Adedayo Ajibola Monsur, Olafiranye Oladipupo, Smith David, Hill Alethea, Zizi Ferdinand, Brown Clinton, Jean-Louis Girardin
Department of Medicine, SUNY Downstate Medical Center (Box 1199), Brooklyn Health Disparities Center, 450 Clarkson Avenue, Brooklyn, NY, 11203-2098, USA.
Sleep Breath. 2014 Mar;18(1):13-8. doi: 10.1007/s11325-012-0760-9. Epub 2012 Aug 18.
Over the past half century, evidence has been accumulating on the emergence of obstructive sleep apnea (OSA), the most prevalent sleep-disordered breathing, as a major risk factor for cardiovascular disease. A significant body of research has been focused on elucidating the complex interplay between OSA and cardiovascular risk factors, including dyslipidemia, obesity, hypertension, and diabetes mellitus that portend increased morbidity and mortality in susceptible individuals.
Although a clear causal relationship of OSA and dyslipidemia is yet to be demonstrated, there is increasing evidence that chronic intermittent hypoxia, a major component of OSA, is independently associated and possibly the root cause of the dyslipidemia via the generation of stearoyl-coenzyme A desaturase-1 and reactive oxygen species, peroxidation of lipids, and sympathetic system dysfunction. The aim of this review is to highlight the relationship between OSA and dyslipidemia in the development of atherosclerosis and present the pathophysiologic mechanisms linking its association to clinical disease. Issues relating to epidemiology, confounding factors, significant gaps in research and future directions are also discussed.
在过去的半个世纪里，有证据不断积累表明，阻塞性睡眠呼吸暂停（OSA）作为最常见的睡眠呼吸紊乱疾病，已成为心血管疾病的主要危险因素。大量研究致力于阐明OSA与心血管危险因素之间的复杂相互作用，这些危险因素包括血脂异常、肥胖、高血压和糖尿病，它们预示着易感个体的发病率和死亡率会增加。
虽然OSA与血脂异常之间的明确因果关系尚未得到证实，但越来越多的证据表明，慢性间歇性缺氧作为OSA的一个主要组成部分，通过硬脂酰辅酶A去饱和酶-1和活性氧的产生、脂质过氧化以及交感神经系统功能障碍，与血脂异常独立相关，并且可能是血脂异常的根本原因。这篇综述的目的是强调OSA与血脂异常在动脉粥样硬化发展过程中的关系，并阐述将其关联与临床疾病联系起来的病理生理机制。还讨论了与流行病学、混杂因素、研究中的重大差距以及未来方向相关的问题。
