnea (OSA) with metabolic abnormalities. The aim of our study was to evaluate the associations of OSA with metabolic abnormalities among the adult population of Sao Paulo, Brazil. Design and Methods: Questionnaires were applied face-to-face, full night polysomnography (PSG) was performed, and blood samples were collected in a population-based survey in Sao Paulo, Brazil, adopting a probabilistic three-stage cluster sample method. The metabolic profile included fasting glucose, insulin, and lipid levels. The hepatic insulin resistance index was assessed by the homeostasis model assessment-estimated insulin resistance (HOMAIR). Results: A total of 1,042 volunteers underwent PSG. Mild OSA and moderate to severe OSA comprised 21.2% and 16.7% of the population, respectively. Subjects with severe to moderate OSA were older, more obese, had higher fasting glucose, HOMAIR, and triglycerides (TG) levels than did the mild and non-OSA group (P < 0.001). Multivariate regression analyses showed that an apnea-hypopnea index (AHI) ≥15 and a time of oxy-hemoglobin saturation <90% were independently associated with impaired fasting glucose, elevated TG, and HOMAIR. Conclusions: The results of this large cross-sectional epidemiological study showed that the associations of OSA and metabolic abnormalities were independent of other risk factors.
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  • Citations (47)
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References35
Published on Jan 1, 2002in Sleep 5.13
Allan Rechtschaffen41
Estimated H-index: 41
(University of Chicago),
Bernard M. Bergmann29
Estimated H-index: 29
(University of Chicago)
+ 2 AuthorsMarcia A. Gilliland12
Estimated H-index: 12
(University of Chicago)
343 Citations Source Cite
Nigel McArdle11
Estimated H-index: 11
,
David R. Hillman42
Estimated H-index: 42
+ 1 AuthorsWatts G.F.78
Estimated H-index: 78
Rationale: Obstructive sleep apnea (OSA) is reported to have a metabolic profile predisposing to cardiovascular disease. However, previous case-control studies have not adequately controlled for confounders.Objectives: To determine whether OSA is associated with increased insulin resistance and related metabolic risk factors.Methods: We performed a matched case-control study (n = 42) examining putative metabolic risks among men with OSA attending a sleep clinic (apnea–hypopnea index [AHI] > 15] ...
185 Citations Source Cite
Published on Oct 1, 2007in Journal of the American College of Cardiology 16.83
Andrew Cassar3
Estimated H-index: 3
(University of Rochester),
Timothy Ian Morgenthaler3
Estimated H-index: 3
(University of Rochester)
+ 2 AuthorsAmir Lerman17
Estimated H-index: 17
(University of Rochester)
Objectives Our purpose was to compare outcomes of patients treated for obstructive sleep apnea (OSA) versus patients with untreated OSA, all of whom had undergone percutaneous coronary intervention (PCI). Background Obstructive sleep apnea has been associated with increases in fatal and nonfatal cardiovascular events. It is not known whether treatment of OSA in patients who have had PCI results in a better outcome. Methods In a retrospective cohort study, a group of patients with OSA diagnosed w...
138 Citations Source Cite
Camila Guindalini11
Estimated H-index: 11
(King's College London),
Mark Howard10
Estimated H-index: 10
(King's)
+ 14 AuthorsTiffany A. Greenwood35
Estimated H-index: 35
The dopamine (DA) transporter DAT1 is a major target bound by cocaine in brain. We examined the influence of functional genetic variants in DAT1 on cocaine addiction. Repeat polymorphisms, including a 30-bp variable-number tandem repeat (VNTR) in intron 8 (Int8 VNTR) with two common alleles, were genotyped in cocaine-dependent abusers (n = 699) and in controls with no past history of drug abuse (n = 866) from Sao Paulo, Brazil. Positive association was observed with allele 3 of the Int8 VNTR and...
144 Citations Source Cite
Published on Mar 1, 2010in Diabetologia 6.02
Isao Muraki10
Estimated H-index: 10
(Osaka University),
Takeshi Tanigawa30
Estimated H-index: 30
(Ehime University)
+ 9 AuthorsTakashi Shimamoto39
Estimated H-index: 39
Aims/hypothesis Although the associations between obstructive sleep apnoea and type 2 diabetes mellitus have been reported in cross-sectional design studies, findings on the prospective association between the two conditions are limited. We examined prospectively the association between nocturnal intermittent hypoxia as a surrogate marker of obstructive sleep apnoea and risk of type 2 diabetes.
86 Citations Source Cite
Kevin J. Reichmuth8
Estimated H-index: 8
(University of Wisconsin-Madison),
Diane Austin11
Estimated H-index: 11
+ 1 AuthorsTerry Young69
Estimated H-index: 69
Rationale: Cross-sectional association has been reported between sleep-disordered breathing (SDB) and insulin resistance, but no prospective studies have been performed to determine whether SDB is causal in the development of diabetes.Objectives: The purpose of our study was to investigate the prevalence and incidence of type II diabetes in subjects with SDB and whether an independent relationship exists between them.Methods: A cross-sectional and longitudinal analysis was performed in 1,387 par...
524 Citations Source Cite
Published on May 1, 2006in Diabetes Research and Clinical Practice 2.55
Bruno Geloneze30
Estimated H-index: 30
,
EnricoM. Repetto3
Estimated H-index: 3
+ 2 AuthorsM.N. Ermetice1
Estimated H-index: 1
183 Citations Source Cite
Published on Jun 1, 2009in Sleep Medicine 3.40
Rogerio Santos-Silva16
Estimated H-index: 16
(Federal University of São Paulo),
Sergio Tufik53
Estimated H-index: 53
(Federal University of São Paulo)
+ 2 AuthorsLia Rita Azeredo Bittencourt32
Estimated H-index: 32
(Federal University of São Paulo)
Abstract Objectives To present the rational design, sampling, and procedures utilized in an Epidemiologic Sleep Study carried out in 2007 to establish the epidemiologic profile of sleep disorders in the adult population of a large metropolitan city, Sao Paulo, Brazil. Methods A population-based survey adopting a probabilistic three-stage cluster sample of Sao Paulo was used to represent the population according to gender, age (20–80 years), and socioeconomic class. Questionnaires, actigraphy, po...
71 Citations Source Cite
Published on Apr 1, 2001in Current Opinion in Cell Biology 10.02
Gregg L. Semenza142
Estimated H-index: 142
(Johns Hopkins University)
Abstract Hypoxia-inducible factor 1 (HIF-1) is an oxygen-regulated transcriptional activator that plays essential roles in mammalian development, physiology and disease pathogenesis. The HIF-1α subunit is subjected to oxygen-dependent ubiquitination and proteasomal degradation that is mediated by the von Hippel-Lindau protein. Interaction of HIF-1α transactivation domains with coactivators is induced by hypoxia. The signal transduction pathway remains enigmatic, but involves generation of reacti...
734 Citations Source Cite
Published on Dec 1, 2009in Sleep Medicine 3.40
Sergio Tufik31
Estimated H-index: 31
(Federal University of São Paulo),
Rogerio Santos-Silva16
Estimated H-index: 16
(Federal University of São Paulo)
+ 1 AuthorsLia Rita Azeredo Bittencourt32
Estimated H-index: 32
(Federal University of São Paulo)
Abstract Objective To estimate the prevalence of Obstructive Sleep Apnea Syndrome (OSAS), using current clinical and epidemiological techniques, among the adult population of Sao Paulo, Brazil. Methods This population-based survey used a probabilistic three-stage cluster sample of Sao Paulo inhabitants to represent the population according to gender, age (20–80years), and socio-economic status. Face-to-face interviews and in-lab full-night polysomnographies using a nasal cannula were performed. ...
426 Citations Source Cite
  • References (35)
  • Citations (47)
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Cited By47
Published on Aug 1, 2013in Journal of the American College of Cardiology 16.83
Luciano F. Drager36
Estimated H-index: 36
(University of São Paulo),
Sonia Maria Togeiro15
Estimated H-index: 15
(Federal University of São Paulo)
+ 1 AuthorsGeraldo Lorenzi-Filho37
Estimated H-index: 37
(University of São Paulo)
Obstructive 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...
240 Citations Source Cite
Published on Jan 1, 2015in The Korean journal of internal medicine
Dae Wui Yoon7
Estimated H-index: 7
(Korea University),
Jin Kwan Kim3
Estimated H-index: 3
,
Chol Shin38
Estimated H-index: 38
(Korea University)
Obstructive sleep apnea (OSA) is one of common sleep disorders in western countries, affecting 4% of males and 2% of females. It is characterized by repeated obstruction of the upper airway during sleep, leading to intermittent hypoxemia, sympathetic activation, and sleep fragmentation. OSA is an independent risk factor for a range of medical problems, including cardiovascular disease, diabetes, depression, and cognitive dysfunctions. The etiology of OSA is complex and incompletely understood, b...
1 Citations Source Cite
Published on May 1, 2016in Sleep and Breathing 2.03
Huajun Xu8
Estimated H-index: 8
(Shanghai Jiao Tong University),
Jian Guan13
Estimated H-index: 13
(Shanghai Jiao Tong University)
+ 10 AuthorsKaiming Su9
Estimated H-index: 9
(Shanghai Jiao Tong University)
Background Lipid metabolism disorder is recognized to be associated with obstructive sleep apnea (OSA); however, inconsistent results have been reported. The aim of this study was to evaluate the association between lipid profile and OSA with adjustments for multiple confounding factors.
14 Citations Source Cite
Published on Sep 1, 2015in Journal of Physiology and Biochemistry 2.74
Pedro González-Muniesa11
Estimated H-index: 11
(University of Navarra),
A. Lopez-Pascual1
Estimated H-index: 1
(University of Navarra)
+ 6 AuthorsJosé Antonio Mirallas Martínez2
Estimated H-index: 2
(University of Navarra)
Strategies designed to reduce adiposity and cardiovascular-accompanying manifestations have been based on nutritional interventions conjointly with physical activity programs. The aim of this 13-week study was to investigate the putative benefits associated to hypoxia plus exercise on weight loss and relevant metabolic and cardiorespiratory variables, when prescribed to obese subjects with sleep apnea syndrome following dietary advice. The participants were randomly distributed in the following ...
10 Citations Source Cite
Published on Apr 17, 2013in PLOS ONE 2.77
Luisa Gilardini13
Estimated H-index: 13
,
Carolina Lombardi24
Estimated H-index: 24
+ 5 AuthorsCecilia Invitti21
Estimated H-index: 21
Background The association of obstructive sleep apnea (OSA) with glucose intolerance and the beneficial effect of lifestyle intervention have been poorly investigated in women particularly before menopausal status. The study explored 1) whether OSA is associated with impaired glucose homeostasis in obese non diabetic premenopausal and menopausal women and 2) the effects of a 3- month lifestyle intervention on glucose homeostasis in OSA women.
7 Citations Source Cite
Published on Dec 1, 2012in Nature and Science of Sleep
Marie-Pierre St-Onge36
Estimated H-index: 36
(Columbia University),
Gary Zammit30
Estimated H-index: 30
+ 8 AuthorsF. Xavier Pi-Sunyer74
Estimated H-index: 74
(Columbia University)
Purpose: Some studies have found an association between sleep disturbances and metabolic risk, but none has examined this association in individuals with type 2 diabetes. The objective of this study was to determine the relationship between sleep disturbances and metabolic risk factors in obese patients with type 2 diabetes. Patients and methods: This study was a cross-sectional examination of the relationship between sleep parameters (apnea/hypopnea index [AHI], time spent in various sleep stag...
10 Citations Source Cite
Published on Nov 1, 2013in Current Opinion in Pulmonary Medicine 3.00
Abd A. Tahrani21
Estimated H-index: 21
,
Asad Ali7
Estimated H-index: 7
(University Hospitals Coventry and Warwickshire NHS Trust),
Martin J. Stevens26
Estimated H-index: 26
PURPOSE OF REVIEW The relationship between obstructive sleep apnoea (OSA) and dysglycaemia is well established. However, uncertainty remains as to the extent that obesity mediates this relationship. The impact of OSA treatment on glucose metabolism and the consequences of having OSA in patients with diabetes is unclear. This review aims to summarize the latest evidence regarding the links between OSA and dysglycaemia. RECENT FINDINGS OSA is associated with insulin resistance in lean individuals ...
28 Citations Source Cite
Published on Jan 1, 2012in Cardiovascular Diabetology 5.24
Aibek E. Mirrakhimov12
Estimated H-index: 12
(Kyrgyz State Medical Academy)
Chronic obstructive pulmonary disease, metabolic syndrome and diabetes mellitus are common and underdiagnosed medical conditions. It was predicted that chronic obstructive pulmonary disease will be the third leading cause of death worldwide by 2020. The healthcare burden of this disease is even greater if we consider the significant impact of chronic obstructive pulmonary disease on the cardiovascular morbidity and mortality.
50 Citations Source Cite
Published on Feb 1, 2015in Clinical Endocrinology 3.08
David Cl Lam1
Estimated H-index: 1
(University of Hong Kong),
Karen Sl L. Lam1
Estimated H-index: 1
(University of Hong Kong),
Mary Sm M. Ip1
Estimated H-index: 1
(University of Hong Kong)
Summary Obstructive sleep apnoea (OSA) is associated with multiple cardiometabolic abnormalities. Obesity is considered a major risk factor for the development of OSA, and it is also an established risk factor for insulin resistance and other cardiometabolic disorders. The enigma remains whether OSA has any causal role in the adverse metabolic profile, independent of or beyond that due to obesity. Sleep apnoeas and hypopnoeas result directly in intermittent hypoxaemia and cerebral arousals, both...
15 Citations Source Cite
Published on Dec 1, 2015in Journal of Human Hypertension 2.43
Carolina C. Gonzaga4
Estimated H-index: 4
,
Adriana Bertolami3
Estimated H-index: 3
+ 2 AuthorsDavid A. Calhoun46
Estimated H-index: 46
Obstructive sleep apnea (OSA) is characterized by recurrent episodes of partial (hypopnea) or complete interruption (apnea) inbreathing during sleep due to airway collapse in the pharyngeal region. OSA and its cardiovascular consequences have been widelyexplored in observational and prospective studies. Most evidence verifies the positive relationship between OSA and hypertension,coronary artery disease, atrial fibrillation, stroke and heart failure. However, more studies are needed to better asse...
39 Citations Source Cite