{"id":26383,"date":"2024-10-21T09:34:02","date_gmt":"2024-10-21T07:34:02","guid":{"rendered":"https:\/\/idibell.cat\/?p=26383"},"modified":"2024-10-21T09:34:02","modified_gmt":"2024-10-21T07:34:02","slug":"un-estudi-de-bellvitge-revela-la-diversitat-en-lapnea-del-son-en-dones-i-proposa-una-revisio-en-els-enfocaments-diagnostics","status":"publish","type":"post","link":"https:\/\/idibell.cat\/2024\/10\/un-estudi-de-bellvitge-revela-la-diversitat-en-lapnea-del-son-en-dones-i-proposa-una-revisio-en-els-enfocaments-diagnostics\/","title":{"rendered":"Un estudi de Bellvitge revela la diversitat en l\u2019apnea del son en dones i proposa una revisi\u00f3 en els enfocaments diagn\u00f2stics"},"content":{"rendered":"<p><span data-contrast=\"auto\">Un estudi pioner dut a terme pel grup de recerca en pneumologia de l\u2019IDIBELL i l\u2019Hospital Universitari de Bellvitge posa de manifest la diversitat de l&#8217;apnea obstructiva del son (AOS) en les dones i q\u00fcestiona els resultats d\u2019estudis anteriors, que es basaven principalment en cohorts masculines. Aquest nou treball, fet exclusivament amb 1.886 pacients femenines tractades a la Unitat del Son de l\u2019Hospital de Bellvitge entre el 2011 i el 2019, demostra que les conclusions extretes d&#8217;estudis previs amb predomini d\u2019homes no reflecteixen adequadament la complexitat i diversitat de com es manifesta l&#8217;AOS en dones.<\/span><span data-ccp-props=\"{&quot;335551550&quot;:6,&quot;335551620&quot;:6,&quot;335559738&quot;:192,&quot;335559739&quot;:120}\">\u00a0<\/span><\/p>\n<p><span data-contrast=\"auto\">L&#8217;AOS \u00e9s un trastorn del son en qu\u00e8 la respiraci\u00f3 s&#8217;interromp de manera repetida, amb greus conseq\u00fc\u00e8ncies per a la salut, com malalties cardiovasculars o cognitives. La majoria d\u2019estudis previs sobre aquesta patologia inclouen poblacions amb predomini d\u2019homes, i sovint s\u2019extrapolen aquests resultats per guiar el diagn\u00f2stic i tractament de la malaltia en dones. Segons la Dra. Carme Monasterio, investigadora principal i coordinadora d\u2019aquest treball, \u201cal principi es pensava que era una malaltia que cl\u00e0ssicament afectava els homes perqu\u00e8 eren els que m\u00e9s consultaven, i s\u2019assumia que les dones presentaven m\u00e9s infradiagn\u00f2stic perqu\u00e8 tenien menys s\u00edmptomes que els homes, per\u00f2 aix\u00f2 ha resultat no ser cert\u201d.<\/span><span data-ccp-props=\"{&quot;335551550&quot;:6,&quot;335551620&quot;:6,&quot;335559738&quot;:192,&quot;335559739&quot;:120}\">\u00a0<\/span><\/p>\n<p><span data-contrast=\"auto\">Aquest enfocament ha generat una comprensi\u00f3 limitada de la manifestaci\u00f3 de l\u2019AOS en dones, ignorant les difer\u00e8ncies de g\u00e8nere en la presentaci\u00f3 de s\u00edmptomes. Segons la Dra. Eva Fontanilles, primera autora de l\u2019estudi, \u201csi fem una an\u00e0lisi espec\u00edfica nom\u00e9s en dones, com hem fet nosaltres, els resultats mostren que la seva manifestaci\u00f3 \u00e9s molt m\u00e9s heterog\u00e8nia del que es pensava\u201d.<\/span><span data-ccp-props=\"{&quot;335551550&quot;:6,&quot;335551620&quot;:6,&quot;335559738&quot;:192,&quot;335559739&quot;:120}\">\u00a0<\/span><\/p>\n<p><b><span data-contrast=\"auto\">Perfils diferenciats en dones amb AOS<\/span><\/b><span data-ccp-props=\"{&quot;335551550&quot;:6,&quot;335551620&quot;:6,&quot;335559738&quot;:192,&quot;335559739&quot;:120}\">\u00a0<\/span><\/p>\n<p><span data-contrast=\"auto\">L&#8217;estudi ha identificat quatre fenotips principals entre les pacients femenines amb AOS, que destaquen per les seves difer\u00e8ncies cl\u00edniques:<\/span><span data-ccp-props=\"{&quot;335551550&quot;:6,&quot;335551620&quot;:6,&quot;335559738&quot;:192,&quot;335559739&quot;:120}\">\u00a0<\/span><\/p>\n<ul>\n<li data-leveltext=\"\uf0b7\" data-font=\"Symbol\" data-listid=\"3\" data-list-defn-props=\"{&quot;335552541&quot;:1,&quot;335559685&quot;:720,&quot;335559991&quot;:360,&quot;469769226&quot;:&quot;Symbol&quot;,&quot;469769242&quot;:[8226],&quot;469777803&quot;:&quot;left&quot;,&quot;469777804&quot;:&quot;\uf0b7&quot;,&quot;469777815&quot;:&quot;hybridMultilevel&quot;}\" aria-setsize=\"-1\" data-aria-posinset=\"1\" data-aria-level=\"1\"><b><span data-contrast=\"auto\">Dones de mitjana edat amb s\u00edmptomes cl\u00e0ssics d&#8217;AOS i factors de risc cardiovascular (47 % de les pacients)<\/span><\/b><span data-contrast=\"auto\">: Aquest \u00e9s el perfil m\u00e9s com\u00fa i es caracteritza per la pres\u00e8ncia de s\u00edmptomes tradicionals com roncs, somnol\u00e8ncia di\u00fcrna i parades de la respiraci\u00f3 observades per familiars. Tamb\u00e9 s\u2019associa amb obesitat i\u00a0 factors de risc cardiovascular.<\/span><span data-ccp-props=\"{&quot;335551550&quot;:6,&quot;335551620&quot;:6,&quot;335559738&quot;:192,&quot;335559739&quot;:120}\">\u00a0<\/span><\/li>\n<\/ul>\n<ul>\n<li data-leveltext=\"\uf0b7\" data-font=\"Symbol\" data-listid=\"3\" data-list-defn-props=\"{&quot;335552541&quot;:1,&quot;335559685&quot;:720,&quot;335559991&quot;:360,&quot;469769226&quot;:&quot;Symbol&quot;,&quot;469769242&quot;:[8226],&quot;469777803&quot;:&quot;left&quot;,&quot;469777804&quot;:&quot;\uf0b7&quot;,&quot;469777815&quot;:&quot;hybridMultilevel&quot;}\" aria-setsize=\"-1\" data-aria-posinset=\"2\" data-aria-level=\"1\"><b><span data-contrast=\"auto\">Dones de mitjana edat amb pocs s\u00edmptomes i sense risc cardiovascular significatiu (27 % de les pacients)<\/span><\/b><span data-contrast=\"auto\">: Aquest perfil inclou dones amb AOS lleu-moderat que no presenten s\u00edmptomes greus i no tenen factors de risc cardiovascular destacats. Un tractament a valorar en aquest cas s\u00f3n mesures higi\u00e8nico-diet\u00e8tiques com millorar la dieta o la higiene postural.<\/span><span data-ccp-props=\"{&quot;335551550&quot;:6,&quot;335551620&quot;:6,&quot;335559738&quot;:192,&quot;335559739&quot;:120}\">\u00a0<\/span><\/li>\n<\/ul>\n<ul>\n<li data-leveltext=\"\uf0b7\" data-font=\"Symbol\" data-listid=\"3\" data-list-defn-props=\"{&quot;335552541&quot;:1,&quot;335559685&quot;:720,&quot;335559991&quot;:360,&quot;469769226&quot;:&quot;Symbol&quot;,&quot;469769242&quot;:[8226],&quot;469777803&quot;:&quot;left&quot;,&quot;469777804&quot;:&quot;\uf0b7&quot;,&quot;469777815&quot;:&quot;hybridMultilevel&quot;}\" aria-setsize=\"-1\" data-aria-posinset=\"3\" data-aria-level=\"1\"><b><span data-contrast=\"auto\">Dones majors (+65 anys) amb pocs s\u00edmptomes, malalties cardiovasculars associades i AOS greu (12 % de les pacients)<\/span><\/b><span data-contrast=\"auto\">: Aquest grup inclou dones amb apnea greu per\u00f2 amb s\u00edmptomes lleus, que a m\u00e9s ja presenten malaltia cardiovascular.<\/span><span data-ccp-props=\"{&quot;335551550&quot;:6,&quot;335551620&quot;:6,&quot;335559738&quot;:192,&quot;335559739&quot;:120}\">\u00a0<\/span><\/li>\n<\/ul>\n<ul>\n<li data-leveltext=\"\uf0b7\" data-font=\"Symbol\" data-listid=\"3\" data-list-defn-props=\"{&quot;335552541&quot;:1,&quot;335559685&quot;:720,&quot;335559991&quot;:360,&quot;469769226&quot;:&quot;Symbol&quot;,&quot;469769242&quot;:[8226],&quot;469777803&quot;:&quot;left&quot;,&quot;469777804&quot;:&quot;\uf0b7&quot;,&quot;469777815&quot;:&quot;hybridMultilevel&quot;}\" aria-setsize=\"-1\" data-aria-posinset=\"4\" data-aria-level=\"1\"><b><span data-contrast=\"auto\">Dones de mitjana edat amb trastorns de l&#8217;estat d&#8217;\u00e0nim, son no restauradora i risc cardiovascular (14 % de les pacients)<\/span><\/b><span data-contrast=\"auto\">: Aquest grup presenta uns s\u00edmptomes \u201cat\u00edpics\u201d sense somnol\u00e8ncia di\u00fcrna, cansament matut\u00ed i pot associar trastorn depressiu. \u00c9s el perfil que tradicionalment s\u2019havia associat a la dona, per\u00f2 no \u00e9s el m\u00e9s prevalent en aquest estudi.<\/span><span data-ccp-props=\"{&quot;335551550&quot;:6,&quot;335551620&quot;:6,&quot;335559738&quot;:192,&quot;335559739&quot;:120}\">\u00a0<\/span><\/li>\n<\/ul>\n<p><span data-contrast=\"auto\">\u201cEl que hem descobert \u00e9s que la presentaci\u00f3 \u201ccl\u00e0ssica\u201d que es considerava pr\u00f2pia de l\u2019AOS en homes tamb\u00e9 es presenta i \u00e9s prevalent en les dones\u201d, afirma la Dra. Monasterio, \u201ctot i que tamb\u00e9 trobem altres manifestacions menys t\u00edpiques, com el son no restaurador o trastorns de l&#8217;estat d&#8217;\u00e0nim\u201d.<\/span><span data-ccp-props=\"{&quot;335551550&quot;:6,&quot;335551620&quot;:6,&quot;335559738&quot;:192,&quot;335559739&quot;:120}\">\u00a0<\/span><\/p>\n<p><b><span data-contrast=\"auto\">Cap a un diagn\u00f2stic personalitzat i amb perspectiva de g\u00e8nere<\/span><\/b><span data-ccp-props=\"{&quot;335551550&quot;:6,&quot;335551620&quot;:6,&quot;335559738&quot;:192,&quot;335559739&quot;:120}\">\u00a0<\/span><\/p>\n<p><span data-contrast=\"auto\">Aquest estudi tamb\u00e9 subratlla la necessitat de revisar els criteris diagn\u00f2stics i tractaments actuals de l&#8217;AOS\u00a0 segons el fenotip trobat en les dones. \u201cHem vist que algunes dones poden tenir\u00a0 s\u00edmptomes at\u00edpics, com l&#8217;insomni o la fatiga emocional, i aix\u00f2 necessita un abordatge diferenciat\u201d, destaca la Dra. Fontanilles.<\/span><span data-ccp-props=\"{&quot;335551550&quot;:6,&quot;335551620&quot;:6,&quot;335559738&quot;:192,&quot;335559739&quot;:120}\">\u00a0<\/span><\/p>\n<p><span data-contrast=\"auto\">A mesura que es desenvolupi una millor comprensi\u00f3 de com es manifesta l&#8217;AOS en dones, ser\u00e0 clau adaptar els tractaments i eines diagn\u00f2stiques per a aquesta poblaci\u00f3. Els resultats d\u2019aquest estudi representen un pas important cap a un diagn\u00f2stic m\u00e9s personalitzat que tingui en compte la diversitat en la presentaci\u00f3 dels s\u00edmptomes i les difer\u00e8ncies de g\u00e8nere.<\/span><span data-ccp-props=\"{&quot;335551550&quot;:6,&quot;335551620&quot;:6,&quot;335559738&quot;:192,&quot;335559739&quot;:120}\">\u00a0<\/span><\/p>\n<p><span data-contrast=\"auto\">Segons les investigadores, aquest \u00e9s l\u2019estudi m\u00e9s gran de fenotips realitzat exclusivament en dones amb AOS fins ara, i pot ampliar la comprensi\u00f3 sobre com es manifesta aquesta malaltia en la poblaci\u00f3 femenina. \u201cDur a terme an\u00e0lisis espec\u00edfiques en dones \u00e9s essencial, tal com succeeix en altres \u00e0mbits m\u00e8dics, per evitar la infrarepresentaci\u00f3 de les condicions m\u00e8diques femenines\u201d, han explicat.<\/span><span data-ccp-props=\"{&quot;335551550&quot;:6,&quot;335551620&quot;:6,&quot;335559738&quot;:192,&quot;335559739&quot;:120}\">\u00a0<\/span><\/p>\n<p><span data-contrast=\"auto\">D\u2019altra banda, les doctores Monasterio i Fontanilles recorden que \u201cla causa m\u00e9s freq\u00fcent de somnol\u00e8ncia a la nostra societat \u00e9s dormir poques hores\u201d. \u201cSi es tracta d\u2019una persona que dorm les hores necess\u00e0ries, per\u00f2, aix\u00ed i tot, t\u00e9 somnol\u00e8ncia, i a m\u00e9s ronca i pateix apnees, tant si \u00e9s home com si \u00e9s dona, aix\u00f2 pot tenir conseq\u00fc\u00e8ncies i cal consultar-ho al seu metge o metgessa de cap\u00e7alera\u201d, han concl\u00f2s.<\/span><span data-ccp-props=\"{&quot;335551550&quot;:6,&quot;335551620&quot;:6,&quot;335559738&quot;:192,&quot;335559739&quot;:120}\">\u00a0<\/span><\/p>\n<p><span data-ccp-props=\"{&quot;335551550&quot;:6,&quot;335551620&quot;:6,&quot;335559738&quot;:192,&quot;335559739&quot;:120}\">\u00a0<\/span><\/p>\n<p><span data-ccp-props=\"{&quot;335551550&quot;:6,&quot;335551620&quot;:6,&quot;335559738&quot;:192,&quot;335559739&quot;:120}\">\u00a0<\/span><\/p>\n<p><i><span data-contrast=\"auto\">L\u2019Institut d&#8217;Investigaci\u00f3 Biom\u00e8dica de Bellvitge (IDIBELL) \u00e9s un centre de recerca en biomedicina creat l\u2019any 2004. Est\u00e0 participat per l&#8217;Hospital Universitari de Bellvitge i l\u2019Hospital de Viladecans de l&#8217;Institut Catal\u00e0 de la Salut, l&#8217;Institut Catal\u00e0 d&#8217;Oncologia, la Universitat de Barcelona i l\u2019Ajuntament de l\u2019Hospitalet de Llobregat.<\/span><\/i><span data-ccp-props=\"{&quot;335551550&quot;:6,&quot;335551620&quot;:6,&quot;335559738&quot;:192,&quot;335559739&quot;:120}\">\u00a0<\/span><\/p>\n<p><i><span data-contrast=\"auto\">L\u2019IDIBELL \u00e9s membre del Campus d&#8217;Excel\u00b7l\u00e8ncia Internacional de la Universitat de Barcelona HUBc i forma part de la instituci\u00f3 CERCA de la Generalitat de Catalunya. L&#8217;any 2009 es va convertir en un dels cinc primers centres d\u2019investigaci\u00f3 espanyols acreditats com a institut d\u2019investigaci\u00f3 sanit\u00e0ria per l\u2019Instituto de Salud Carlos III. A m\u00e9s, forma part del programa \u201cHR Excellence in Research\u201d de la Uni\u00f3 Europea i \u00e9s membre de EATRIS i REGIC. Des de l\u2019any 2018, l\u2019IDIBELL \u00e9s un Centro Acreditado de la Fundaci\u00f3n Cient\u00edfica AECC (FCAECC).<\/span><\/i><span data-ccp-props=\"{&quot;335551550&quot;:6,&quot;335551620&quot;:6,&quot;335559738&quot;:192,&quot;335559739&quot;:120}\">\u00a0<\/span><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Aquest nou estudi, basat en 1.886 dones amb apnea del son, revela una presentaci\u00f3 heterog\u00e8nia de la patologia en dones similar a la dels homes, contrariant la literatura pr\u00e8via que sovint associava les dones a una presentaci\u00f3 predominantment at\u00edpica.<\/p>\n","protected":false},"author":8,"featured_media":26384,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"site-sidebar-layout":"default","site-content-layout":"","ast-site-content-layout":"default","site-content-style":"default","site-sidebar-style":"default","ast-global-header-display":"","ast-banner-title-visibility":"","ast-main-header-display":"","ast-hfb-above-header-display":"","ast-hfb-below-header-display":"","ast-hfb-mobile-header-display":"","site-post-title":"","ast-breadcrumbs-content":"","ast-featured-img":"","footer-sml-layout":"","theme-transparent-header-meta":"default","adv-header-id-meta":"","stick-header-meta":"default","header-above-stick-meta":"","header-main-stick-meta":"","header-below-stick-meta":"","astra-migrate-meta-layouts":"set","ast-page-background-enabled":"default","ast-page-background-meta":{"desktop":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center 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