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Obstructive Sleep Apnea and Metabolic Syndrome: Alterations in Glucose Metabolism and Inflammation
Abstract
Metabolic syndrome (MS), the commonly used term for the clustering of obesity, insulin resistance, hypertension, and dyslipidemia, affects millions of people worldwide, and is associated with an increased risk of cardiovascular disease and type 2 diabetes. Recently, it has been suggested that obstructive sleep apnea (OSA), an increasingly prevalent condition, may contribute to the development of MS and diabetes. Despite substantial evidence from both clinical and population studies to suggest an independent link between OSA and metabolic abnormalities, the issue still remains controversial. Obesity, particularly visceral obesity, is an important factor in the assessment of adverse metabolic outcome in OSA. Further prospective and interventional studies, with adequate sample sizes and longer follow-up, rigorous control for adiposity, and, ideally, randomization and control for any therapeutic intervention, are clearly needed to address the direction of causality. There are multiple mechanistic pathways involved in the interaction between OSA, obesity, and metabolic derangements. Chronic intermittent hypoxia and sleep fragmentation with sleep loss in OSA are likely key triggers that initiate or contribute to the sustenance of inflammation as a prominent phenomenon, but their complex interplay remains to be elucidated. In summary, OSA may represent a novel risk factor for MS and diabetes, and thus clinicians should be encouraged to systematically evaluate the presence of metabolic abnormalities in OSA and vice versa.
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“It is now well-documented that OSA, independently of age, sex, BMI, and other confounders, is associated with glucose intolerance, insulin resistance, and diabetes (for review, see [175, 177]).”
From Sleep and metabolic function (2012) · cites this paper as [175]
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The sleep apnea cardiovascular endpoints (SAVE) trial: Rationale and start-up phase.
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The Sleep Apnea cardioVascular Endpoints (SAVE) Trial: Rationale, Ethics, Design, and Progress
Antic, N. A., Heeley, E. L., Anderson, C. S., Luo, Y., Wang, J., Neal, B. C., Grunstein, R. R., Barbé, F., Lorenzi‐Filho, G., Huang, S., et al. (2015) · SLEEP · doi:10.5665/sleep.4902 · Cited by 48
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Cardiovascular and metabolic comorbidities in patients with obstructive sleep apnoea syndrome.
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Mild Maternal Obstructive Sleep Apnea in Non-obese Pregnant Women and Accelerated Fetal Growth
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Morning headache in habitual snorers: Frequency, characteristics, predictors and impacts
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Estimating sleep from multisensory armband measurements: validity and reliability in teens
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Cardiovascular disease risk reduction with sleep apnea treatment
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Metadata
- Authors
- Tasali, E., & Ip, M. S. M.
- Affiliations
- University of Chicago (US)
- Department of Medicine, Queen Mary Hospital, University of Hong Kong, Pokfulam, Hong Kong Special Administrative Region, People's Republic of China
- ORCID
- Tasali, Esra
- Venue
- Proceedings of the American Thoracic Society
- Publisher
- Oxford University Press (OUP)
- Published
- 2008-02
- Volume
- 5
- Issue
- 2
- Pages
- 207-217
- ISSN
- 1546-3222 (ISSN-L)
- 1943-5665
- OpenAlex
- W1972056446
- Cited by
- 365
- References
- 136
- Citations by year
- 2026: 14 · 2025: 11 · 2024: 8 · 2023: 15 · 2022: 11 · 2021: 18 · 2020: 16 · 2019: 14 · 2018: 21 · 2017: 13 · 2016: 20 · 2015: 24 · 2014: 22 · 2013: 31 · 2012: 26
- FWCI
- 3.60
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Proceedings of the American Thoracic Society (publishedVersion)
- PubMed (publishedVersion)
- The HKU Scholars Hub (University of Hong Kong) (submittedVersion)
- Funders
- National Center for Research Resources (P41RR013642)
- Topics
- Health Sciences › Medicine › Physiology (medical) › Obstructive Sleep Apnea Research
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Adipokines, Inflammation, and Metabolic Diseases
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Keywords
- obstructive sleep apnea, metabolic syndrome, glucose metabolism, insulin resistance, inflammation, intermittent hypoxia, sleep fragmentation, obesity, visceral obesity, type 2 diabetes, cardiovascular risk
- MeSH terms
- Adult, Blood Glucose, Humans, Inflammation, Risk Factors, Sleep Apnea, Obstructive, Metabolic Syndrome
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