RESUMEN
Obstructive sleep apnoea (OSA) seems to worsen metabolism. This effect has not been evaluated in morbid obesity (MO). We hypothesised that the metabolic profile is more impaired in MO patients with OSA than in those without, and investigated whether any specific metabolic dysfunction is related to OSA in MO. A prospective multicentre cross-sectional study was conducted in consecutive subjects before bariatric surgery. OSA was defined as apnoea/hypopnoea index (AHI) ≥15 by overnight polysomnography. Anthropometrical, blood pressure (BP) and fasting blood measurements were obtained the morning after. Metabolic syndrome (MetS) was defined according to National Cholesterol Education Program Adult Treatment Panel III modified criteria. 159 patients were studied: 72% were female and 72% had OSA. MetS prevalence was 70% in OSA versus 36% in non-OSA (p<0.001). As AHI severity increased, metabolic parameters progressively worsened, even in those without type 2 diabetes (DM2). AHI was independently associated with systolic and diastolic BP, triglycerides and the percentage of glycosylated haemoglobin (HbA1c) in the total sample, and with systolic BP, high-density lipoprotein cholesterol and HbA1c in those samples without DM2. OSA increased the adjusted odds ratio of having MetS by 2.8 (95% CI 1.3-6.2; p=0.009). In MO, OSA is associated with major metabolic impairment caused by higher BP and poorer lipid and glucose control, independent of central obesity or DM2.
Asunto(s)
Síndrome Metabólico/complicaciones , Obesidad Mórbida/complicaciones , Apnea Obstructiva del Sueño/complicaciones , Adolescente , Adulto , Glucemia/análisis , Presión Sanguínea , Diabetes Mellitus Tipo 2/complicaciones , Femenino , Hemoglobina Glucada/análisis , Humanos , Lípidos/sangre , Masculino , Persona de Mediana Edad , Obesidad Mórbida/metabolismo , Oxígeno/sangre , Polisomnografía , Apnea Obstructiva del Sueño/fisiopatología , Adulto JovenRESUMEN
No disponible
Asunto(s)
Humanos , Administración por Inhalación , Enfermedad Pulmonar Obstructiva Crónica , Glucocorticoides , Neoplasias PulmonaresRESUMEN
We report a case of a 26 year old man who was diagnosticated of ALS. This case is a graphic example of the pulmonary function evolution through the flow-volume loop. In the first study the espirometric values were in the normal range. The Static pulmonary pressures were weackle decreased. This was the only sign of respiratory muscle impairement. Its important to study close enough the pulmonary function through the flow/volume loop, maximal respiratory pressures and maximal voluntary Ventilation in order to know the empairment rate, and also to detect intercurrent procedures as bulbar involvement, that can affect the prognosis of the disease.
Asunto(s)
Enfermedad de la Neurona Motora/fisiopatología , Pruebas de Función Respiratoria , Músculos Respiratorios/fisiopatología , Adulto , Progresión de la Enfermedad , Resultado Fatal , Humanos , Masculino , Insuficiencia Respiratoria/etiología , EspirometríaRESUMEN
Presentamos el caso de un paciente de 26 años de edad diagnosticado de esclerosis lateral amiotrófica (ELA), periódicamente evaluado en su función pulmonar durante los 5,5 años que duró su enfermedad. Se destacan la evolución de la fuerza muscular respiratoria a través de la determinación de las presiones respiratorias máximas y la resistencia muscular vista a partir de la ventilación voluntaria máxima. Asimismo, la forma de la curva flujo/volumen permitió analizar la inestabilidad de la vía aérea superior, que coincidió con la aparición de síntomas bulbares. El estudio de la función pulmonar debe formar parte de la monitorización de las enfermedades neuromusculares (AU)
