Division of Cardiovascular Diseases, Department of Internal Medicine, Mayo Clinic College of Medicine, Mayo Foundation, Rochester, MN 55905, USA.
Chest. 2010 Mar;137(3):711-9. doi: 10.1378/chest.09-0360.
Obstructive sleep apnea (OSA) adversely affects multiple organs and systems, with particular relevance to cardiovascular disease. Several conditions associated with OSA, such as high BP, insulin resistance, systemic inflammation, visceral fat deposition, and dyslipidemia, are also present in other conditions closely related to OSA, such as obesity and reduced sleep duration. Weight loss has been accompanied by improvement in characteristics related not only to obesity but to OSA as well, suggesting that weight loss might be a cornerstone of the treatment of both conditions. This review seeks to explore recent developments in understanding the interactions between body weight and OSA. Weight loss helps reduce OSA severity and attenuates the cardiometabolic abnormalities common to both diseases. Nevertheless, weight loss has been hard to achieve and maintain using conservative strategies. Since bariatric surgery has emerged as an alternative treatment of severe or complicated obesity, impressive results have often been seen with respect to sleep apnea severity and cardiometabolic disturbances. However, OSA is a complex condition, and treatment cannot be limited to any single symptom or feature of the disease. Rather, a multidisciplinary and integrated strategy is required to achieve effective and long-lasting therapeutic success.
阻塞性睡眠呼吸暂停（OSA）会对多个器官和系统产生不利影响，尤其与心血管疾病密切相关。与 OSA 相关的几种情况，如高血压、胰岛素抵抗、全身炎症、内脏脂肪沉积和血脂异常，也存在于与 OSA 密切相关的其他情况下，如肥胖和睡眠时间减少。体重减轻伴随着与肥胖和 OSA 相关的特征的改善，这表明体重减轻可能是治疗这两种情况的基石。本综述旨在探讨理解体重与 OSA 之间相互作用的最新进展。体重减轻有助于降低 OSA 严重程度，并减轻两种疾病常见的心血管代谢异常。然而，使用保守策略很难实现和维持体重减轻。由于减重手术已成为严重或复杂肥胖症的替代治疗方法，因此在睡眠呼吸暂停严重程度和心血管代谢紊乱方面经常会看到令人印象深刻的结果。然而，OSA 是一种复杂的疾病，治疗不能局限于疾病的任何单一症状或特征。相反，需要采用多学科和综合的策略来实现有效的和持久的治疗成功。
