ReviewThe metabolic syndrome, diabetes and lung dysfunctionSyndrome métabolique, diabète et dysfonction pulmonaire
Section snippets
Abbreviations
- OSA
obstructive sleep apnoea
- CRP
C-reactive protein
- IL-6
interleukin-6
- TNF-α
tumor necrosis factor-alpha
- CPAP
continuous positive airway pressure
- AHI
apnoea/hypopnoea index
- ICAM-1
intracellular adhesion molecule-1
- FVC
forced vital capacity
- FEV
forced expiratory flow
- ARIC
atherosclerosis risk in communities
- NF-kB
nuclear factor-kB
- IGT
impaired glucose tolerance
- COPD
chronic obstructive pulmonary disease
- SDB
sleep-disordered breathing
- ER
endoplasmic reticulum
- EPC
endothelial progenitor cells
- MetSyn
metabolic syndrome
- PAH
pulmonary
The metabolic syndrome and sleep apnoea
OSA is a prevalent disorder particularly among middle-aged, obese men, although its presence in women as well as in lean individuals is being increasingly recognized. Indeed, 17–24% of adult men and 5–9% of women demonstrate an AHI of more than five events per hour, the originally proposed criteria for sleep apnoea [10]. A large majority of adult sleep apnoea sufferers present with many of the features of MetSyn. There is, in fact, a strong association between OSA and obesity, particularly the
Lung dysfunction and diabetes
Diabetes may be either a cause or a consequence of SDB, or it may be both. The diabetic status is associated with periodic breathing, a respiratory disorder induced by abnormal central respiratory control [33]. Among the participants of the Sleep Heart Health Study [32], the prevalence of periodic breathing was 5.4% and 2.5% in diabetics and in non-diabetics, respectively, with an odds ratio of 2.23. However, as type 2 diabetes is also associated with obesity, this may have an effect on the
Circulating progenitor cell alterations in metabolic and pulmonary diseases
One of the most exciting and recent advances in the knowledge of chronic disease pathogenesis is the recognition that bone marrow-derived progenitor cells have the ability to repopulate different tissues in addition to the haematopoietic lineages. Once these cells have reached the bloodstream, they are involved in repair and regeneration of the myocardium, endothelium, smooth and skeletal muscles, epithelium, bone and cartilage. Disturbance in one or more of these progenitor cell lineages may
Conclusion
SDB is a prevalent condition associated with significant comorbidity such as obesity, diabetes, hypertension, insulin resistance and cardiovascular disease. It has been seen that the severity of insulin resistance is correlated to the degree of SDB. Data from the literature support a two-way, pernicious association between sleep apnoea and insulin resistance. Visceral obesity and its consequential insulin resistance may, indeed, be the principal culprit leading to sleep apnoea which, in turn,
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2022, Metabolism: Clinical and ExperimentalCitation Excerpt :The downstream pathway regulates antiapoptotic programs, thus managing cellular damage and enhancing survival [24–28]. Abnormal insulin sensitivity, called insulin resistance, is associated with lung dysfunction in humans [29–32]. Endothelial restoration of insulin receptor (IR) rescues vascular impairment of IR heterogenic knockout [33].
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