Abstract
BackgroundMetabolic syndrome (MS) occurs frequently in patients with obstructive sleep apnea-hypopnea syndrome (OSAHS). We hypothesized that aldosterone levels are elevated in OSAHS and associated with the presence of MS.MethodsWe studied 66 patients with OSAHS (33 with MS and 33 without MS) and 35 controls. The occurrence of the MS was analyzed according to the National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP III) clinical criteria. Measurements of plasma renin activity (PRA), aldosterone, aldosterone:PRA ratio, creatinine, glucose, triglycerides, cholesterol and HDL cholesterol were obtained at baseline and after CPAP treatment.ResultsAldosterone levels were associated with the severity of OSAHS and higher than controls (p = 0.046). Significant differences in aldosterone levels were detected between OSAHS patients with and without MS (p = 0.041). A significant reduction was observed in the aldosterone levels in patients under CPAP treatment (p = 0.012).ConclusionThis study shows that aldosterone levels are elevated in OSAHS in comparison to controls, and that CPAP therapy reduces aldosterone levels. It also shows that aldosterone levels are associated with the presence of metabolic syndrome, suggesting that aldosterone excess might predispose or aggravate the metabolic and cardiovascular complications of OSAHS.Trial registrationThe study is not a randomized controlled trial and was not registered.
Highlights
Current data indicate that obstructive sleep apnea-hypopnea syndrome (OSAHS) is highly associated with the metabolic syndrome (MS) [1]–[3] The underlying mechanistic links between OSAHS and the metabolic syndrome have not been well delineated.There is a close relationship between the Renin-AngiotensinAldosterone (RAS) system and hypertension [4]–[6]
These findings show that aldosterone levels are elevated in OSAHS in comparison to controls, and continuous positive airway pressure (CPAP) therapy reduces aldosterone levels
Aldosterone levels were significantly higher in OSAHS patients than in subjects without OSAHS (p = 0.046)
Summary
Current data indicate that obstructive sleep apnea-hypopnea syndrome (OSAHS) is highly associated with the metabolic syndrome (MS) [1]–[3] The underlying mechanistic links between OSAHS and the metabolic syndrome have not been well delineated.There is a close relationship between the Renin-AngiotensinAldosterone (RAS) system and hypertension [4]–[6]. Current data indicate that obstructive sleep apnea-hypopnea syndrome (OSAHS) is highly associated with the metabolic syndrome (MS) [1]–[3] The underlying mechanistic links between OSAHS and the metabolic syndrome have not been well delineated. Findings from observational studies demonstrated that high aldosterone levels are associated with impaired pancreatic b-cell function and insulin resistance and long-term clinical trials of antihypertensive agents have shown that direct inhibitors of the RAS system (angiotensin converting enzyme inhibitors and angiotensin receptor blockers) significantly improved insulin sensitivity and reduced the risk of incident diabetes[9]. In the Framingham Offspring study aldosterone was found to correlate positively with both the development of the MS and an increase in systolic blood pressure, indicating that aldosterone would predict the onset of hypertension and the MS[14]. Metabolic syndrome (MS) occurs frequently in patients with obstructive sleep apnea-hypopnea syndrome (OSAHS). We hypothesized that aldosterone levels are elevated in OSAHS and associated with the presence of MS
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