Metabolický syndrom a sympatický nervový systém: Je obstrukční spánková apnoe klíčem k pochopení?

Chronically increased sympathetic nervous system activity may contribute to the onset and progression of the metabolic syndrome. However, the primary cause of increased sympathetic activity in patients with this syndrome remains unclear. Obstructive sleep apnea has a high incidence in the general population and may be a significant independent risk factor for some cardiovascular diseases. Despite these considerations, obstructive sleep apnea remains generally underestimated phenomenon in both clinical practice as well as research. Data from clinical and basic research suggest that obstructive sleep apnea is associated with, and may contribute to, a significant increase in sympathetic activity, body weight and body fat, and systemic blood pressure. Obstructive sleep apnea is also associated with insulin and leptin resistance. Moreover, obstructive sleep apnea is linked with systemic inflammation, endothelial dysfunction, oxidative stress and a protrombotic state. Similarities in regulatory and metabolic abnormalities in obstructive sleep apnea and the metabolic syndrome, as well as the high prevalence of both metabolic syndrome and obstructive sleep apnea in the general population, suggest that obstructive sleep apnea may contribute to the pathophysiology and progression of the metabolic syndrome.