Impaired Glucose Metabolisms of Patients with Obstructive Sleep Apnea and Type 2 Diabetes

Abstract

Aims Obstructive sleep apnea (OSA) is a very common disorder which is associated with metabolic comorbidities. The aims of this study were to analyze clinical data of patients with OSA and evaluate influence of sleep-disordered breathing on glycometabolism and its underlying mechanisms. Methods We designed a cross-sectional study involving 53 OSA patients in The First Hospital of Jilin University from March 2015 to March 2016. They underwent a full-night polysomnography, measurement of fasting blood glucose and blood lipid profiles. Besides, we chose 20 individuals with type 2 diabetes mellitus (T2DM) as a subgroup for an in-depth study. This group additionally underwent a steamed bread meal test and measurement of HbA1c, C-reactive protein, tumor necrosis factor-α, interleukin 6, morning plasma cortisol, and growth hormone. Results The two groups which with or without T2DM showed no significant differences in baseline characteristics. As for OSA patients with T2DM, the severe OSA group had higher homeostasis model assessment of insulin resistance (HOMA-IR) (P = 0.013) than the mild-to-moderate OSA group, whereas had lower morning plasma cortisol levels (P = 0.005) than the mild-to-moderate OSA group. AHI was positive correlated with HOMA-IR (r = 0.523, P = 0.018), yet negative correlated with morning plasma cortisol (r = −0.694, P = 0.001). However, nadir SpO2 was positive correlated with morning plasma cortisol (rs = 0.646, P = 0.002), while negative correlated with HOMA-IR (rs = −0.489, P = 0.029). Conclusions Our study showed that sleep-disordered breathing exerted negative influence on glucose metabolisms. The impairment of hypothalamic-pituitary-adrenal axis activity may be one of the underlying mechanisms of the glycometabolic dysfunctions in OSA with T2DM patients.

Development and validation of a nomogram for predicting the risk of obstructive sleep apnea in patients with type 2 diabetes

“…In patients with OSA and T2DM, the effects of sleep-disordered breathing on glucose metabolism and the underlying mechanisms have yet to be thoroughly investigated. Nevertheless, in agreement with the findings of our study, previous research has demonstrated that severe OSA is associated with higher HOMA-IR (45).…”

Compared to Individuals with Mild to Moderate Obstructive Sleep Apnea (OSA), Individuals with Severe OSA Had Higher BMI and Respiratory-Disturbance Scores

“…Similarly, OSA appeared to be associated with autoimmune rheumatic disease [ 10 ]. Next, OSA appeared to be an independent factor for cardiovascular diseases [ 11 , 12 , 13 , 14 ] and all-cause mortality [ 14 ], while further associations were observed among the occurrence of OSA and diabetes mellitus [ 15 , 16 , 17 , 18 , 19 ] and hormonal disorders [ 20 ]. For morning saliva and blood cortisol levels, compared to adult healthy controls, adults with OSAS had no difference in cortisol levels [ 21 ].…”

Postprandial glucose and HbA1c are associated with severity of obstructive sleep apnoea in non-diabetic obese subjects

“…Moreover, several other blood metabolites other than 2 h-PG, HbA1c and uric acid, such as circulating complement component 3, CRP and erythropoietin, have recently been raised as promising biomarkers supporting the diagnosis of OSA [48][49][50][51].…”