Schuster Steven R, Tabba Maher, Sahota Pradeep
University of Missouri School of Medicine, Columbia, MO, USA.
J Cardiometab Syndr. 2006 Summer;1(3):204-8. doi: 10.1111/j.1559-4564.2006.05846.x.
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.
阻塞性睡眠呼吸暂停（OSA）的特征是尽管呼吸持续用力，但气流停止至少10秒，是我们社会中的一种普遍病症。最近的研究表明，OSA是胰岛素抵抗和心脏代谢综合征的独立危险因素。OSA引起的低氧血症和睡眠碎片化似乎会导致自主神经激活、神经内分泌功能改变以及炎症细胞因子（白细胞介素6和肿瘤坏死因子α）数量增加。这些变量在胰岛素抵抗和心脏代谢综合征的发病机制中起重要作用。可以得出结论，胰岛素敏感性是心脏代谢综合征发病机制的关键因素，主要由肥胖程度决定，在较小程度上由OSA决定。作者回顾了OSA，并总结了最近的发现以及OSA与胰岛素抵抗和心脏代谢综合征之间因果关系的提出机制，这些机制独立于许多混杂的合并症。
