Relazione tra apnea ostruttiva del sonno e obesità: una rassegna sugli aspetti endocrini, metabolici e nutrizionali

  • Iona Zalcman Zimberg Universidade Federal de Sao Paulo
  • Camila Maria de Melo Departamento de Psicobiologia, Universidade Federal de São Paulo
  • Mariana Del Re Departamento de Psicobiologia, Universidade Federal de São Paulo
  • Marcus Vinicius dos Santos Departamento de Biociências, Universidade Federal de São Paulo
  • Cibele Aparecida Crispim Faculdade de Medicina, Universidade Federal de Uberlândia
  • Tássia do Vale Cardoso Lopes Faculdade de Medicina, Universidade Federal de Uberlândia
  • Sérgio Tufik Departamento de Psicobiologia, Universidade Federal de São Paulo
  • Marco Túlio de Mello Departamento de Psicobiologia, Universidade Federal de São Paulo. Departamento de Educação Fí­sica e Esporte, Universidade Federal de Minas Gerais
Parole chiave: Apnea, Obesità, Metabolismo, Perdita di peso

Abstract

Attualmente, l'OSAS è riconosciuto come un fattore predittivo indipendente per l'obesità e l'obesità, a sua volta, è caratterizzata come il principale fattore di rischio per l'OSAS. Pertanto, questo articolo mira a rivedere la letteratura esistente sulla relazione tra OSAS e obesità, considerando gli aspetti endocrini e metabolici di questa relazione, oltre a discutere il ruolo della perdita di peso nel trattamento di questa sindrome. Diversi studi hanno dimostrato che l'OSAS è direttamente associato ai cambiamenti endocrini, come i livelli di leptina e grelina, ormoni legati alla fame e alla sazietà, oltre a contribuire all'aumento della resistenza all'insulina e al cortisolo, aumentando il rischio di malattie croniche, come quelle cardiovascolari. patologia. Considerando che l'OSAS è un fattore di rischio indipendente per l'ipertensione e le malattie cardiovascolari, oltre ad essere fortemente associato all'obesità e all'insulino-resistenza, oggi sono stati proposti diversi trattamenti, tra cui interventi chirurgici, dispositivi intraorali, uso di CPAP, nonché cambiamenti nello stile di vita, che si concentrano sull'inclusione degli esercizi fisici e sulla riduzione dell'apporto calorico, che promuove la riduzione delle misurazioni antropometriche e il miglioramento dell'AHI e dei parametri respiratori. Si conclude che OSAS e obesità innescano cambiamenti endocrini e metabolici, che possono influire negativamente sulla salute dell'individuo. Pertanto, si può affermare che la riduzione della massa corporea è clinicamente importante per i pazienti obesi con OSAS e dovrebbe essere una misura di attenzione importante nel trattamento di questa malattia.

Biografia autore

Iona Zalcman Zimberg, Universidade Federal de Sao Paulo

Departamento de Psicobiologia

Riferimenti bibliografici

-Araghi, M.H.; Chen, Y.F.; Jagielski, A.; Choudhury, S.; Banerjee, D.; Hussain, S.; Thomas, G.N.; Taheri, S. Effectiveness of lifestyle interventions on obstructive sleep apnea (OSA): systematic review and meta-analysis. Sleep. Vol. 36. Núm. 10. p. 1553-62. 2013.

-Arnardottir, E.S.; Mackiewicz, M.; Gislason, T.; Teff, K.L.; Pack, A.I. Molecular signatures of obstructive sleep apnea in adults: a review and perspective. Sleep. Vol. 32. Núm. 4.p. 447-70. 2009.

-Barnes, M.; Goldsworthy, U.R.; Cary, B.A.; Hill, C.J. A diet and exercise program to improve clinical outcomes in patients with obstructive sleep apnea-a feasibility study. J Clin Sleep Med. Vol. 5. Núm. 5. p. 409-15. 2009.

-Brooks, B.; Cistulli, P.A.; Borkman, M.; Ross, G.; McGhee, S.; Grunstein, R.R.; Sullivan, C.E.; Yue, D.K. Obstructive sleep apnea in obese noninsulin-dependent diabetic patients: effect of continuous positive airway pressure treatment on insulin responsiveness. J Clin Endocrinol Metab. Vol. 79. Núm. 6. p. 1681-5. 1994.

-Carmelli, D.; Swan, G.E.; Bliwise, D.L. Relationship of 30-year changes in obesity to sleep-disordered breathing in the Western Collaborative Group Study. Obes Res. Vol. 8. Núm. 9. p. 632-7. 2000.

-Chin, K.; Shimizu, K.; Nakamura, T.; Narai, N.; Masuzaki, H.; Ogawa, Y.; Mishima, M.; Nakamura, T.; Nakao, K.; Ohi, M. Changes in intra-abdominal visceral fat and serum leptin levels in patients with obstructive sleep apnea syndrome following nasal continuous positive airway pressure therapy. Circulation. Vol. 100. Núm. 7. p. 706-12. 1999.

-Davies, R.J.; Turner, R.; Crosby, J.; Stradling, J.R. Plasma insulin and lipid levels in untreated obstructive sleep apnoea and snoring; their comparison with matched controls and response to treatment. J Sleep Res. Vol. 3. Núm. 3. p. 180-5. 1994.

-Dempsey, J.A.; Veasey, S.C.; Morgan, B.J.; O'Donnell, C.P. Pathophysiology of sleep apnea. Physiol Rev. Vol. 90. Núm. 1. p. 47-112. 2010.

-Foster, G.E.; Poulin, M.J.; Hanly, P.J. Intermittent hypoxia and vascular function: implications for obstructive sleep apnoea. Exp Physiol. Vol. 92. Núm. 1. p. 51-65. 2007.

-Ge, X.; Han, F.; Huang, Y.; Zhang, Y.; Yang, T.; Bai, C.; Guo, X. Is obstructive sleep apnea associated with cardiovascular and all-cause mortality? PLoS One. Vol. 8. Núm. 7.p. e69432. 2013.

-Grigg-Damberger, M.M. The AASM scoring manual: a critical appraisal. Curr Opin Pulm Med. Vol. 15. Núm. 6. p. 540-9. 2009.

-Han, T.S.; Oh, M.K.; Kim, S.M.; Yang, H.J.; Lee, B.S.; Park, S.Y.; Lee, W.J. Relationship between Neck Length, Sleep, and Cardiovascular Risk Factors. Korean J Fam Med. Vol. 36. Núm. 1. p. 10-21. 2015.

-Harsch, I.A.; Konturek, P.C.; Koebnick, C.; Kuehnlein, P.P.; Fuchs, F.S.; Pour Schahin, S.; Wiest, G.H.; Hahn, E.G.; Lohmann, T.; Ficker, J.H. Leptin and ghrelin levels in patients with obstructive sleep apnoea: effect of CPAP treatment. Eur Respir J. Vol. 22. Núm. 2. p. 251-7. 2003.

-Hasler, G.; Buysse, D.J.; Klaghofer, R.; Gamma, A.; Ajdacic, V.; Eich, D.; Rossler, W.; Angst, J. The association between short sleep duration and obesity in young adults: a 13-year prospective study. Sleep. Vol. 27. Núm. 4. p. 661-6. 2004.

-Hermans, M.P.; Ahn, S.A.; Mahadeb, Y.P.; Rousseau, M.F. Sleep apnoea syndrome and 10-year cardiovascular risk infemales with type 2 diabetes: relationship with insulin secretion and insulin resistance. Diabetes Metab Res Rev. Vol. 29. Núm. 3. p. 227-34. 2013.

-Hertz, G.; Cataletto, M.; Feinsilver, S.H.; Angulo, M. Developmental trends of sleep-disordered breathing in Prader-Willi syndrome: the role of obesity. Am J Med Genet. Vol. 56. Núm. 2. p. 188-90. 1995.

-Ho, M.L.; Brass, S.D. Obstructive sleep apnea. Neurol Int. Vol.3. Núm.3. p. e15. 2011.

-Ip, M.S.; Lam, B.; Ng, M.M.; Lam, W.K.; Tsang, K.W.; Lam, K.S. Obstructive sleep apnea is independently associated with insulin resistance. Am J Respir Crit Care Med. Vol. 165. Núm. 5. p. 670-6. 2002.

-Johansson, K.; Neovius, M.; Lagerros, Y.T.; Harlid, R.; Rossner, S.; Granath, F.; Hemmingsson, E. Effect of a very low energy diet on moderate and severe obstructive sleep apnoea in obese men: a randomised controlled trial. BMJ. Vol. 339. p. b4609. 2009.

-Kapas, L.; Hong, L.; Cady, A.B.; Opp, M.R.; Postlethwaite, A.E.; Seyer, J.M.; Krueger, J.M. Somnogenic, pyrogenic, and anorectic activities of tumor necrosis factor-alpha and TNF-alpha fragments. Am J Physiol. Vol. 263. Núm. 3 Pt 2. p. R708-15. 1992.

-Kim, J.H.; Kim, K.R.; Cho, K.H.; Yoo, K.B.; Kwon, J.A.; Park, E.C. The association between sleep duration and self-rated health in the Korean general population. J Clin Sleep Med. Vol. 9. Núm. 10. p. 1057-64. 2013.

-Maki-Nunes, C.; Toschi-Dias, E.; Cepeda, F.X.; Rondon, M.U.; Alves, M.J.; Fraga, R.F.; Braga, A.M.; Aguilar, A.M.; Amaro, A.C.; Drager, L.F. Diet and exercise improve chemoreflex sensitivity in patients with metabolic syndrome and obstructive sleepapnea. Obesity (Silver Spring). Vol. 23. Núm. 8. p. 1582-90. 2015.

-Mannarino, M.R.; Di Filippo, F.; Pirro, M. Obstructive sleep apnea syndrome. Eur J Intern Med. Vol. 23. Núm. 7. p. 586-93. 2012.

-Marinilli Pinto, A.; Gorin, A.A.; Raynor, H.A.; Tate, D.F.; Fava, J.L.; Wing, R.R. Successful weight-loss maintenance in relation to method of weight loss. Obesity (Silver Spring). Vol. 16. Núm. 11. p. 2456-61. 2008.

-Mastorakos, G.; Chrousos, G.P.; Weber, J.S. Recombinant interleukin-6 activates the hypothalamic-pituitary-adrenal axis in humans. J Clin Endocrinol Metab. Vol. 77. Núm. 6. p. 1690-4. 1993.

-Mathur, R.; Douglas, N.J. Family studies in patients with the sleep apnea-hypopnea syndrome. Ann Intern Med. Vol. 122. Núm. 3. p. 174-8. 1995.

-Mello, M.T.; Santana, M.G.; Souza, L.M.; Oliveira, P.C.; Ventura, M.L.; Stampi, C.; Tufik, S. Sleep patterns and sleep-related complaints of Brazilian interstate bus drivers. Braz J Med Biol Res. Vol. 33. Núm. 1. p. 71-7. 2000.

-Michel, P.H.; Ahn, S.A.; Rousseau, M.F. Cardiometabolic phenotype and UKPDS risk in male type 2 diabetic patients with obstructive sleep apnoea. Diabetes & Metabolic Syndrome: Clinical Research & Reviews. Vol. 3. p. 4. 2009.

-Millman, R.P.; Redline, S.; Carlisle, C.C.; Assaf, A.R.; Levinson, P.D. Daytime hypertension in obstructive sleep apnea. Prevalence and contributing risk factors. Chest. Vol. 99. Núm. 4. p. 861-6. 1991.

-Morselli, L.; Leproult, R.; Balbo, M.; Spiegel, K. Role of sleep duration in the regulation of glucose metabolism and appetite. Best Pract Res Clin Endocrinol Metab. Vol. 24. Núm. 5. p. 687-702. 2010.

-Nerfeldt, P.; Nilsson, B.Y.; Mayor, L.; Udden, J.; Friberg, D. A two-year weight reduction program in obese sleep apnea patients. J Clin Sleep Med. Vol. 6. Núm. 5. p. 479-86. 2010.

-Opp, M.R.; Kapas, L.; Toth, L.A. Cytokine involvement in the regulation of sleep. Proc Soc Exp Biol Med. Vol. 201. Núm. 1. p. 16-27. 1992.

-Pamidi, S.; Wroblewski, K.; Broussard, J.; Day, A.; Hanlon, E.C.; Abraham, V.; Tasali, E. Obstructive sleep apnea in young lean men: impact on insulin sensitivity and secretion. Diabetes Care. Vol. 35. Núm. 11. p. 2384-9. 2012.

-Peiser, J.; Lavie, P.; Ovnat, A.; Charuzi, I. Sleep apnea syndrome in the morbidly obese as an indication for weight reduction surgery. Ann Surg. Vol. 199. Núm. 1. p. 112-5. 1984.

-Pelttari, L.; Rauhala, E.; Polo, O.; Hyyppa, M.T.; Kronholm, E.; Viikari, J.; Kantola, I. Upper airway obstruction in hypothyroidism. J Intern Med. Vol. 236. Núm. 2. p. 177-81. 1994.

-Peppard, P.E.; Young, T.; Palta, M.; Dempsey, J,; Skatrud, J. Longitudinal study of moderate weight change and sleep-disordered breathing. JAMA. Vol. 284. Núm. 23. p. 3015-21. 2000.

-Pillai, A.; Warren, G.; Gunathilake, W.; Idris, I. Effects of sleep apnea severity on glycemic control in patients with type 2 diabetes prior to continuous positive airway pressure treatment. Diabetes Technol Ther. Vol. 13. Núm. 9. p. 945-9. 2011.

-Pillar, G.; Shehadeh, N. Abdominal fat and sleepapnea: the chicken or the egg? Diabetes Care. Vol. 31. Suppl 2. p. S303-9. 2008.

-Punjabi, N.M.; Beamer, B.A. Alterations in Glucose Disposal in Sleep-disordered Breathing. Am J Respir Crit Care Med. Vol. 179. Núm. 3. p. 235-40. 2009.

-Punjabi, N.M.; Sorkin, J.D.; Katzel, L.I.; Goldberg, A.P.; Schwartz, A.R.; Smith, P.L. Sleep-disordered breathing and insulin resistance in middle-aged and overweightmen. Am J Respir Crit Care Med. Vol. 165. Núm. 5. p. 677-82. 2002.

-Ramar, K.; Dort, L.C.; Katz, S.G.; Lettieri, C.J.; Harrod, C.G.; Thomas, S.M.; Chervin, R.D. Clinical Practice Guideline for the Treatment of Obstructive Sleep Apnea and Snoring with Oral Appliance Therapy: An Update for 2015. J Clin Sleep Med. Vol. 11. Núm. 7. p. 773-827. 2015.

-Redline, S.; Tishler, P.V.; Tosteson, T.D.; Williamson, J,; Kump, K,; Browner, I,; Ferrette, V,; Krejci, P. The familial aggregation of obstructive sleep apnea. Am J Respir Crit Care Med. Vol. 151. Núm. 3 Pt 1. p. 682-7. 1995.

-Sahlman, J.; Seppa, J.; Herder, C.; Peltonen, M.; Peuhkurinen, K.; Gylling, H.; Vanninen, E.; Tukiainen, H.;Punnonen, K.; Partinen, M. Effect of weight loss on inflammation in patients with mild obstructive sleep apnea. Nutr Metab Cardiovasc Dis. Vol. 22. Núm. 7. p. 583-90. 2012.

-Salvador, J.; Iriarte, J.; Silva, C.; Gomez Ambrosi, J.; Diez Caballero, A.; Fruhbeck, G. The obstructive sleep apnoea syndrome in obesity: a conspirator in the shadow. Rev Med Univ Navarra. Vol. 48. Núm. 2. p. 55-62. 2004.

-Sateia, M.J. Neuropsychological impairment and quality of life in obstructive sleep apnea. Clin Chest Med. Vol. 24. Núm. 2. p. 249-59. 2003.

-Schenck, C.H.; Mahowald, M.W. Review of nocturnal sleep-related eating disorders. Int J Eat Disord. Vol. 15. Núm. 4. p. 343-56. 1994.

-Shechter, A.; St-Onge, M.P.; Kuna, S.T.; Zammit, G.; RoyChoudhury, A.; Newman, A.B.; Millman, R.P.; Reboussin, D.M.; Wadden, T.A.; Jakicic, J.M. Sleep architecture following a weight loss intervention in overweight and obese patients with obstructive sleep apnea and type 2 diabetes: relationship to apnea-hypopnea index. J Clin Sleep Med. Vol. 10. Núm. 11. p. 1205-11. 2014.

-Shipley, J.E.; Schteingart, D.E.; Tandon, R.; Starkman, M.N. Sleep architecture and sleep apnea in patientswith Cushing's disease. Sleep. Vol. 15. Núm. 6. p. 514-8. 1992.

-Spiegel, K.; Leproult, R.; L'Hermite-Baleriaux, M.; Copinschi, G.; Penev, P.D.; Van Cauter, E. Leptin levels are dependent on sleep duration: relationships with sympathovagal balance, carbohydrate regulation, cortisol, and thyrotropin. J Clin Endocrinol Metab. Vol. 89. Núm. 11. p. 5762-71. 2004.

-Spiegel, K.; Leproult, R.; Van Cauter, E. Impact of sleep debt on metabolicand endocrine function. Lancet. Vol. 354. Núm. 9188. p. 1435-9. 1999.

-Steiropoulos, P.; Papanas, N.; Nena, E.; Antoniadou, M.; Serasli, E.; Papoti, S.; Hatzizisi, O.; Kyriazis, G.; Tzouvelekis, A.; Maltezos, E. Inflammatory markers in middle-aged obese subjects: does obstructive sleep apnea syndrome play a role? Mediators Inflamm. Vol. 20. Núm. 10. 2010.

-Strohl, K.P.; Novak, R.D.; Singer, W.; Cahan, C.; Boehm, K.D.; Denko, C.W.; Hoffstem, V.S. Insulin levels, blood pressure and sleep apnea. Sleep. Vol. 17. Núm. 7. p. 614-8. 1994.

-Sutherland, K.; Lee, R.W.; Phillips, C.L.; Dungan, G.; Yee, B.J.; Magnussen, J.S.; Grunstein, R.R.; Cistulli, P.A. Effect of weight loss on upper airway size and facial fat in men with obstructive sleep apnoea. Thorax. Vol. 66. Núm. 9. p. 797-803. 2011.

-Tavares, M.C.M.F.A.S. Apnéia do Sono em Obesos. Arquivos Brasileiros de Endocrinologia e Metabologia. Vol. 44. Núm. 1. p. 9. 2000.

-Trakada, G.; Steiropoulos, P.; Zarogoulidis, P.; Nena, E.; Papanas, N.; Maltezos, E.; Bouros, D. A fatty meal aggravates apnea and increases sleep in patients with obstructive sleep apnea. Sleep Breath. Vol. 18. Núm. 1. p. 53-8. 2014.

-Tsai, A.G.; Wadden, T.A. The evolution of very-low-calorie diets: an update and meta-analysis. Obesity (Silver Spring). Vol. 14. Núm. 8. p. 1283-93. 2006.

-Tufik, S.; Santos-Silva, R.; Taddei, J.A.; Bittencourt, L.R. Obstructive sleep apnea syndrome in the Sao Paulo Epidemiologic Sleep Study. Sleep Med. Vol. 11. Núm. 5. p. 441-6. 2010.

-Tuomilehto, H.; Gylling, H.; Peltonen, M.; Martikainen, T.; Sahlman, J.; Kokkarinen, J.; Randell, J.; Tukiainen, H.; Vanninen, E.; Partinen, M. Sustained improvement in mild obstructive sleep apnea after a diet-and physical activity-based lifestyle intervention: postinterventional follow-up. Am J Clin Nutr. Vol. 92. Núm. 4. p. 688-96. 2010.

-Tuomilehto, H.P.; Seppa, J.M.; Partinen, M.M.; Peltonen, M.; Gylling, H.; Tuomilehto, J.O.; Vanninen, E.J.; Kokkarinen, J.; Sahlman, J.K.; Martikainen, T. Lifestyle intervention with weight reduction: first-line treatment in mild obstructive sleep apnea. Am J Respir Crit Care Med. Vol. 179. Núm. 4. p. 320-7. 2009.

-Vgontzas, A.N.; Bixler, E.O.; Chrousos, G.P. Sleep apnea is a manifestation of the metabolic syndrome. Sleep Med Rev. Vol. 9. Núm. 3. p. 211-24. 2005.

-Vgontzas, A.N.; Papanicolaou, D.A.; Bixler, E.O.; Kales, A.; Tyson, K.; Chrousos, G.P. Elevation of plasma cytokines in disorders of excessive daytime sleepiness: role of sleep disturbance and obesity. J Clin Endocrinol Metab. Vol. 82. Núm. 5. p. 1313-6. 1997.

-Weikel, J.C.; Wichniak, A.; Ising, M.; Brunner, H.; Friess, E.; Held, K.; Mathias, S.; Schmid, D.A.; Uhr, M.; Steiger, A. Ghrelin promotes slow-wave sleep in humans.Am J Physiol Endocrinol Metab. Vol. 284. Núm. 2. p. E407-15. 2003.

-White, D.P.; Douglas, N.J.; Pickett, C.K.; Zwillich, C.W.; Weil, J.V. Sleep deprivation and the control ofventilation. Am Rev Respir Dis. Vol. 128. Núm. 6. p. 984-6. 1983.

-Young, T.; Peppard, P.E.; Gottlieb, D.J. Epidemiology of obstructive sleep apnea: a population health perspective. Am J Respir Crit Care Med. Vol. 165. Núm. 9. p. 1217-39. 2002.

Pubblicato
2017-06-18
Come citare
Zimberg, I. Z., de Melo, C. M., Del Re, M., dos Santos, M. V., Crispim, C. A., Lopes, T. do V. C., Tufik, S., & de Mello, M. T. (2017). Relazione tra apnea ostruttiva del sonno e obesità: una rassegna sugli aspetti endocrini, metabolici e nutrizionali. Giornale Brasiliano Di obesità, Nutrizione E Perdita Di Peso, 11(64), 250-260. Recuperato da https://www.rbone.com.br/index.php/rbone/article/view/527
Sezione
Articoli Scientifici - Original

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