RT Journal Article
SR Electronic
T1 Obstructive sleep apnoea and metabolic impairment in severe obesity
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP 1089
OP 1097
DO 10.1183/09031936.00198810
VO 38
IS 5
A1 M. Gasa
A1 N. Salord
A1 A.M. Fortuna
A1 M. Mayos
A1 N. Vilarrasa
A1 J. Dorca
A1 J.M. Montserrat
A1 M.R. Bonsignore
A1 C. Monasterio
YR 2011
UL http://erj.ersjournals.com/content/38/5/1089.abstract
AB Obstructive sleep apnoea (OSA) seems to worsen metabolism. This effect has not been evaluated in morbid obesity (MO). We hypothesised that the metabolic profile is more impaired in MO patients with OSA than in those without, and investigated whether any specific metabolic dysfunction is related to OSA in MO. A prospective multicentre cross-sectional study was conducted in consecutive subjects before bariatric surgery. OSA was defined as apnoea/hypopnoea index (AHI) ≥15 by overnight polysomnography. Anthropometrical, blood pressure (BP) and fasting blood measurements were obtained the morning after. Metabolic syndrome (MetS) was defined according to National Cholesterol Education Program Adult Treatment Panel III modified criteria. 159 patients were studied: 72% were female and 72% had OSA. MetS prevalence was 70% in OSA versus 36% in non-OSA (p<0.001). As AHI severity increased, metabolic parameters progressively worsened, even in those without type 2 diabetes (DM2). AHI was independently associated with systolic and diastolic BP, triglycerides and the percentage of glycosylated haemoglobin (HbA1c) in the total sample, and with systolic BP, high-density lipoprotein cholesterol and HbA1c in those samples without DM2. OSA increased the adjusted odds ratio of having MetS by 2.8 (95% CI 1.3–6.2; p=0.009). In MO, OSA is associated with major metabolic impairment caused by higher BP and poorer lipid and glucose control, independent of central obesity or DM2.