Diabetes mellitus prevalence and control in sleep-disordered breathing: The European Sleep Apnea Cohort (ESADA) study

BACKGROUND: OSA is associated with an increased risk of cardiovascular morbidity. A driver of this is metabolic dysfunction and in particular type 2 diabetes mellitus (T2DM). Prior studies identifying a link between OSA and T2DM have excluded subjects with undiagnosed T2DM, and there is a lack of population-level data on the interaction between OSA and glycemic control among patients with diabetes. We assessed the relationship between OSA severity and T2DM prevalence and control in a large multinational population.METHODS: We performed a cross-sectional analysis of 6,616 participants in the European Sleep Apnea Cohort (ESADA) study, using multivariate regression analysis to assess T2DM prev…

Management of obstructive sleep apnea in Europe.

Objectives: In Europe, the services provided for the investigation and management of obstructive sleep apnoea (OSA) varies from country to country. The aim of this questionnaire-based study was to investigate the current status of diagnostic pathways and therapeutic approaches applied in the treatment of OSA in Europe, qualification requirements of physicians involved in diagnosis and treatment of OSA, and reimbursement of these services. Methods: Two questionnaires were sent to 39 physicians in 22 countries in Europe. In order to standardize the responses, the questionnaire was accompanied by an example. Results: Sleep centers from 21 countries (38 physicians) participated. A broad consist…

Hyperuricemia and non-dipping blood pressure

Oreste Marrone,1 Maria Rosaria Bonsignore1,21National Research Council, Institute of Biomedicine and Molecular Immunology, Palermo, Italy; 2Biomedical Department of Internal and Specialistic Medicine, University of Palermo, Palermo, ItalyThe strong association between the metabolic derangements that characterize the metabolic syndrome with arterial hypertension is very well-known, as it is the common finding of hyperuricemia in the patients with the metabolic syndrome. Besides, hyperuricemia has been found to be associated with cardiovascular, renal, and metabolic diseases; including not only gout but also type 2 diabetes mellitus, although its role as a risk factor is still debated.1 We we…

Apnee ostruttive del sonno e lavoro: studio condotto su un gruppo di lavoratori

Conseguenze metaboliche dell'ipossia

Riassunto La sopravvivenza in condizioni di ipossia dipende dall’attivazione di processi cellulari complessi, con risposte di adattamento (quali il potenziamento del trasporto di O2 attraverso l’aumento dell’eritropoiesi, l’attivazione dell’angiogenesi e l’aumento della glicolisi anaerobica) e l’inibizione di processi metabolici che richiedono alta disponibilità di O2. Ciò consente di mantenere l’omeostasi energetica anche in condizioni di ridotta disponibilità di O2. Nel modello fisiologico del soggiorno ad alta quota si verificano riduzione di peso e della capacità di lavoro associata a riduzione della massa muscolare, che però sono reversibili al ripristino di condizioni di normossia. Le…

Chronic kidney disease in European patients with obstructive sleep apnea: the ESADA cohort study

Abstract: The cross-sectional relationship of obstructive sleep apnea with moderate to severe chronic kidney disease, defined as an estimated glomerular filtration rate = 30) was found in 34% of subjects. The lowest nocturnal oxygen saturation was 81 +/- 10.2%. Chronic kidney disease prevalence in the whole sample was 8.7% or 6.1%, according to the Modification of Diet in Renal Disease or the Chronic Kidney Disease-Epidemiology Collaboration equations, respectively. Subjects with lower estimated glomerular filtration rate were older, more obese, more often female, had worse obstructive sleep apnea and more co-morbidities (P < 0.001, each). With both equations, independent predictors of esti…