A Tahrani Abd
Centre of Endocrinology, Diabetes and Metabolism, University of Birmingham; Birmingham, UK; Department of Diabetes and Endocrinology, Birmingham Heartlands Hospital, Birmingham, UK.
Eur Endocrinol. 2015 Aug;11(2):81-89. doi: 10.17925/EE.2015.11.02.81. Epub 2015 Aug 19.
Obstructive sleep apnoea (OSA) is common and is associated with many vascular risk factors, such as hypertension, insulin resistance, albuminuria, dyslipidaemia, increased inflammation and endothelial dysfunction. Epidemiological studies have shown that OSA is associated with increased cardiovascular disease (CVD) and that continuous positive airway pressure (CPAP) might reduce CVD events in patients with OSA. In addition, OSA has also been shown to be associated with albuminuria, chronic kidney disease, a wide range of ocular diseases and peripheral neuropathy. Considering that CVD and microvascular complications are major contributors to the morbidity, mortality and the economic burden of diabetes and that OSA is common in patients with type 2 diabetes (T2D), it is important to understand the role of OSA in the development and/or progression of vascular disease in patients with T2D and to explore the impact of CPAP on diabetes-related vascular outcomes. The purpose of this article is to review the evidence for the relationship and impact of OSA on vascular disease and vascular risk factors particularly in patients with T2D.
阻塞性睡眠呼吸暂停(OSA)很常见,且与许多血管危险因素相关,如高血压、胰岛素抵抗、蛋白尿、血脂异常、炎症增加和内皮功能障碍。流行病学研究表明,OSA与心血管疾病(CVD)增加有关,持续气道正压通气(CPAP)可能会降低OSA患者的CVD事件。此外,OSA还被证明与蛋白尿、慢性肾脏病、多种眼部疾病和周围神经病变有关。鉴于CVD和微血管并发症是糖尿病发病、死亡及经济负担的主要因素,且OSA在2型糖尿病(T2D)患者中很常见,了解OSA在T2D患者血管疾病发生和/或进展中的作用,并探讨CPAP对糖尿病相关血管结局的影响非常重要。本文旨在综述OSA与血管疾病及血管危险因素之间关系和影响的证据,尤其是在T2D患者中的证据。