Neuroendocrine alterations in obese patients with sleep apnea syndrome
Open accessAbstract
Obstructive sleep apnea syndrome (OSAS) is a serious, prevalent condition that has significant morbidity and mortality when untreated. It is strongly associated with obesity and is characterized by changes in the serum levels or secretory patterns of several hormones. Obese patients with OSAS show a reduction of both spontaneous and stimulated growth hormone (GH) secretion coupled to reduced insulin-like growth factor-I (IGF-I) concentrations and impaired peripheral sensitivity to GH. Hypoxemia and chronic sleep fragmentation could affect the sleep-entrained prolactin (PRL) rhythm. A disrupted Hypothalamus-Pituitary-Adrenal (HPA) axis activity has been described in OSAS. Some derangement in Thyroid-Stimulating Hormone (TSH) secretion has been demonstrated by some authors, whereas a normal thyroid activity has been described by others. Changes of gonadal axis are common in patients with OSAS, who frequently show a hypogonadotropic hypogonadism. Altogether, hormonal abnormalities may be considered as adaptive changes which indicate how a local upper airway dysfunction induces systemic consequences. The understanding of the complex interactions between hormones and OSAS may allow a multi-disciplinary approach to obese patients with this disturbance and lead to an effective management that improves quality of life and prevents associated morbidity or death.
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Obese patients with OSAS show alterations in GH/IGF-I axis function, PRL secretion, HPA axis and gonadal axis activity.
“Obese patients with OSAS show alterations in the GH/IGF-I axis function, PRL secretion, HPA axis and gonadal axis activity.”
From Sleep apnea syndrome and hypothyroidism (2013) · cites this paper as [6]
Sections 3.1, 3.3 and 3.5 describe altered GH/IGF-I, HPA-axis and gonadal-axis activity in obese patients with OSAS. Section 3.2 says findings on PRL secretion conflict: some studies report altered PRL pulse frequency, while the authors found similar PRL measures in obese patients with and without OSAS. The unqualified claim of altered PRL secretion is therefore stronger than the review supports. (LLM, conf=0.86)
Experimental — accuracy not yet measuredOSAS is strongly associated with obesity and is characterized by endocrine and metabolic abnormalities that are frequently more marked than those in obese patients without OSAS, suggesting that factors other than obesity per se have a role in this clinical condition.
“It is strongly associated with obesity and is characterized by several endocrine and metabolic abnormalities that are frequently more marked than those in obese patients without OSAS, suggesting that factors other than obesity per se have a role in this clinical condition [6].”
From Sleep apnea syndrome and hypothyroidism (2013) · cites this paper as [6]
Some derangement in TSH secretion in obesity with or without OSAS has been demonstrated by some authors, whereas normal thyroid activity has been described by others.
“Some derangement in TSH secretion in obesity with or without OSAS has been demonstrated by some authors, whereas a normal thyroid activity has been described by others [5,6].”
From Sleep apnea syndrome and hypothyroidism (2013) · cites this paper as [6]
OSA is linked with increased risk of developing diabetes mellitus due to deregulation of glucose metabolism and alteration in the hypothalamic-pituitary adrenal axis.
“OSA has been linked with increased risk of developing DM due to deregulation of glucose metabolism and alteration in the hypothalamic –pituitary adrenal axis (HPA) axis(103, 104).”
From Sleep: important considerations for the prevention of cardiovascular disease (2016) · cites this paper as [104]
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- Authors
- Lanfranco, F., Motta, G., Minetto, M. A., Baldi, M., Balbo, M., Ghigo, E., Arvat, E., & Maccario, M.
- Affiliations
- University of Turin (IT)
- Corresponding author
- Lanfranco, Fabio
- ORCID
- Venue
- International Journal of Endocrinology
- Publisher
- Wiley
- Published
- 2010
- Volume
- 2010
- Pages
- 1-11
- ISSN
- 1687-8337 (ISSN-L)
- 1687-8345
- PMC
- PMC2826879
- OpenAlex
- W2094648479
- Cited by
- 78
- References
- 129
- Citations by year
- 2026: 3 · 2025: 6 · 2024: 1 · 2023: 3 · 2022: 4 · 2021: 3 · 2020: 5 · 2019: 4 · 2018: 5 · 2017: 6 · 2016: 6 · 2015: 9 · 2014: 4 · 2013: 4 · 2012: 7
- FWCI
- 4.11
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Locations
- International Journal of Endocrinology (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Institutional Research Information System University of Turin (University of Turin) (submittedVersion)
- Topics
- Health Sciences › Medicine › Physiology › Obstructive Sleep Apnea Research
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Growth Hormone and Insulin-like Growth Factors
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Pituitary Gland Disorders and Treatments
- Keywords
- obstructive sleep apnea, obesity, neuroendocrine changes, growth hormone secretion, insulin-like growth factor I, hypoxemia, sleep fragmentation, hypothalamic-pituitary-adrenal axis, thyroid-stimulating hormone, gonadal axis, hypogonadotropic hypogonadism, hormone resistance
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