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Pneumologie 2008; 62(2): 88-91
DOI: 10.1055/s-2007-996175
Übersicht
© Georg Thieme Verlag Stuttgart · New York

Obstruktive Schlaf-Apnoe und metabolisches Syndrom

Obstructive Sleep Apnoea and Metabolic SyndromeR.  Schulz1 , H.-J.  Eisele1 , F.  Reichenberger1 , W.  Seeger1
  • 1Medizinische Klinik II/Schlaflabor, (Direktor: Prof. Dr. med. Werner Seeger), Universitätsklinikum Gießen und Marburg, Standort Gießen
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Publication History

eingereicht 23.10.2007

akzeptiert 19.11.2007

Publication Date:
15 February 2008 (online)

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Zusammenfassung

Das metabolische Syndrom, d. h. das kombinierte Auftreten von Adipositas, erhöhtem Blutdruck, Insulinresistenz und Dyslipidämie (erhöhte Triglyceride, erniedrigtes HDL-Cholesterin), ist mit einer deutlichen Erhöhung des kardiovaskulären Risikos verbunden. Patienten mit obstruktiver Schlaf-Apnoe (OSA) weisen sehr häufig ein metabolisches Syndrom auf. Die Adipositas gilt als Hauptrisikofaktor der OSA und die OSA selbst wird jetzt als häufigste Ursache der sekundären arteriellen Hypertonie angesehen. Die Kausalität der Beziehungen zwischen OSA und metabolischen Veränderungen ist aufgrund des Einflusses der Variable „Adipositas” weniger gut etabliert, jedoch sprechen epidemiologische Untersuchungen zumindest für eine unabhängige Assoziation zwischen OSA und Insulinresistenz. Die CPAP-Therapie kann die OSA-assoziierte arterielle Hypertonie günstig beeinflussen, ob und in welchem Umfang dadurch auch Insulinresistenz und Dyslipidämie gebessert werden können, muss hingegen noch durch Plazebo-kontrollierte, randomisierte Langzeit-Studien mit ausreichend hohen Patientenzahlen geklärt werden.

Abstract

Metabolic syndrome, i. e., the combined occurrence of obesity, arterial hypertension, insulin resistance and dyslipidaemia (increased triglycerides, reduced HDL cholesterol), is associated with a marked increase in cardiovascular risk. The prevalence of metabolic syndrome in patients with obstructive sleep apnoea (OSA) is very high. Obesity is the main risk factor for OSA and OSA itself is now considered to be the most frequent cause of secondary arterial hypertension. Due to the confounding influence of obesity, the causal connection between OSA and metabolic disturbances is less well established, however, epidemiological data are at least in favour of an independent link between OSA and insulin resistance. It is known that CPAP therapy can ameliorate OSA-associated hypertension. In contrast, the effects of CPAP treatment on insulin resistance and dyslipidaemia have to be further elucidated by large, randomised interventional trials.

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Prof. Dr. med. Richard Schulz

Medizinische Klinik II/Schlaflabor, Universitätsklinikum Gießen und Marburg, Standort Gießen

Paul-Meimberg-Str. 5

35392 Gießen

Email: Richard.Schulz@innere.med.uni-giessen.de

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