Metabolic consequences of intermittent hypoxia: relevance to obstructive sleep apnea.
Metabolic consequences of intermittent hypoxia: relevance to obstructive sleep apnea.
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DOI：
10.1016/j.beem.2010.08.011
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发表时间：
2010-10
期刊：
影响因子：
--
通讯作者：
Polotsky VY
中科院分区：
文献类型：
--
作者：
Drager LF;Jun JC;Polotsky VY
阻塞性睡眠呼吸暂停（OSA）是一种反复发生的上呼吸道阻塞，导致睡眠破碎和睡眠期间间歇性缺氧（IH）。越来越多的OSA动物模型证据表明，IH与代谢功能障碍（包括血脂异常和胰岛素抵抗）独立相关。IH诱导代谢紊乱的确切机制尚不完全清楚。在过去的十年里，几个研究小组开发了一种啮齿类动物的IH模型，它模拟了人类OSA的氧合血红蛋白谱。在小鼠模型中，IH诱导血脂异常、胰岛素抵抗和胰腺内分泌功能障碍，与人类OSA相似。最近的报道为IH影响脂质和葡萄糖代谢的可能机制提供了新的见解。IH可能通过上调肝脏的脂质生物合成，增加脂肪组织的脂质分解以及随后的游离脂肪酸向肝脏的通量，以及抑制脂蛋白清除来诱导血脂异常。IH可能通过诱导交感神经激活、增加全身性炎症、增加反调节激素和脂肪酸以及引起直接的胰腺细胞损伤来影响葡萄糖代谢。OSA的IH模型提高了我们对OSA代谢影响的认识，但在将最近的基础研究成果转化为临床实践之前，还需要进一步的研究。
Obstructive sleep apnea (OSA) is recurrent obstruction of the upper airway leading to sleep fragmentation and intermittent hypoxia (IH) during sleep. There is growing evidence from animal models of OSA that IH is independently associated with metabolic dysfunction, including dyslipidemia and insulin resistance. The precise mechanisms by which IH induces metabolic disturbances are not fully understood. Over the last decade, several groups of investigators developed a rodent model of IH, which emulates the oxyhemoglobin profile in human OSA. In the mouse model, IH induces dyslipidemia, insulin resistance and pancreatic endocrine dysfunction, similar to those observed in human OSA. Recent reports provided new insights in possible mechanisms by which IH affects lipid and glucose metabolism. IH may induce dyslipidemia by up-regulating lipid biosynthesis in the liver, increasing adipose tissue lipolysis with subsequent free fatty acid flux to the liver, and inhibiting lipoprotein clearance. IH may affect glucose metabolism by inducing sympathetic activation, increasing systemic inflammation, increasing counter-regulatory hormones and fatty acids, and causing direct pancreatic beta cell injury. IH models of OSA have improved our understanding of the metabolic impact of OSA, but further studies are needed before we can translate recent basic research findings to clinical practice.
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影响因子：
2.9
作者：
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