<p>Obstructive Sleep Apnea Exacerbates Glucose Dysmetabolism and Pancreatic β-Cell Dysfunction in Overweight and Obese Nondiabetic Young Adults</p>

Abstract

This study aimed to investigate the effects of obstructive sleep apnea (OSA) on the pancreatic β-cells dysfunction and their implications in the glucose dysmetabolism of overweight and obese nondiabetic young adults. Materials and Methods: The cross-sectional analysis included 422 subjects (261 males/ 161 females) with the mean age of 27.77 ± 7.51 years and average body mass index (BMI) of 34.84 ± 5.69 kg/m 2. All subjects underwent polysomnography (PSG), oral glucose toleranceinsulin releasing test (OGTT-IRT) and serum glycosylated hemoglobin A1 (HbA1c) measurement. The glucose metabolism and pancreatic β-cell function in relation to measures of OSA were determined adjustment for important confounders such as age and sex. Results: OSA subjects accounted for 54.91% in the normal glucose tolerance (NGT) group and 72.11% in the prediabetes (preDM) group (P =0.001). HbA1c was the highest in the preDM subjects with severe OSA. In the NGT subjects, the 1-h glucose level significantly elevated with the OSA severity, and the homeostasis model assessment-β (HOMA-β) was negatively related to nocturnal mean SpO 2 (P <0.05). In the preDM subjects, HOMA-β, early phase insulinogenic index (ΔI 30 /ΔG 30), total area under the curve of insulin in 180 min (AUC-I 180), and the oral disposition index (DI O) were the lowest in the severe OSA group. DI O was associated with higher oxygen desaturation index (ODI) and lower nocturnal mean SpO 2 , and AUC-I 180 was negatively related to TS90 (P <0.05). Conclusion: Our study indicated higher prevalence of OSA in overweight and obese nondiabetic young adults, especially preDM subjects. The impaired glucose tolerance was observed early after glucose intake in the NGT subjects. OSA induces compensatory increase in the pancreatic β-cell function in the NGT subjects, while pancreatic β-cell dysfunction is present in the preDM subjects with severe OSA.

Obstructive sleep apnea, prediabetes and progression of type 2 diabetes: A systematic review and meta‐analysis

“…The summary characteristics of all included studies in the present meta‐analysis are listed in Table 1 . Eight were cohort studies 6 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 14 were cross‐sectional studies 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 and three were case–control studies 3 , 43 , 44 . A meta‐analysis of each study design was carried out separately.…”

“…Regarding study classifications, most of the studies included both female and male participants, except for three studies that included only men 3 , 22 , 24 and one study that included only women 36 . Eight studies reported OSA and IFG risk 3 , 6 , 31 , 36 , 37 , 40 , 41 , 42 ; 10 reported OSA and IGT risk 3 , 6 , 31 , 32 , 35 , 36 , 37 , 40 , 41 , 43 ; five reported IFG and/or IGT risk 6 , 30 , 33 , 34 , 40 ; and 19 reported OSA and type 2 diabetes mellitus risk 6 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 33 , 34 , 35 , 37 , 38 , 39 , 42 , 44 . Eight studies reported an association of OSA with type 2 diabetes mellitus according to AHI severity 23 , 26 , 28 ...…”

“…A total of 10 articles 3 , 6 , 31 , 32 , 35 , 36 , 37 , 40 , 41 , 43 met the required criteria (OSA n = 1618; non‐OSA n = 1,161). Because there was only one cohort and two case–control studies, a meta‐analysis was carried out for the seven cross‐sectional studies 31 , 32 , 35 , 36 , 37 , 40 , 41 .…”

“…Obstructive sleep apnea with impaired fasting glucose Eight articles 3,6,31,36,37,[40][41][42] met the required criteria (OSA n = 1,705; non-OSA n = 1,689). Because there was only one cohort and one case-control study, a meta-analysis was carried out for the six cross-sectional studies 31,36,37,[40][41][42] .…”

“…Five articles 6,30,33,34,40 met the required criteria (OSA: n = 1,249; non-OSA: n = 1,024). Because there was only one cohort, a meta-analysis was carried out for the four crosssectional studies 30,33,34,40 .…”