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The impact of obstructive sleep apnea on metabolic and inflammatory markers in consecutive patients with metabolic syndrome.

AbstractBACKGROUND:
Obstructive Sleep Apnea (OSA) is tightly linked to some components of Metabolic Syndrome (MetS). However, most of the evidence evaluated individual components of the MetS or patients with a diagnosis of OSA that were referred for sleep studies due to sleep complaints. Therefore, it is not clear whether OSA exacerbates the metabolic abnormalities in a representative sample of patients with MetS.
METHODOLOGY/PRINCIPAL FINDINGS:
We studied 152 consecutive patients (age 48+/-9 years, body mass index 32.3+/-3.4 Kg/m2) newly diagnosed with MetS (Adult Treatment Panel III). All participants underwent standard polysomnography irrespective of sleep complaints, and laboratory measurements (glucose, lipid profile, uric acid and C-reactive protein). The prevalence of OSA (apnea-hypopnea index>or=15 events per hour of sleep) was 60.5%. Patients with OSA exhibited significantly higher levels of blood pressure, glucose, triglycerides, cholesterol, LDL, cholesterol/HDL ratio, triglycerides/HDL ratio, uric acid and C-reactive protein than patients without OSA. OSA was independently associated with 2 MetS criteria: triglycerides: OR: 3.26 (1.47-7.21) and glucose: OR: 2.31 (1.12-4.80). OSA was also independently associated with increased cholesterol/HDL ratio: OR: 2.38 (1.08-5.24), uric acid: OR: 4.19 (1.70-10.35) and C-reactive protein: OR: 6.10 (2.64-14.11). Indices of sleep apnea severity, apnea-hypopnea index and minimum oxygen saturation, were independently associated with increased levels of triglycerides, glucose as well as cholesterol/HDL ratio, uric acid and C-reactive protein. Excessive daytime sleepiness had no effect on the metabolic and inflammatory parameters.
CONCLUSIONS/SIGNIFICANCE:
Unrecognized OSA is common in consecutive patients with MetS. OSA may contribute to metabolic dysregulation and systemic inflammation in patients with MetS, regardless of symptoms of daytime sleepiness.
AuthorsLuciano F Drager, Heno F Lopes, Cristiane Maki-Nunes, Ivani C Trombetta, Edgar Toschi-Dias, Maria Janieire N N Alves, Raffael F Fraga, Jonathan C Jun, Carlos E Negrão, Eduardo M Krieger, Vsevolod Y Polotsky, Geraldo Lorenzi-Filho
JournalPloS one (PLoS One) Vol. 5 Issue 8 Pg. e12065 (Aug 11 2010) ISSN: 1932-6203 [Electronic] United States
PMID20711453 (Publication Type: Journal Article, Research Support, N.I.H., Extramural, Research Support, Non-U.S. Gov't, Research Support, U.S. Gov't, Non-P.H.S.)
Chemical References
  • Biomarkers
Topics
  • Biomarkers (metabolism)
  • Humans
  • Inflammation (metabolism)
  • Linear Models
  • Logistic Models
  • Male
  • Metabolic Syndrome (complications, metabolism)
  • Middle Aged
  • Multivariate Analysis
  • Risk
  • Sleep Apnea, Obstructive (complications)

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