DOI: http://dx.doi.org/10.18203/issn.2454-2156.IntJSciRep20174871

Moving beyond the metabolic syndrome: syndrome Z in Indian subcontinent: a case report and review of literature

Akash Mathur, Tanmay Gandhi, Aditya Bajaj, Anil H. Inamdar

Abstract


Conventionally the combination of obstructive sleep apnea (OSA) and the metabolic syndrome (syndrome X) has been described as syndrome Z. With the dawn of modern era while there has been a rapid upsurge in the incidence of syndrome Z there has also been a paradigm shift in its topographical distribution. Syndrome Z earlier a disease predominantly of the developed world is now rapidly acquiring the magnitude of an epidemic in the developing nations as well. Coexisting OSA and metabolic syndrome also have a synergistic impact in increasing the risk for cardiovascular diseases. Hence, we present here a case report of syndrome Z and review of literature from the Indian subcontinent to essentially prime the physicians regarding this syndrome with significant social and economic impact, so that early health measures can be initiated to identify and treat the syndrome Z epidemic.


Keywords


Syndrome Z, OSA, Metabolic syndrome, Syndrome X, AHI

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References


Kasper D, Fauci A, Hauser S, Longo D, Jameson J, Loscalzo J. Harrison's principles of internal medicine. 19th ed. New York: McGraw-Hill; 2015.

Sleep-related breathing disorders in adults: recommendations for syndrome definition and measurement techniques in clinical research. The Report of an American Academy of Sleep Medicine Task Force. Sleep. 1999;22(5):667-89.

Sharma SK, Reddy EV, Sharma A, Kadhiravan T, Mishra HK, Sreenivas V, Mishra HK, Lakshmy R. Prevalence and risk factors of syndrome Z in urban Indians. Sleep Med. 2010;11(6):562-8.

Reddy EV, Kadhiravan T, Mishra HK, Sreenivas V, Handa KK, Sinha S, et al. Prevalence and risk factors of obstructive sleep apnea among middle-aged urban Indians: A community-based study. Sleep Med. 2009;10:913–8.

Lam JC, Sharma SK, Lam B. Obstructive sleep apnoea: Definitions, epidemiology and natural history. Indian J Med Res. 2010;131:165–70.

Wilcox I, McNamara SG, Collins FL, Grunstein RR, Sullivan CE. ‘‘Syndrome Z’’: the interaction of sleep apnoea, vascular risk factors and heart disease. Thorax. 1998;53:25–8.

Peppard PE, Young T, Barnet JH, Palta M, Hagen EW, Hla KM. Increased prevalence of sleepdisordered breathing in adults. Am J Epidemiol. 2013;177(9):1006-14.

Young T, Peppard PE, Gottlieb DJ. Epidemiology of obstructive sleep apnea: a population health perspective. Am J Respir Crit Care Med. 2002;165(9):1217-39.

Goldbart AD. Sleep medicine. Curr Opin Pediatr. 2015;27(3):329-33.

Agrawal S, Sharma SK, Sreenivas V, Lakshmy R. Prevalence of metabolic syndrome in a north Indian hospital-based population with obstructive sleep apnoea. Indian J Med Res. 2011;134:639-44.

Mishra B, Mishra B. Acute onset sleep apnea with severe transient hyperglycemia in young adult: the diagnostic dilemma and management controversy. Int J Res Med Sci. 2013;1:168-72.

Hasan A, Uzma N, Swamy T, Shoba A, Kumar B. Correlation of clinical profiles with obstructive sleep apnea and metabolic syndrome. Sleep Breathing. 2011;16(1):111-6.

Khot R, Sinha N, Joshi R, Wankhade N. Prevalence and Clinical Profile of Syndrome Z in Type 2 Diabetes Mellitus. Vidarbha J Internal Med. 2017;23:6-12.

Iyer S. Sleep and Type 2 Diabetes Mellitus- Clinical Implications. JAPI. 2012;60:42-7.

Soneja M, Singh V. Metabolic abnormalities in obstructive sleep apnea: A double whammy. Lung India. 2012;29:107-8.

Sharma SK, Agrawal S, Damodaran D, Sreenivas V, Kadhiravan T, Lakshmy R. CPAP for the Metabolic Syndrome in Patients with Obstructive Sleep Apnea. N Engl J Med. 2011;365:2277-86.

Dubey AP, Rajput AK, Suhag V, Sharma D, Kandpal A, Keisham R. Prevalence of obstructive sleep apnoea in metabolic syndrome. Int J Adv Med. 2017;4:722-7.

Iyer S, Iyer R. Sleep and obesity in the causation of metabolic syndrome. Int J Diab Dev Ctries. 2006;26(2):63-9.

Pandharipande M, Manohar T, Joshi P. Metabolic syndrome and Obsructive sleep apnea - Syndrome Z. Vidarbha J Internal Med. 2017;23:4-5.

Ravindran C, Arun P, Harilakshmanan P. Calicut Medical J. 2007;5(1):1.