scholarly journals Reduced Systemic Levels of IL-10 Are Associated with the Severity of Obstructive Sleep Apnea and Insulin Resistance in Morbidly Obese Humans

2015 ◽  
Vol 2015 ◽  
pp. 1-9 ◽  
Author(s):  
Sonia Leon-Cabrera ◽  
Yoaly Arana-Lechuga ◽  
Enrique Esqueda-León ◽  
Guadalupe Terán-Pérez ◽  
Antonio Gonzalez-Chavez ◽  
...  
Keyword(s):  
Insulin Resistance ◽  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Interleukin 10 ◽  
Interleukin 12 ◽  
Apnea Hypopnea Index ◽  
Morbidly Obese ◽  
Necrosis Factor Alpha ◽  
Present Sample ◽  
Obstructive Sleep

Obstructive sleep apnea (OSA) has been related to elevation of inflammatory cytokines and development of insulin resistance in morbidly obese (MO) subjects. However, it is still unclear whether the systemic concentration of anti-inflammatory mediators is also affected in MO subjects directly related to the severity of OSA and level of insulin resistance. Normal weight and MO subjects were subjected to overnight polysomnography in order to establish the severity of OSA, according to the apnea-hypopnea index (AHI). Blood samples were obtained for estimation of total cholesterol and triglycerides, insulin, glucose, insulin resistance, tumor necrosis factor alpha (TNF-α), interleukin 12 (IL12), and interleukin 10 (IL-10). Serum levels of IL-10 were significantly lower in MO subjects with OSA than in MO and control individuals without OSA. Besides being inversely associated with serum TNF-αand IL-12, decreased IL-10 levels were significantly related to increased AHI, hyperinsulinemia, and insulin resistance. Serum IL-10 is significantly reduced in morbidly obese subjects with severe OSA while also showing a clear relationship with a state of hyperinsulinemia and insulin resistance probably regardless of obesity in the present sample. It may be of potential clinical interest to identify the stimulatory mechanisms of IL-10 in obese individuals with OSA.

Improvement in Obstructive Sleep Apnea (OSA) in Super Morbidly Obese Patients After Bariatric Surgery

2020 ◽  
Vol 103 (8) ◽  
pp. 725-728
Keyword(s):  
Bariatric Surgery ◽  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Lifestyle Modification ◽  
Apnea Hypopnea Index ◽  
Morbidly Obese ◽  
Obese Patients ◽  
Obstructive Sleep ◽  
Objective Evidence

Background: Lifestyle modification is the mainstay therapy for obese patients with obstructive sleep apnea (OSA). However, most of these patients are unable to lose the necessary weight, and bariatric surgery (BS) has been proven to be an effective modality in selected cases. Objective: To provide objective evidence that BS can improve OSA severity. Materials and Methods: A prospective study was conducted in super morbidly obese patients (body mass index [BMI] greater than 40 kg/m² or BMI greater than 35 kg/m² with uncontrolled comorbidities) scheduled for BS. Polysomnography (PSG) was performed for preoperative assessment and OSA was treated accordingly. After successful surgery, patients were invited to perform follow-up PSG at 3, 6, and 12 months. Results: Twenty-four patients with a mean age of 35.0±14.0 years were enrolled. After a mean follow-up period of 7.8±3.4 months, the mean BMI, Epworth sleepiness scale (ESS), and apnea-hypopnea index (AHI) significantly decreased from 51.6±8.7 to 38.2±6.8 kg/m² (p<0.001), from 8.7±5.9 to 4.7±3.5 (p=0.003), and from 87.6±38.9 to 28.5±21.5 events/hour (p<0.001), respectively. Conclusion: BS was shown to dramatically improve clinical and sleep parameters in super morbidly obese patients. Keywords: Morbid obesity, Bariatric surgery, Obstructive sleep apnea (OSA)

scholarly journals Circulating sTweak is associated with visceral adiposity and severity in patients with obstructive sleep apnea syndrome

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Sule Cilekar ◽  
Selvihan Beysel ◽  
Savas Karatas ◽  
Aydin Balci ◽  
Kursad Akaslan ◽  
...  
Keyword(s):  
Insulin Resistance ◽  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Glucose Metabolism ◽  
Obstructive Sleep Apnea Syndrome ◽  
Sleep Apnea Syndrome ◽  
Visceral Adiposity ◽  
Apnea Hypopnea Index ◽  
Obstructive Sleep ◽  
Apnea Syndrome

AbstractHypoxia is linked to an inflammatory imbalance in obstructive sleep apnea syndrome (OSAS). Circulating soluble tumor necrosis factor (TNF)-like weak inducer of apoptosis (sTWEAK) is a cytokine that regulates inflammation and insulin resistance in adipose tissue. This study first investigated sTWEAK concentrations in patients OSAS and evaluated associations between sTWEAK concentrations and visceral adiposity, metabolic dysfunction, and hypoxia observed in OSAS. Forty age, sex, and body mass index-matched patients with simple habitual snoring (HSS) and 70 patients with OSAS were included. Patients were divided according to OSAS severity: mild-moderate (apnea–hypopnea index, AHI 5–30 events/h) and severe (AHI ≥ 30 events/h). Anthropometric data, glucose metabolism, visceral fat (VF) ratio, and sTWEAK levels were compared. sTWEAK levels were higher in the OSAS group than in the HSS group (931.23 ± 136.48 vs. 735.22 ± 102.84 ng/L, p = 0.001). sTWEAK levels were higher in severe OSAS than in mild-moderate OSAS (1031.83 ± 146.69 vs. 891.01 ± 110.01 ng/L, p = 0.002. When we evaluated the sTWEAK value and AHI, VF ratio, total cholesterol, blood pressure, homeostasis model of assessment-insulin resistance, and high-sensitivity C-reactive protein using multiple regression analysis, a significant correlation was found between sTWEAK levels and AHI (p < 0.001). It was found that sTWEAK levels were not correlated with glucose metabolism and VF ratio. Increased circulating sTWEAK levels were associated with the severity of OSAS. High sTWEAK levels were correlated with increased AHI. sTWEAK concentrations are linked to severe OSAS.

scholarly journals Circulating Endocannabinoids and Insulin Resistance in Patients with Obstructive Sleep Apnea

2016 ◽  
Vol 2016 ◽  
pp. 1-8 ◽  
Author(s):  
Xiaoya Wang ◽  
Qin Yu ◽  
Hongmei Yue ◽  
Jiabin Zhang ◽  
Shuang Zeng ◽  
...  
Keyword(s):  
Insulin Resistance ◽  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Resistance Index ◽  
Control Group ◽  
Apnea Hypopnea Index ◽  
Insulin Resistance Index ◽  
Obstructive Sleep ◽  
Insulin Homeostasis ◽  
The Relationship

Objectives. The purpose of this study is to investigate the relationship between plasma endocannabinoids and insulin resistance (IR) in patients with obstructive sleep apnea (OSA).Methods. A population of 64 with OSA and 24 control subjects was recruited. Body mass index (BMI), waist circumference, lipids, blood glucose and insulin, homeostasis model of assessment for insulin resistance index (HOMA-IR), anandamide (AEA), 1/2-arachidonoylglycerol (1/2-AG), and apnea-hypopnea index (AHI) were analyzed.Results. Fasting blood insulin (22.9 ± 7.8 mIU/L versus 18.5 ± 7.2 mIU/L,P<0.05), HOMA-IR (2.9 ± 1.0 versus 2.4 ± 0.9,P<0.01), AEA (3.2 ± 0.7 nmol/L versus 2.5 ± 0.6 nmol/L,P<0.01), and 1/2-AG (40.8 ± 5.7 nmol/L versus 34.3 ± 7.7 nmol/L,P<0.01) were higher in OSA group than those in control group. In OSA group, AEA, 1/2-AG, and HOMA-IR increase with the OSA severity. The correlation analysis showed significant positive correlation between HOMA-IR and AHI (r=0.44,P<0.01), AEA and AHI (r=0.52,P<0.01), AEA and HOMA-IR (r=0.62,P<0.01), and 1/2-AG and HOMA-IR (r=0.33,P<0.01). Further analysis showed that only AEA was significantly correlated with AHI and HOMA-IR after adjusting for confounding factors.Conclusions. The present study indicated that plasma endocannabinoids levels, especially AEA, were associated with IR and AHI in patients with OSA.

Abstract P461: The Association of NOV/CCN3 With Obstructive Sleep Apnea in Severe Morbid Obesity: Preliminary Evidence of a Novel Biomarker in OSA

Hypertension ◽  
2017 ◽  
Vol 70 (suppl_1) ◽  
Author(s):  
Jeremy A Weingarten ◽  
Lars Bellner ◽  
Stephen J Peterson ◽  
Moe Zaw ◽  
Puja Chadha ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Clinical Evaluation ◽  
Matrix Protein ◽  
Extracellular Matrix Protein ◽  
Apnea Hypopnea Index ◽  
Morbidly Obese ◽  
Obstructive Sleep ◽  
Obese Subjects ◽  
Lean Group

Background: Obstructive sleep apnea (OSA) is strongly associated with cardiovascular and metabolic abnormalities, although the mechanism driving this association is not well understood. NOV/CCN3, a multifunctional extracellular matrix protein, may play a mechanistic and/or prognostic role in these associations. We hypothesized that patients with OSA will have increased levels of NOV, and that NOV can serve as a biomarker in patients to predict OSA as well as metabolic and cardiac risk. Materials and Methods: 10 morbidly obese subjects presenting to the sleep laboratory for clinical evaluation of possible OSA and 10 healthy lean controls underwent overnight polysomnography and clinical evaluation. Blood samples were analyzed for NOV levels, adiponectin, and IL-6. Results: OSA was found in 9 obese subjects and 3 lean subjects. NOV levels were significantly higher in the obese vs lean group (2.2±0.3 vs 1.4±0.2 fold change, p<0.03) while apnea-hypopnea index (AHI) was similarly higher in the obese vs lean group (22.9±6.7 vs 8.4±4.1 events/hr, p<0.03). NOV and AHI were positively correlated (ρ=0.49, p=0.033). IL-6 was elevated while adiponectin was reduced in obese vs lean. Conclusions: NOV levels and AHI, a measure of OSA severity, were higher in obese subjects vs lean controls and were correlated with each other. NOV may be a marker of OSA severity and a biomarker for cardiovascular and metabolic disease in OSA patients.

scholarly journals The role of inflammation in the association between gestational diabetes and obstructive sleep apnea: A pilot study

2018 ◽  
Vol 11 (4) ◽  
pp. 186-191 ◽  
Author(s):  
MH Bublitz ◽  
M Carpenter ◽  
S Amin ◽  
ML Okun ◽  
R Millman ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Gestational Diabetes ◽  
Interleukin 6 ◽  
Interleukin 8 ◽  
Apnea Hypopnea Index ◽  
Necrosis Factor Alpha ◽  
Obstructive Sleep ◽  
Factor Alpha ◽  
Necrosis Factor

Background Obstructive sleep apnea is associated with pregnancy complications including gestational diabetes. Mechanisms underlying the association between obstructive sleep apnea and gestational diabetes remain to be elucidated. Methods Twenty-three participants with gestational diabetes underwent home sleep apnea testing. Obstructive sleep apnea was defined as an apnea hypopnea index > 5. Fasting morning blood samples were measured using multianalyte profiling (xMAP) multiplexed bead array immunoassay for Interleukin 6, tumor necrosis factor-alpha, and Interleukin 8. Results Age, body mass index, and gestational age at enrollment were 31 + 4.4 years, 35.7 + 7.4 kg/m2, and 28 ± 4 weeks, respectively. Participants were 52% Caucasian and 16% had obstructive sleep apnea. We observed positive correlations between apnea hypopnea index and Interleukin 6 (r = 0.62, p = 0.005), Interleukin 8 (r = 0.56, p = .56), and tumor necrosis factor-alpha (r = .58, p = .009). Women with obstructive sleep apnea had higher levels of Interleukin 6 (F = 5.01, p = .037) and Interleukin 8 (F = 6.33, p = .021) vs. women without obstructive sleep apnea. Conclusion These preliminary results indicate that in women with gestational diabetes, apnea hypopnea index is associated with an elevated inflammatory profile.

scholarly journals Insulin resistance and affecting factors in patients with obstructive sleep apnea syndrome

2017 ◽  
Vol 3 (4) ◽  
pp. 986
Author(s):  
Hatice Beyazal Polat ◽  
Metin Çeliker ◽  
Songül Özyurt ◽  
Suat Terzi ◽  
Abdülkadir Özgür
Keyword(s):  
Insulin Resistance ◽  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Obstructive Sleep Apnea Syndrome ◽  
Sleep Apnea Syndrome ◽  
Apnea Hypopnea Index ◽  
Obese Patients ◽  
Obstructive Sleep ◽  
The Mean ◽  
Apnea Syndrome

<p class="abstract"><strong>Background:</strong> Metabolic syndrome and insulin resistance are common in patients with obstructive sleep apnea syndrome (OSAS) independently of obesity. This study aims to examine and evaluate the insulin resistance and the factors affecting the insulin resistance in patients with OSAS.</p><p class="abstract"><strong>Methods:</strong> Patients admitted to the sleep disorders clinic of our hospital with snoring complaints and diagnosed with OSAS in the last 6 months were included to the study. Insulin resistance was calculated by the Homa-IR formula. &gt;2.7 was considered insulin resistance.  </p><p class="abstract"><strong>Results:</strong> The mean Homa-IR value was 3.86±4.69 and 42 (49.4%) patients were found to have insulin resistance. Mean insulin resistance was 2.68±2.2 in normal weight patients, 2.30±1.41 in overweight patients, 3.96±1.83 in obese patients, and 8.61±12.13 in morbid obese patients. The mean apnea hypopnea index of the patients was 22.95±15.20; 30 (35.2%) were with mild, 26 (30.6%) were with moderate and 29 (34.1%) were with severe OSAS. Insulin resistance was 2.35±1.36 in patients with mild AHI; 3.09±1.30 in<strong> </strong>patients with moderate AHI, and 6.11±7.35 in severe cases. In our study, the most significant relationship was found to be between insulin resistance in OSAS patients with insulin resistance and BMI and AHI.</p><p><strong>Conclusions:</strong> Insulin resistance is common in patients with OSAS independently of obesity. In our study, BMI and AHI were found to be the most important factors associated with insulin resistance in patients with OSAS.</p>

scholarly journals Insulin Resistance and Type 2 Diabetes in Asymptomatic Obstructive Sleep Apnea: Results of the PROOF Cohort Study After 7 Years of Follow-Up

2021 ◽  
Vol 12 ◽  
Author(s):  
Laurine Vacelet ◽  
David Hupin ◽  
Vincent Pichot ◽  
Sébastien Celle ◽  
Isabelle Court-Fortune ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Insulin Resistance ◽  
Obstructive Sleep Apnea ◽  
Cohort Study ◽  
Sleep Apnea ◽  
The Elderly ◽  
Apnea Hypopnea Index ◽  
Obstructive Sleep ◽  
Increased Risk

The aim of the study was to assess potential associations between obstructive sleep apnea (OSA) and the occurrence of diabetes mellitus and insulin resistance in the elderly. Nondiabetic volunteers (n = 549) with undiagnosed or untreated asymptomatic OSA (66.2+/−1 years at the inclusion) were evaluated as an ancillary study of the PROOF cohort study (n = 1,011). After 7 years follow-up, 494 subjects underwent assessment of fasting insulin and glucose levels. OSA was defined by an apnea-hypopnea index (AHI) of ≥15/h using polygraphy. Diabetes mellitus was defined by a fasting glucose ≥ 1.26 g/L and/or when requiring pharmacological treatment, while insulin resistance corresponded to HOMA-IR ≥ 2. Asymptomatic OSA subjects (men or women) did not display increased risk of incident diabetes (2.8 vs. 3.9%, p = 0.51). However, there was a greater frequency of insulin resistance in subjects with severe OSA (AHI &gt; 30) [OR 2.21; 95% CI (1.22–4.02); p = 0.009]. Furthermore, multiple logistic regression showed that triglycerides levels [OR 1.61; 95% CI (1.10–2.36); p = 0.01] and fasting glycaemia [OR 4.69; 95% CI (1.12–192.78); p = 0.04], but not AHI or oxyhemoglobin desaturation index were independently associated with higher rate of insulin resistance. The deleterious metabolic effect of asymptomatic OSA in the population may be indirectly mediated via perturbations in lipids, and is particularly likely to become manifest in severe apneic subjects with higher glycemic levels.

Aerodynamics Analysis of the Impact of Nasal Surgery on Patients with Obstructive Sleep Apnea and Nasal Obstruction

ORL ◽  
2021 ◽  
pp. 1-8
Author(s):  
Lifeng Li ◽  
Demin Han ◽  
Hongrui Zang ◽  
Nyall R. London
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Nasal Obstruction ◽  
Upper Airway ◽  
Apnea Hypopnea Index ◽  
Nasal Surgery ◽  
Subjective Sleep Quality ◽  
Obstructive Sleep ◽  
Significant Difference ◽  
The Impact

<b><i>Objective:</i></b> The purpose of this study was to evaluate the effects of nasal surgery on airflow characteristics in patients with obstructive sleep apnea (OSA) by comparing the alterations of airflow characteristics within the nasal and palatopharyngeal cavities. <b><i>Methods:</i></b> Thirty patients with OSA and nasal obstruction who underwent nasal surgery were enrolled. A pre- and postoperative 3-dimensional model was constructed, and alterations of airflow characteristics were assessed using the method of computational fluid dynamics. The other subjective and objective clinical indices were also assessed. <b><i>Results:</i></b> By comparison with the preoperative value, all postoperative subjective symptoms statistically improved (<i>p</i> &#x3c; 0.05), while the Apnea-Hypopnea Index (AHI) changed little (<i>p</i> = 0.492); the postoperative airflow velocity and pressure in both nasal and palatopharyngeal cavities, nasal and palatopharyngeal pressure differences, and total upper airway resistance statistically decreased (all <i>p</i> &#x3c; 0.01). A significant difference was derived for correlation between the alteration of simulation metrics with subjective improvements (<i>p</i> &#x3c; 0.05), except with the AHI (<i>p</i> &#x3e; 0.05). <b><i>Conclusion:</i></b> Nasal surgery can decrease the total resistance of the upper airway and increase the nasal airflow volume and subjective sleep quality in patients with OSA and nasal obstruction. The altered airflow characteristics might contribute to the postoperative reduction of pharyngeal collapse in a subset of OSA patients.

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