Obesity metabolic and hormonal disorders associated with obstructive sleep apnea and their impact on the risk of cardiovascular events

• Published in: Metabolism, clinical and experimental Vol. 84; pp. 76 - 84
• Main Authors: Carneiro, Glaucia, Zanella, Maria T.
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01-07-2018
• Subjects: Cardiovascular diseases; Cardiovascular Diseases - epidemiology; Cardiovascular Diseases - etiology; Cardiovascular Diseases - metabolism; Comorbidity; Endocrine System Diseases - epidemiology; Endocrine System Diseases - etiology; Hormones; Humans; Metabolic Diseases - epidemiology; Metabolic Diseases - etiology; Obesity; Obesity - complications; Obesity - epidemiology; Obesity - metabolism; Obstructive sleep apnea; Prevalence; Risk Factors; Sleep Apnea, Obstructive - complications; Sleep Apnea, Obstructive - epidemiology; Sleep Apnea, Obstructive - metabolism; Weight Loss - physiology; Obesity; Hormones; Cardiovascular diseases; Obstructive sleep apnea
• ISSN: 0026-0495; 1532-8600
• DOI: 10.1016/j.metabol.2018.03.008

To analyze metabolic and hormonal disorders resulting from the association between obesity and obstructive sleep apnea (OSA) syndrome that predispose to cardiovascular diseases and investigate the clinical benefits obtained from treatment approaches for both conditions.
A literature review between 1997 and 2017 was conducted in the PubMed search database.
Obesity is the most important risk factor for OSA, and the progressive increase in its prevalence also affects OSA incidence. In addition, OSA may aggravate weight gain and obesity comorbidities. Both conditions lead to an increase in the risk of cardiovascular events and mortality. The gold standard treatment for moderate to severe OSA is CPAP, but significant reduction in major cardiovascular events was not observed in clinical trials. Body weight reduction appears effective to improve OSA, as long as it is maintained. Lifestyle modifications and drug therapy seem to be the preferred approach to treat obesity, but in severe obesity and moderate to severe OSA, bariatric surgery is probably the most adequate treatment.
Weight control is essential to decrease the risk of cardiovascular events and mortality potentially linked to both obesity and OSA. CPAP seems to treat only OSA without decreasing these risks. Other treatment strategies are lifestyle modifications and drug therapy, which need further investigation as well as bariatric surgery for severe cases.
•OSA and obesity present a bidirectional relationship creating a vicious cycle with positive feedback between both conditions;•Weight control is necessary to decrease the risk of cardiovascular events and mortality linked to both obesity and OSA;•Lifestyle modification and drug therapies seem to be the most relevant non-surgical weight loss strategies.