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Interações entre síndrome da apnéia obstrutiva do sono e resistência à insulina

Published on Oct 1, 2007in Arquivos Brasileiros De Endocrinologia E Metabologia
· DOI :10.1590/S0004-27302007000700003
Glaucia Carneiro11
Estimated H-index: 11
(UNIFESP: Federal University of São Paulo),
Fernando Flexa Ribeiro Filho8
Estimated H-index: 8
(UNIFESP: Federal University of São Paulo)
+ 2 AuthorsMaria Teresa Zanella19
Estimated H-index: 19
(UNIFESP: Federal University of São Paulo)
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Abstract
Previous studies have shown Obstructive Sleep Apnea (OSA) as a risk factor for development of cardiovascular and cerebrovascular disease. However, controversies remain as to whether these changes are consequences of the associated obesity or OSA itself results in endocrine and metabolic changes, including impairment of insulin sensitivity, growth hormone, secretion inflammatory cytokines alterations, activation of peripheral sympathetic activity, and hipothalamic-pituitary-adrenal (HPA) axis, that may predispose to vascular disease. Furthermore many cardiovascular risk factors, such as hypertension, obesity, insulin resistance and type 2 diabetes, are strongly associated with OSA. In this article, we will review the evidence and discuss possible mechanisms underlying these links and the pathophysiology of OSA morbidities.
  • References (43)
  • Citations (11)
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References43
Newest
Published on Feb 28, 2005in JAMA Internal Medicine 20.77
Ambika Babu3
Estimated H-index: 3
,
James Herdegen1
Estimated H-index: 1
+ 2 AuthorsTheodore Mazzone37
Estimated H-index: 37
Background: Sleep-disordered breathing (SDB) is a prevalent condition associated with significant comorbidities, including hypertension, obesity, cardiovascular disease, and insulin resistance. It has been previously shown that the severity of insulin resistance is related to the severity of SDB. Methods: Using a 72-hour continuous glucose monitoring system, we studied changes in interstitial glucose levels and measured hemoglobin A1c levels in 25 patients with type 2 diabetes mellitus before an...
365 Citations Source Cite
Published on Jan 1, 2005in Obesity Research
Robert Wolk30
Estimated H-index: 30
(Mayo Clinic),
Anna Svatikova17
Estimated H-index: 17
(Mayo Clinic)
+ 4 AuthorsVirend K. Somers96
Estimated H-index: 96
(Mayo Clinic)
Objective: Obstructive sleep apnea (OSA) is associated with obesity, sympathetic activation, systemic inflammation, and cardiovascular morbidity. Obesity, β-adrenergic agonists, and inflammation are linked to decreased expression and/or secretion of an adipose tissue-derived antiatherogenic hormone, adiponectin. The purpose of the study was to investigate whether OSA affected plasma levels of adiponectin, which might help explain OSA-associated cardiovascular morbidity. Research Methods and Proc...
75 Citations Source Cite
Published on Sep 15, 2004in American Journal of Epidemiology 4.47
Naresh M. Punjabi49
Estimated H-index: 49
(Johns Hopkins University),
Eyal Shahar72
Estimated H-index: 72
(UMN: University of Minnesota)
+ 3 AuthorsHelaine E. Resnick59
Estimated H-index: 59
(Memorial Hospital of South Bend)
Abstract Clinic-based studies suggest that sleep-disordered breathing (SDB) is associated with glucose intolerance and insulin resistance. However, in the available studies, researchers have not rigorously controlled for confounding variables to assess the independent relation between SDB and impaired glucose metabolism. The objective of this study was to determine whether SDB was associated with glucose intolerance and insulin resistance among community-dwelling subjects (n=2,656) participating...
756 Citations Source Cite
Published on Sep 1, 2004in The Journal of Clinical Endocrinology and Metabolism 5.61
Alexandros N. Vgontzas61
Estimated H-index: 61
,
Emmanuel Zoumakis14
Estimated H-index: 14
(NIH: National Institutes of Health)
+ 3 AuthorsGeorge P. Chrousos150
Estimated H-index: 150
(NIH: National Institutes of Health)
The proinflammatory cytokines, TNFα and IL-6, are elevated in obstructive sleep apnea (OSA) and have been proposed as mediators of excessive daytime sleepiness in humans. We tested the effects of etanercept, a medication that neutralizes TNFα and is approved by the FDA for the treatment of rheumatoid arthritis, in eight obese male apneics. These patients participated in a pilot, placebo-controlled, double-blind study during which nighttime polysomnography, multiple sleep latency test, and fastin...
262 Citations Source Cite
Published on Mar 1, 2004in Hypertension 7.02
Theodore L. Goodfriend30
Estimated H-index: 30
,
David A. Calhoun47
Estimated H-index: 47
Hypertension resistant to 2 antihypertensive drugs is more common among obese patients than among lean patients. The case we describe and the observations we report suggest that refractoriness among obese hypertensives is frequently caused by obstructive sleep apnea and/or inappropriately high plasma aldosterone levels. In other words, obese hypertensives may have sleep apnea, obese hypertensives without sleep apnea may have inappropriately elevated levels of plasma aldosterone, and a surprising...
233 Citations Source Cite
Published on Jan 1, 2004in Chinese Medical Journal 1.55
ZHANGXi-long9
Estimated H-index: 9
,
Kai-Sheng Yin5
Estimated H-index: 5
+ 2 AuthorsYu Yang3
Estimated H-index: 3
Background Adiponectin, secreted by adipocytes, has been found to be associated with diabetes, obesity and some cardiovascular diseases. Obstructive sleep apnea hypopnea syndrome (OSAHS) is also closely related to obesityand easily complicated with diabetes and some cardiovascular diseases. This study was carried out to explore the change of serum adiponectin level in patients with OSAHS. Methods Polysomnography was performed in 71 patients with OSAHS (OSAHS group) and 26 simple obese controls (...
22 Citations
Published on Jan 1, 2004in Clinical Endocrinology 2.90
Fabio Lanfranco26
Estimated H-index: 26
(UNITO: University of Turin),
L. Gianotti31
Estimated H-index: 31
(UNITO: University of Turin)
+ 6 AuthorsMauro Maccario38
Estimated H-index: 38
(UNITO: University of Turin)
Summary objective Obstructive sleep apnoea syndrome (OSAS) is strongly associated with obesity (OB) and is characterized by several changes in endocrine functions, e.g. GH/IGF-I axis, adrenal and thyroid activity. It is still unclear whether these alterations simply reflect overweight or include peculiar hypoxia-induced hormonal alterations. Hormonal evaluations have been generally performed in basal conditions but we have recently reported that OSAS is characterized by a more severe reduction o...
42 Citations Source Cite
Published on Oct 1, 2003in Biological Research For Nursing 1.51
Eileen R. Chasens21
Estimated H-index: 21
(UPenn: University of Pennsylvania),
Terri E. Weaver35
Estimated H-index: 35
(UPenn: University of Pennsylvania),
Mary Grace Umlauf17
Estimated H-index: 17
(UPenn: University of Pennsylvania)
The science of sleep is in early stages of development, and the biochemical consequences of obstructive sleep apnea (OSA) are slowly being identified. Only recently have investigators begun to identify the commonalities and interaction between OSA and insulin resistance, the underlying pathology of type 2 diabetes. Obesity and increasing age play important parts in the natural history of both conditions, which frequently coexist. The purpose of this article is, first, to examine the extent and s...
24 Citations Source Cite
Published on Oct 1, 2003in The Journal of Physiology
Vsevolod Y. Polotsky39
Estimated H-index: 39
(Johns Hopkins University),
Jianguo Li19
Estimated H-index: 19
(Johns Hopkins University)
+ 4 AuthorsChristopher P. O'Donnell37
Estimated H-index: 37
(Johns Hopkins University)
Obstructive sleep apnoea, a syndrome that leads to recurrent intermittent hypoxia, is associated with insulin resistance in obese individuals, but the mechanisms underlying this association remain unknown. We utilized a mouse model to examine the effects of intermittent hypoxia on insulin resistance in lean C57BL/6J mice and leptin-deficient obese (C57BL/6J−Lepob) mice. In lean mice, exposure to intermittent hypoxia for 5 days (short term) resulted in a decrease in fasting blood glucose levels (...
297 Citations Source Cite
Cited By11
Newest
Objetivo Investigar a inter-relacao entre proteina C-reativa de alta sensibilidade e hemoglobina glicada na predicao do risco de apneia obstrutiva do sono. Metodos Foram incluidos todos os individuos participantes do programa de check-up do Centro de Medicina Preventiva Hospital Israelita Albert Einstein em 2014. Foi aplicado o questionario de Berlin sobre risco de apneia do sono, e avaliadas as dosagens de hemoglobina glicada e proteina C-reativa de alta sensibilidade. Resultados Foram incluido...
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Paula Caitano Fontela3
Estimated H-index: 3
,
Eliane Roseli Winkelmann4
Estimated H-index: 4
+ 1 AuthorsEvelise Moraes Berlezi6
Estimated H-index: 6
Introduction Sleep respiratory disorders (SRDs) are often found in patients with type 2 diabetes mellitus (T2DM). Objective The aim was to establish the prevalence of risk to develop an SRD using the Clinical Berlin Questionnaire (CBQ) and Epworth Sleepiness Scale (ESS) in patients with T2DM and verifying the correlation of anthropometric measurements and life quality (LQ) with ESS. Methods A descriptive and analytical study of a case series evaluating 208 patients with T2DM, submitted to clinic...
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Published on Mar 1, 2014in Endocrine Practice 4.15
L. Tock7
Estimated H-index: 7
,
Glaucia Carneiro11
Estimated H-index: 11
+ 4 AuthorsMaria Tereza Zanella12
Estimated H-index: 12
Objective: Some studies have shown a higher prevalence of nonalcoholic fatty liver disease (NAFLD) and obstructive sleep apnea (OSA) in patients with polycystic ovary syndrome (PCOS). The objective of this study was to assess NAFLD in PCOS women with and without OSA. A possible role of high serum androgen levels in the development of OSA in PCOS women was also investigated.Methods: Biochemical, hormonal, and polysomnography parameters were determined in 38 premenopausal PCOS patients. NAFLD was ...
12 Citations Source Cite
Published on Dec 1, 2011in Otolaryngology-Head and Neck Surgery 2.31
Yuan Ping Xiong2
Estimated H-index: 2
(SJTU: Shanghai Jiao Tong University),
Hongliang Yi12
Estimated H-index: 12
(SJTU: Shanghai Jiao Tong University)
+ 6 AuthorsBin Chen5
Estimated H-index: 5
(SJTU: Shanghai Jiao Tong University)
Objectives. To investigate predictors of surgical outcomes of uvulopalatopharyngoplasty (UPPP) for obstructive sleep apnea hypopnea syndrome (OSAHS).Study Design. Case series with planned data collection.Setting. A university medical center.Subjects and Methods. Thirty-nine patients with OSAHS received Z-palatopharyngoplasty (ZPPP) or Han-uvulopalatopharyngoplasty (H-UPPP). All patients were evaluated within 3 months before surgery and at 6 to 12 months after surgery. Statistical analyses were c...
14 Citations Source Cite
Published on Apr 1, 2011
Laís Gomes de Araujo1
Estimated H-index: 1
(UFJF: Universidade Federal de Juiz de Fora),
Patrícia Rocha Coelho1
Estimated H-index: 1
(UFJF: Universidade Federal de Juiz de Fora),
Josemar Parreira Guimarães5
Estimated H-index: 5
(UFJF: Universidade Federal de Juiz de Fora)
Objective: To report the case of a patient with moderate OSAHS. Case relate: The present case concerns patient, 64 years old, with moderate carrier apnea syndrome and obstructive sleep hypopnea syndrome (OSAHS), presented to the ATM Service – Service of Diagnosis and Orientation for patients with temporomandibular disorders in the Faculty of Dentistry/UFJF with the following symptoms: sleepiness and daytime tiredness, snoring, insufficient night’s sleep, waking up several times at night, morning...
Published on Jan 31, 2011
Os efeitos de substâncias toxicas, mutagenicas e genotoxica sobre orgaos-alvos e o genoma de peixes tem sido objeto de muitos estudos, sobretudo daqueles que buscam estabelecer respostas destes orgaos e dos genes aos estimulos ambientais. Estudos histopatologicos, mutagenicos, genotoxicos e em Poecilia reticulata (Guppy) foram motivados pela escassez de dados na literatura referente aos efeitos provocados pela formulacao do herbicida Roundup Transorb®. Com tudo, pretendeu-se conhecer os efeitos ...
Published on Feb 1, 2009
Alex Pinheiro Gordia2
Estimated H-index: 2
(UFPR: Federal University of Paraná),
Teresa Maria Bianchini de Quadros9
Estimated H-index: 9
(UFSC: Universidade Federal de Santa Catarina)
+ 1 AuthorsEdio Luiz Petroski22
Estimated H-index: 22
(UFSC: Universidade Federal de Santa Catarina)
Objetivo Analisar as associacoes do Nivel de Atividade Fisica (NAF), consumo de alcool, Indice de Massa Corporal (IMC) e variaveis sociodemograficas com o dominio fisico da Qualidade de Vida (QV) de adolescentes. Metodos A amostra foi composta por 608 adolescentes com idades entre 14 e 20 anos, de ambos os sexos, regularmente matriculados na rede publica e particular do ensino medio do municipio da Lapa, Parana, Brasil. Foram investigadas variaveis referentes a QV dos adolescentes (dominio fisic...
15 Citations Source Cite