Obstructive Sleep Apnea, Insulin Resistance, and Steatohepatitis in Severe Obesity

Objective: The aim of this research was to assess the relationship between prevalence and severity of obstructive sleep apnea (OSA) and insulin resistance among patients with increased risk of OSA without diabetes mellitus. Method and materials: our study group involved 102 individuals with suspected OSA, mean age 53.02 ± 12.37 years. Data on medical history, medication usage, sleep habits, sleep quality and daytime sleepiness, were obtained using questionnaires. All patients underwent standardized full night polysomnography. Serum fasting insulin and glucose concentration were analyzed, the homeostatic model assessment-insulin resistance (HOMA-IR) index was calculated. Results: polysomnographic study indicated that in the group with OSA mean values of apnea–hypopnea index (AHI), oxygen desaturation index (ODI), duration of SpO2 < 90% and average desaturation drop were significantly higher compared to the group without OSA, while the minimum SpO2 was significantly lower. The carbohydrate metabolism parameters did not differ within those groups. Significantly higher fasting insulin concentration and HOMA-IR index were found in the group with AHI ≥ 15 compared to the group with AHI < 15 and in the group with AHI ≥ 30 compared to the group with AHI < 30. Higher AHI and ODI were independent risk factors for higher fasting insulin concentration and higher HOMA-IR index. Increased duration of SpO2 < 90% was an independent risk factor for higher fasting glucose concentration. Conclusions: Individuals with moderate to severe OSA without diabetes mellitus had a higher prevalence of insulin resistance.

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Continuous Positive Airway Pressure Therapy Improves Hypoadiponectinemia in Severe Obese Men With Obstructive Sleep Apnea Without Changes in Insulin Resistance

Metabolic Syndrome and Related Disorders ◽

10.1089/met.2009.0019 ◽

2009 ◽

Vol 7 (6) ◽

pp. 537-542 ◽

Cited By ~ 37

Author(s):

Gláucia Carneiro ◽

Sônia Maria Togeiro ◽

Fernando Flexa Ribeiro-Filho ◽

Eveli Truksinas ◽

Artur Beltrame Ribeiro ◽

...

Keyword(s):

Insulin Resistance ◽

Obstructive Sleep Apnea ◽

Sleep Apnea ◽

Continuous Positive Airway Pressure ◽

Airway Pressure ◽

Positive Airway Pressure ◽

Pressure Therapy ◽

Positive Airway Pressure Therapy ◽

Obstructive Sleep

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Obstructive sleep apnea and insulin resistance: correlation or causation?

Expert Review of Endocrinology & Metabolism ◽

10.1586/17446651.1.5.575 ◽

2006 ◽

Vol 1 (5) ◽

pp. 575-578

Author(s):

Tobias D Wiesner ◽

Michael Stumvoll

Keyword(s):

Insulin Resistance ◽

Obstructive Sleep Apnea ◽

Sleep Apnea ◽

Obstructive Sleep

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Relationship between the mitochondria-derived peptide MOTS-c and insulin resistance in obstructive sleep apnea

Sleep And Breathing ◽

10.1007/s11325-020-02273-0 ◽

2021 ◽

Author(s):

Filiz Alkan Baylan ◽

Esra Yarar

Keyword(s):

Insulin Resistance ◽

Obstructive Sleep Apnea ◽

Sleep Apnea ◽

Obstructive Sleep

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Association between sleep disordered breathing in early pregnancy and glucose metabolism

SLEEP ◽

10.1093/sleep/zsab281 ◽

2022 ◽

Author(s):

Laura Sanapo ◽

Margaret H Bublitz ◽

Alice Bai ◽

Niharika Mehta ◽

Geralyn M Messerlian ◽

...

Keyword(s):

Insulin Resistance ◽

Obstructive Sleep Apnea ◽

Sleep Apnea ◽

Glucose Metabolism ◽

Early Pregnancy ◽

Airway Pressure ◽

Sleep Disordered Breathing ◽

Positive Airway Pressure ◽

Obstructive Sleep ◽

Respiratory Event

Abstract Study Objectives To examine the association between maternal sleep disordered breathing (SDB) and glucose metabolism in early gestation. Methods Women with body mass index (BMI) ≥27 kg/m2 and singleton pregnancies underwent in-home sleep study (HSAT) and homeostatic model assessment (HOMA) in early pregnancy. Insulin resistance (HOMA-IR) and β-cell function (HOMA %B) were derived. Exclusion criteria included pregestational diabetes, use of continuous positive airway pressure and chronic steroid therapy. We performed linear regression analyses to evaluate the association between continuous measures of SDB (respiratory event index (REI), and oxygen desaturation index (ODI)) and glucose metabolism parameters (HOMA-IR and HOMA %B). Analyses were adjusted for a set of a priori selected variables which included gestational age, maternal age, BMI, ethnicity, race, and parity. Results One hundred and ninety-two pregnant women with median (interquartile range) BMI of 35.14 (8.30) kg/m2 underwent HSAT and HOMA assessment at 11.14 (3) and 15.35 (4.14) gestational weeks, respectively. REI and ODI, as continuous values, were associated with HOMA-IR after adjusting for covariates. OSA (obstructive sleep apnea) diagnosis (REI > 5 events per hour) was not associated with HOMA-IR after adjusting for BMI (p ≥ 0.05). None of the parameters were associated with HOMA %B (p > 0.07). Conclusions SDB and insulin resistance are associated in early pregnancy, with a dose response association between respiratory event index severity and insulin resistance. Further studies are needed to establish if pregnant women with overweight and obesity may benefit from early SDB screening to improve glucose metabolic outcome. Clinical trials: NCT02412696, Positive Airway Pressure, Sleep Apnea, and the Placenta (PAP-SAP) https://clinicaltrials.gov/ct2/show/NCT02412696?term=Bourjeily&draw=2&rank=2 and NCT02917876, Predictors of De-novo Development of Obstructive Sleep Apnea in Pregnancy (Predictors) https://clinicaltrials.gov/ct2/show/NCT02917876?term=Bourjeily&draw=2&rank=1

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