The adipose tissue in obesity and obstructive sleep apnea

197 words) An ERS Research Seminar on “Metabolic alterations in obstructive sleep apnea (OSA)” was jointly organised in October 2009 together with two EU COST Actions (“Cardiovascular Risk in the Obstructive Sleep Apnea Syndrome” Action B26, and “Adipose Tissue and the Metabolic Syndrome” Action BM0602) in order to discuss the interactions between obesity and OSA. Such interactions can be particularly significant in the pathogenesis of metabolic abnormalities and increased cardiovascular risk in OSA patients. Studying the respective role of OSA and obesity, however, is difficult in patients, making it necessary to refer to animal models or in vitro systems. Since most OSA patients are obese, their management requires a multidisciplinary approach. This review summarizes some aspects of the pathophysiology and treatment of obesity, and the possible effects of sleep loss on metabolism. OSA-associated metabolic dysfunction (insulin resistance, liver dysfunction, atherogenic dyslipidemia) is discussed from the perspectives of both obesity and OSA in adults and children. Finally, the effects of treatment for obesity or OSA, or both, on cardio-metabolic variables are summarized. Further interdisciplinary research is needed in order to develop new comprehensive treatment approaches aimed at reducing sleep disordered breathing, obesity and cardiovascular risk.