Division of Pulmonary, Critical Care, and Sleep Medicine, UC San Diego Department of Medicine, La Jolla, CA, United States.
Division of Endocrinology, UC San Diego Department of Medicine, La Jolla, CA, United States.
Metabolism. 2018 Jul;84:94-98. doi: 10.1016/j.metabol.2017.09.004. Epub 2017 Sep 28.
Obstructive sleep apnea (OSA) is common, and many cross-sectional and longitudinal studies have established OSA as an independent risk factor for the development of a variety of adverse metabolic disease states, including hypertension, insulin resistance, type 2 diabetes, nonalcoholic fatty liver disease, dyslipidemia, and atherosclerosis. Nasal continuous positive airway pressure (CPAP) has long been the mainstay of therapy for OSA, but definitive studies demonstrating the efficacy of CPAP in improving metabolic outcomes, or in reducing incident disease burden, are lacking; moreover, CPAP has variable rates of adherence. Therefore, the future of OSA management, particularly with respect to limiting OSA-related metabolic dysfunction, likely lies in a coming wave of alternative approaches to endophenotyping OSA patients, personalized care, and defining and targeting mechanisms of OSA-induced adverse health outcomes.
阻塞性睡眠呼吸暂停（OSA）很常见，许多横断面和纵向研究已经确定 OSA 是多种不良代谢疾病状态发展的独立危险因素，包括高血压、胰岛素抵抗、2 型糖尿病、非酒精性脂肪肝疾病、血脂异常和动脉粥样硬化。鼻持续气道正压通气（CPAP）一直是 OSA 的主要治疗方法，但缺乏明确的研究证明 CPAP 在改善代谢结局或降低疾病负担方面的疗效；此外，CPAP 的依从率也存在差异。因此，OSA 管理的未来，特别是在限制 OSA 相关代谢功能障碍方面，可能在于即将出现的一波针对 OSA 患者表型的替代方法、个性化护理以及确定和针对 OSA 引起的不良健康后果的机制。
