| Apnea obstructiva del sueño y diabetes tipo 2: ¿Hay un enlace? |
Obstructive sleep apnea and type 2 diabetes: is there a link?
Pamidi S, Tasali E.
Respiratory Division, Department of Medicine, McGill University Montreal, QC, Canada.
Front Neurol. 2012;3:126. Epub 2012 Aug 13.
Abstract
Type 2 diabetes is a chronic illness that is increasing in epidemic proportions worldwide. Major factors contributing to the development of type 2 diabetes include obesity and poor lifestyle habits (e.g., excess dietary intake and limited physical activity). Despite the proven efficacy of lifestyle interventions and the use of multiple pharmacological agents, the economic and public health burden of type 2 diabetes remains substantial. Obstructive sleep apnea (OSA) is a treatable sleep disorder that is pervasive among overweight and obese adults, who represent about two thirds of the U.S. population today. An ever-growing number of studies have shown that OSA is associated with insulin resistance, glucose intolerance and type 2 diabetes, independent of obesity. Evidence from animal and human models that mimic OSA provides potential mechanisms for how OSA may alter glucose metabolism. Up to 83% of patients with type 2 diabetes suffer from unrecognized OSA and increasing severity of OSA is associated with worsening glucose control. However, it is still unclear whether OSA may lead to the development of diabetes over time. More data from large-scale longitudinal studies with rigorous assessments of diabetes and OSA are needed. In addition, there is still controversy whether continuous positive airway pressure (CPAP) treatment of OSA improves glucose metabolism. Large-scale randomized-controlled trials of CPAP treatment of OSA with well-validated assessments of insulin sensitivity and glucose tolerance are needed. These studies may reveal that OSA represents a novel, modifiable risk factor for the development of prediabetes and type 2 diabetes.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3449487/pdf/fneur-03-00126.pdf
|
| Apnea obstructiva del sueño como riesgo para ateroesclerosis-implicaciones preventivas y de tratamiento personalizado |
Obstructive sleep apnoea as a risk factor for atherosclerosis - implication for preventive and personalised treatment.
Tuleta I, Pabst S, Juergens UR, Nickenig G, Skowasch D.
University of Bonn, Bonn, Germany.
EPMA J. 2011 Mar;2(1):39-47. doi: 10.1007/s13167-011-0070-5. Epub 2011 Mar 26.Abstract
Atherosclerosis with its manifestations and associated diseases is a main cause of morbidity and mortality in industrial countries. The pathomechanisms underlying atherosclerosis are complex and comprise exogenous factors as well as genetic predisposition. Beyond the well-defined risk factors for the development of atherosclerosis, obstructive sleep apnoea (OSA) merits more and more attention. A growing body of evidence has associated OSA with vascular pathologies. Although the exact mechanisms involved are not known, the occurrence of intermittent hypoxia typical for OSA may lead to oxidative stress, inflammation, metabolic and neural changes which in turn are responsible for vessel dysfunction underlying atherosclerosis. It has been demonstrated that therapy with continuous positive airway pressure (CPAP) plays a vasoprotective role. This review summarises data resulting from epidemiological and clinical studies with emphasis on the possible mechanisms linking OSA with atherosclerosis, predictive biomarkers helping identify OSA patients at high cardiovascular risk and personalised treatment approaches.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3405376/pdf/13167_2011
|
|
No hay comentarios:
Publicar un comentario