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Opstruktivna apneja u snu i kardiometabolički rizik

Obstructive sleep apnea and cardiometabolic risk

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2019
Opstruktivna_apneja_u_pub_2019.pdf (262.6Kb)
Authors
Vekić, Jelena
Jelić-Ivanović, Zorana
Zeljković, Aleksandra
Stefanović, Aleksandra
Spasojević-Kalimanovska, Vesna
Article (Published version)
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Abstract
Opstruktivna apneja u snu (OSA) je hronično progresivno oboljenje sa visokom prevalencom u populaciji koje, bez pravovremene dijagnoze i terapije, može dovesti do značajnih posledica po kvalitet života pacijenata. OSA je čest komorbiditet kod pacijenata sa metaboličkim sindromom (MS) i kardiovaskularnim bolestima (KVB) i predstavlja važan faktor rizika za nastanak ovih oboljenja, a prisustvo nelečenog, teškog oblika OSA povezano je sa porastom ukupnog i mortaliteta usled koronarnih događaja. Brojne studije su ukazale na vezu između MS i OSA, te je ovaj fenomen opisan kao poseban poremećaj - sindrom Z. Istraživanje uzročno-posledične veze između OSA i KVB je u velikoj meri otežano kompleksnom prirodom samog oboljenja. Smatra se da je kardiometabolički rizik u OSA udružen sa arterijskom hipertenzijom, insulinskom rezistencijom, endotelnom disfunkcijom, inflamacijom, dislipidemijom i oksidativnim stresom. Lečenje OSA se danas najefikasnij...e sprovodi neinvazivnom ventilacijom, pomoću uređaja koji obezbeđuje pozitivan pritisak u gornjim disajnim putevima (eng. continuous positive airway pressure, CPAP) i na taj način sprečava pojavu apneja tokom spavanja. Rezultati kliničkih studija su pokazali da CPAP terapija značajno poboljšava hemodinamske parametre, reguliše hipertenziju, povećava osetljivost na insulin i koriguje dislipidemiju. Buduća istraživanja bi trebalo da rasvetle da li je apneja u snu faktor rizika za KVB per se ili je ta veza posledica šireg patofiziološkog procesa, čiji je deo i OSA.

Obstructive sleep apnea (OSA) is a chronic, progressive disorder with a high prevalence in the population. Without timely diagnosis and therapy OSA can significantly affect the quality of life of the patients. OSA is a common co-morbidity in patients with metabolic syndrome (MS) and cardiovascular disease (CVD) and is an important risk factor for their development. The presence of untreated, severe OSA is associated with an increase in total and cardiovascular mortality. Numerous studies have pointed to the relationship between MS and OSA, and this phenomenon was described as syndrome Z. Investigation of the causal relationship between OSA and CVD has been greatly confounded by the complex nature of the disease itself. Cardiometabolic risk in OSA is associated with arterial hypertension, insulin resistance, endothelial dysfunction, inflammation, dyslipidemia, and oxidative stress. The treatment of OSA is now most effectively performed by contin...uous positive airway pressure (CPAP), a type of non-invasive ventilation which prevents the onset of sleep apnea. The results of clinical studies have shown that CPAP therapy significantly improves haemodynamic parameters, regulates hypertension, increases insulin sensitivity, and corrects dyslipidemia. Future investigations should clarify whether sleep apnea is a risk factor for CVD per se or is a consequence of a broader pathophysiological process, of which OSA is part.

Keywords:
intermitentna hipoksija / gojaznost / dislipidemija / metabolički sindrom / intermittent hypoxia / obesity / dyslipidemia / metabolic syndrome
Source:
Arhiv za farmaciju, 2019, 69, 3, 153-164
Publisher:
  • Beograd : Savez farmaceutskih udruženja Srbije
Projects:
  • Interactive role of dyslipidemia, oxidative stress and inflammation in atherosclerosis and other diseases: genetic and biochemical markers (RS-175035)

DOI: 10.5937/arhfarm1903153

ISSN: 0004-1963

Scopus: 2-s2.0-85081224015
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URI
http://farfar.pharmacy.bg.ac.rs/handle/123456789/3491
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