School of Medicine, The Conway Institute, University College Dublin, Dublin, Ireland.
Pulmonary and Sleep Disorders Unit, St. Vincent's University Hospital, Dublin, Ireland.
Eur Respir Rev. 2019 Jun 26;28(152). doi: 10.1183/16000617.0006-2019. Print 2019 Jun 30.
Obstructive sleep apnoea (OSA) is a major health concern worldwide and adversely affects multiple organs and systems. OSA is associated with obesity in >60% of cases and is independently linked with the development of numerous comorbidities including hypertension, arrhythmia, stroke, coronary heart disease and metabolic dysfunction. The complex interaction between these conditions has a significant impact on patient care and mortality. The pathophysiology of cardiometabolic complications in OSA is still incompletely understood; however, the particular form of intermittent hypoxia (IH) observed in OSA, with repetitive short cycles of desaturation and re-oxygenation, probably plays a pivotal role. There is fast growing evidence that IH mediates some of its detrimental effects through adipose tissue inflammation and dysfunction. This article aims to summarise the effects of IH on adipose tissue in experimental models in a comprehensive way. Data from well-designed controlled trials are also reported with the final goal of proposing new avenues for improving phenotyping and personalised care in OSA.
阻塞性睡眠呼吸暂停(OSA)是一个全球性的重大健康问题,对多个器官和系统都有不利影响。超过 60%的 OSA 病例与肥胖有关,并且与多种合并症的发展独立相关,包括高血压、心律失常、中风、冠心病和代谢功能障碍。这些情况之间的复杂相互作用对患者的护理和死亡率有重大影响。OSA 中心血管代谢并发症的病理生理学仍不完全清楚;然而,在 OSA 中观察到的特殊形式的间歇性低氧(IH),即反复短暂的缺氧和再氧化循环,可能起着关键作用。越来越多的证据表明,IH 通过脂肪组织炎症和功能障碍介导其一些有害影响。本文旨在全面总结 IH 对实验模型中脂肪组织的影响。还报告了精心设计的对照试验的数据,最终目的是为改善 OSA 表型和个体化护理提出新途径。