Obstructive Sleep Apnea and the Metabolic Syndrome

Jamie C.M. Lam; Mary S.M. Ip


Expert Rev Resp Med. 2009;3(2):177-186. 

In This Article

Expert Commentary and Five-year View

With the growing pandemic of obesity, the global prevalences of OSA, as well as the metabolic syndrome and the various cardiometabolic disorders it denotes, will continue to increase. This trend is not only confined to adults but also observed in children and adolescents. Given that the metabolic syndrome is a cluster of highly related cardiometabolic manifestations, it is a useful counterpoint in the study of the relationship between OSA and cardiometabolic function. Whether OSA forms part of the metabolic syndrome, or OSA itself is a syndrome with multi-organ dysfunction is probably not of strategic importance. The primary target of research is the understanding of the role of OSA in regulation of metabolism and their interactions within the complex network, and their interplay with genetic and environmental factors, which will determine the outcome in each individual. Such knowledge would ultimately impact upon the overall reduction of cardiometabolic morbidity and mortality. With concerted efforts of regional, national or international consortiums, further information from large-scale prospective databases and their longitudinal cohort follow-up should be available from Europe, North America and the Asia-Pacific. Such information would hopefully also shed light on the potential influence of genetics and environmental factors on OSA and cardiometabolic outcomes.[131] Rigorous evidence of the effect of treatment of OSA on cardiometabolic morbidity and mortality requires randomized, controlled, interventional trials of both short-term and long-term duration. The latter are limited by concerns of withholding effective available treatment for proven indications, but it is anticipated that data from trials conducted on selected cohorts will be forthcoming. Experimental work with animal models, cells and tissues will contribute significantly to advancing our understanding of the basic mechanisms that underpin these metabolic aberrations. Meanwhile, holistic healthcare practice demands early recognition and appropriate management of potential metabolic disorders in the patient with OSA and vice versa.


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