Obstructive sleep apnea and dyslipidemia: evidence and underlying mechanism.
Obstructive sleep apnea and dyslipidemia: evidence and underlying mechanism.
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DOI：
10.1007/s11325-012-0760-9
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发表时间：
2014-03
期刊：
影响因子：
--
通讯作者：
Jean-Louis G
中科院分区：
文献类型：
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作者：
Adedayo AM;Olafiranye O;Smith D;Hill A;Zizi F;Brown C;Jean-Louis G
在过去的半个世纪，越来越多的证据表明阻塞性睡眠呼吸暂停（OSA）是最常见的睡眠呼吸障碍，是心血管疾病的主要危险因素。大量的研究集中在阐明OSA和心血管危险因素之间复杂的相互作用，包括血脂异常、肥胖、高血压和糖尿病，这些危险因素预示着易感个体的发病率和死亡率增加。虽然OSA和血脂异常之间的因果关系尚不明确，但越来越多的证据表明，慢性间歇性缺氧（OSA的主要组成部分）与血脂异常独立相关，可能是通过硬脂酰辅酶A去饱和酶-1和活性氧、脂质过氧化和交感神经系统功能障碍引起的血脂异常的根本原因。本文综述了阻塞性睡眠呼吸暂停与血脂异常在动脉粥样硬化发生发展中的关系，并阐述了阻塞性睡眠呼吸暂停与临床疾病的病理生理机制。还讨论了有关流行病学，混杂因素，研究和未来方向的重大差距的问题。
Over the past half century, evidence has been accumulating on the emergence of obstructive sleep apnea (OSA), the most prevalent sleep-disordered breathing, as a major risk factor for cardiovascular disease. A significant body of research has been focused on elucidating the complex interplay between OSA and cardiovascular risk factors, including dyslipidemia, obesity, hypertension, and diabetes mellitus that portend increased morbidity and mortality in susceptible individuals. Although a clear causal relationship of OSA and dyslipidemia is yet to be demonstrated, there is increasing evidence that chronic intermittent hypoxia, a major component of OSA, is independently associated and possibly the root cause of the dyslipidemia via the generation of stearoyl-coenzyme A desaturase-1 and reactive oxygen species, peroxidation of lipids, and sympathetic system dysfunction. The aim of this review is to highlight the relationship between OSA and dyslipidemia in the development of atherosclerosis and present the pathophysiologic mechanisms linking its association to clinical disease. Issues relating to epidemiology, confounding factors, significant gaps in research and future directions are also discussed.