Relationship between the cardiometabolic syndrome and obstructive sleep apnea. 2006

Steven R Schuster, and Maher Tabba, and Pradeep Sahota
University of Missouri School of Medicine, Columbia, MO, USA.

Obstructive sleep apnea (OSA), characterized by cessation of air flow for a minimum of 10 seconds despite continuous respiratory effort, is a prevalent condition in our society. Recent studies demonstrate that OSA is an independent risk factor for insulin resistance and the cardiometabolic syndrome. Hypoxemia and sleep fragmentation from OSA appear to produce autonomic activation, alterations in neuroendocrine function, and increased amounts of inflammatory cytokines (interleukin 6 and tumor necrosis factor alpha). These variables have important roles in the pathogenesis of insulin resistance and the cardiometabolic syndrome. It can be concluded that insulin sensitivity, a key contributor to the pathogenesis of the cardiometabolic syndrome, is mainly determined by the extent of obesity and, to a lesser extent, by OSA. The authors review OSA and summarize recent discoveries and proposed mechanisms of the causal relationship that OSA has with insulin resistance and the cardiometabolic syndrome independent of many confounding comorbidities.

UI MeSH Term Description Entries
D007333 Insulin Resistance Diminished effectiveness of INSULIN in lowering blood sugar levels: requiring the use of 200 units or more of insulin per day to prevent HYPERGLYCEMIA or KETOSIS. Insulin Sensitivity,Resistance, Insulin,Sensitivity, Insulin
D005947 Glucose A primary source of energy for living organisms. It is naturally occurring and is found in fruits and other parts of plants in its free state. It is used therapeutically in fluid and nutrient replacement. Dextrose,Anhydrous Dextrose,D-Glucose,Glucose Monohydrate,Glucose, (DL)-Isomer,Glucose, (alpha-D)-Isomer,Glucose, (beta-D)-Isomer,D Glucose,Dextrose, Anhydrous,Monohydrate, Glucose
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D001341 Autonomic Nervous System The ENTERIC NERVOUS SYSTEM; PARASYMPATHETIC NERVOUS SYSTEM; and SYMPATHETIC NERVOUS SYSTEM taken together. Generally speaking, the autonomic nervous system regulates the internal environment during both peaceful activity and physical or emotional stress. Autonomic activity is controlled and integrated by the CENTRAL NERVOUS SYSTEM, especially the HYPOTHALAMUS and the SOLITARY NUCLEUS, which receive information relayed from VISCERAL AFFERENTS. Vegetative Nervous System,Visceral Nervous System,Autonomic Nervous Systems,Nervous System, Autonomic,Nervous System, Vegetative,Nervous System, Visceral,Nervous Systems, Autonomic,Nervous Systems, Vegetative,Nervous Systems, Visceral,System, Autonomic Nervous,System, Vegetative Nervous,System, Visceral Nervous,Systems, Autonomic Nervous,Systems, Vegetative Nervous,Systems, Visceral Nervous,Vegetative Nervous Systems,Visceral Nervous Systems
D012307 Risk Factors An aspect of personal behavior or lifestyle, environmental exposure, inborn or inherited characteristic, which, based on epidemiological evidence, is known to be associated with a health-related condition considered important to prevent. Health Correlates,Risk Factor Scores,Risk Scores,Social Risk Factors,Population at Risk,Populations at Risk,Correlates, Health,Factor, Risk,Factor, Social Risk,Factors, Social Risk,Risk Factor,Risk Factor Score,Risk Factor, Social,Risk Factors, Social,Risk Score,Score, Risk,Score, Risk Factor,Social Risk Factor
D014409 Tumor Necrosis Factor-alpha Serum glycoprotein produced by activated MACROPHAGES and other mammalian MONONUCLEAR LEUKOCYTES. It has necrotizing activity against tumor cell lines and increases ability to reject tumor transplants. Also known as TNF-alpha, it is only 30% homologous to TNF-beta (LYMPHOTOXIN), but they share TNF RECEPTORS. Cachectin,TNF-alpha,Tumor Necrosis Factor Ligand Superfamily Member 2,Cachectin-Tumor Necrosis Factor,TNF Superfamily, Member 2,TNFalpha,Tumor Necrosis Factor,Cachectin Tumor Necrosis Factor,Tumor Necrosis Factor alpha
D015850 Interleukin-6 A cytokine that stimulates the growth and differentiation of B-LYMPHOCYTES and is also a growth factor for HYBRIDOMAS and plasmacytomas. It is produced by many different cells including T-LYMPHOCYTES; MONOCYTES; and FIBROBLASTS. Hepatocyte-Stimulating Factor,Hybridoma Growth Factor,IL-6,MGI-2,Myeloid Differentiation-Inducing Protein,Plasmacytoma Growth Factor,B Cell Stimulatory Factor-2,B-Cell Differentiation Factor,B-Cell Differentiation Factor-2,B-Cell Stimulatory Factor 2,B-Cell Stimulatory Factor-2,BSF-2,Differentiation Factor, B-Cell,Differentiation Factor-2, B-Cell,IFN-beta 2,IL6,Interferon beta-2,B Cell Differentiation Factor,B Cell Differentiation Factor 2,B Cell Stimulatory Factor 2,Differentiation Factor 2, B Cell,Differentiation Factor, B Cell,Differentiation-Inducing Protein, Myeloid,Growth Factor, Hybridoma,Growth Factor, Plasmacytoma,Hepatocyte Stimulating Factor,Interferon beta 2,Interleukin 6,Myeloid Differentiation Inducing Protein,beta-2, Interferon
D045422 Continuous Positive Airway Pressure A technique of respiratory therapy, in either spontaneously breathing or mechanically ventilated patients, in which airway pressure is maintained above atmospheric pressure throughout the respiratory cycle by pressurization of the ventilatory circuit. (On-Line Medical Dictionary [Internet]. Newcastle upon Tyne(UK): The University Dept. of Medical Oncology: The CancerWEB Project; c1997-2003 [cited 2003 Apr 17]. Available from: http://cancerweb.ncl.ac.uk/omd/) Airway Pressure Release Ventilation,BiPAP Bilevel Positive Airway Pressure,BiPAP Biphasic Positive Airway Pressure,Bilevel Positive Airway Pressure,Biphasic Positive Airway Pressure,APRV Ventilation Mode,Bilevel Continuous Positive Airway Pressure,Biphasic Continuous Positive Airway Pressure,CPAP Ventilation,Nasal Continuous Positive Airway Pressure,nCPAP Ventilation,APRV Ventilation Modes,Ventilation Mode, APRV,Ventilation Modes, APRV,Ventilation, CPAP,Ventilation, nCPAP
D020181 Sleep Apnea, Obstructive A disorder characterized by recurrent apneas during sleep despite persistent respiratory efforts. It is due to upper airway obstruction. The respiratory pauses may induce HYPERCAPNIA or HYPOXIA. Cardiac arrhythmias and elevation of systemic and pulmonary arterial pressures may occur. Frequent partial arousals occur throughout sleep, resulting in relative SLEEP DEPRIVATION and daytime tiredness. Associated conditions include OBESITY; ACROMEGALY; MYXEDEMA; micrognathia; MYOTONIC DYSTROPHY; adenotonsilar dystrophy; and NEUROMUSCULAR DISEASES. (From Adams et al., Principles of Neurology, 6th ed, p395) Obstructive Sleep Apnea,Upper Airway Resistance Sleep Apnea Syndrome,Apnea, Obstructive Sleep,OSAHS,Obstructive Sleep Apnea Syndrome,Sleep Apnea Hypopnea Syndrome,Sleep Apnea Syndrome, Obstructive,Syndrome, Obstructive Sleep Apnea,Syndrome, Sleep Apnea, Obstructive,Syndrome, Upper Airway Resistance, Sleep Apnea,Apneas, Obstructive Sleep,Obstructive Sleep Apneas,Sleep Apneas, Obstructive
D024821 Metabolic Syndrome A cluster of symptoms that are risk factors for CARDIOVASCULAR DISEASES and TYPE 2 DIABETES MELLITUS. The major components of metabolic syndrome include ABDOMINAL OBESITY; atherogenic DYSLIPIDEMIA; HYPERTENSION; HYPERGLYCEMIA; INSULIN RESISTANCE; a proinflammatory state; and a prothrombotic (THROMBOSIS) state. Cardiometabolic Syndrome,Insulin Resistance Syndrome X,Metabolic Syndrome X,Reaven Syndrome X,Dysmetabolic Syndrome X,Metabolic Cardiovascular Syndrome,Metabolic X Syndrome,Syndrome X, Insulin Resistance,Syndrome X, Metabolic,Cardiometabolic Syndromes,Cardiovascular Syndrome, Metabolic,Cardiovascular Syndromes, Metabolic,Metabolic Syndromes,Syndrome X, Dysmetabolic,Syndrome X, Reaven,Syndrome, Cardiometabolic,Syndrome, Metabolic,Syndrome, Metabolic Cardiovascular,Syndrome, Metabolic X,Syndromes, Cardiometabolic,Syndromes, Metabolic,X Syndrome, Metabolic

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