Dept of Psychiatry, Pennsylvania State University College of Medicine, PA, USA.
Eur Respir J. 2013 Mar;41(3):601-9. doi: 10.1183/09031936.00183411. Epub 2012 Jun 27.
In obese male subjects, visceral adiposity has been associated with obstructive sleep apnoea (OSA), while studies in overweight males and females are limited. Our goal was to examine the association between OSA and visceral fat in a relatively nonobese population and assess the effects of 2 months placebo-controlled continuous positive airway pressure (CPAP) use on abdominal fat. 81 subjects, 22 middle-aged males and 20 post-menopausal females with OSA, and 19 male and 20 female controls were studied in the sleep laboratory for four nights. Abdominal (visceral (VAT) and subcutaneous (SAT) adipose tissue) and liver fat were assessed with computed tomography. OSA patients were re-assessed post-CPAP and post sham-CPAP. Apnoeic males had significantly higher VAT than controls, while apnoeic females had higher SAT than controls. In both sexes, OSA was associated with increased liver fat. In males, apnoea was associated with VAT whereas in females it was associated with subcutaneous, visceral and total fat. CPAP did not affect abdominal and liver fat. In overweight males, visceral adiposity is associated with OSA whereas in females it is associated with global adiposity. In overweight males, our therapeutic goal should be the reduction of visceral adiposity and its metabolic correlates, whereas, in females, weight loss may be sufficient. Short-term CPAP treatment does not affect general, abdominal or intra-hepatic adiposity.
在肥胖男性中，内脏脂肪与阻塞性睡眠呼吸暂停（OSA）有关，而超重男性和女性的研究则有限。我们的目标是在相对非肥胖人群中研究 OSA 与内脏脂肪之间的关系，并评估为期 2 个月的安慰剂对照持续气道正压通气（CPAP）治疗对腹部脂肪的影响。81 名受试者，22 名中年男性和 20 名绝经后女性患有 OSA，19 名男性和 20 名女性对照在睡眠实验室中进行了 4 个晚上的研究。使用计算机断层扫描评估腹部（内脏（VAT）和皮下（SAT）脂肪组织）和肝脏脂肪。对 OSA 患者进行 CPAP 治疗后和假 CPAP 治疗后评估。有呼吸暂停的男性 VAT 明显高于对照组，而有呼吸暂停的女性 SAT 明显高于对照组。在两性中，OSA 与肝脏脂肪增加有关。在男性中，呼吸暂停与 VAT 有关，而在女性中，呼吸暂停与皮下、内脏和总脂肪有关。CPAP 治疗不影响腹部和肝脏脂肪。在超重男性中，内脏脂肪与 OSA 有关，而在女性中，它与全身脂肪有关。在超重男性中，我们的治疗目标应该是减少内脏脂肪及其代谢相关物，而在女性中，减肥可能就足够了。短期 CPAP 治疗不会影响全身、腹部或肝内脂肪堆积。
