Metabolic syndrome, insulin resistance, fibrinogen, homocysteine, leptin, and C-reactive protein in obese patients with obstructive sleep apnea syndrome

Abstract

OBJECTIVE:The prevalence of obstructive sleep apnea syndrome (OSAS) and metabolic syndrome is increasing worldwide, in part linked to epidemic of obesity. The purposes of this study were to establish the rate of metabolic syndrome and to compare fibrinogen, homocysteine, high-sensitivity C-reactive protein (hsCRP), leptin levels, and homeostasis model assessment insulin resistance (HOMA-IR) in the obese patients with and without OSAS.METHODS:The study population included 36 consecutive obese patients with OSAS (23 males; mean age, 50.0 ±19.7 years), and 34 obese patients without OSAS (17 males; mean age, 49.7±11.1 years) were enrolled as control group. Metabolic syndrome was investigated; fibrinogen, homocysteine, CRP, and leptin levels were measured, and IR was assessed.RESULTS:Metabolic syndrome was found in 17 (47.2%) obese OSAS patients, whereas only 29.4% of obese subjects had metabolic syndrome (P > 0.05). Obese patients with OSAS had significantly higher mean levels of triglyceride (P < 0.001), total-cholesterol (P = 0.003), low-density lipoprotein-cholesterol (P = 0.001), fasting glucose (P = 0.01), HOMA-IR (P <0.001), thyroid-stimulating hormone (P = 0.03), fibrinogen (P < 0.003), hsCRP (P <0.001), and leptin (P = 0.03) than control group . Besides, leptin level was positively correlated with waist (r = 0.512, P = 0.03) and neck circumferences (r = 0.547, P = 0.03), and fasting glucose (r = 0.471, P = 0.04) in OSAS patients, but not in obese subjects.CONCLUSION:This study demonstrated that obese OSAS patients may have an increased rate of metabolic syndrome and higher levels of serum lipids, fasting glucose, IR, leptin, fibrinogen, and hsCRP than obese subjects without sleep apnea. Thus, clinicians should be encouraged to systematically evaluate the presence of metabolic abnormalities in OSAS and vice versa.

Morbidity and Predicted Mortality in Older Adults with Central Sleep Apnea

“…Our findings were also consistent with previously published work which shows an association between SDB and conditions such as diabetes [17] and atrial fibrillation [18,19].…”

Risk factors of atherosclerosis in elderly senile obstructive sleep apnea hypopnea syndrome patients with hypertension and type 2 diabetes

“…Both OSAHS and Hcy are considered as independent risk factors for cardiovascular disease. [11] Thakre et al [12] have found that the level of Hcy in OSAHS people was significantly higher than that in non-OSAHS people, Sales et al [13] also came to similar results in their research. Animal models have confirmed that the level of Hcy in OSAHS rats is higher than that in non-OSAHS rats; hypoxic changes in OSAHS rats may result from the fact that increased level of Hcy enhances inflammatory responses in the body and leads to the occurrence of AS in cerebral arteries.…”

“…In the study of OSAHS and metabolic syndrome, Basoglu et al [11] have found that the level of Hs-CRP in OSAHS group was higher than that in control group, and OSAHS may have a causal relationship with metabolic syndrome. This study showed that OSAHS could promote the increase of Hs-CRP level in patients with cardiovascular diseases such as hypertension and type 2 diabetes, with the severity of AS increased.…”

“…[14] Cintra et al [15] have found that, in their research, there is no difference in the level of Hcy between OSAHS and non-OSAHS groups; there is no difference in the level of Hcy between obese patients with and without OSAHS. [11] Hence, the change in Hcy level remains to be controversial and worthy of being studied further.…”

Trust, Verify and Replicate

“…[1][2][3][4] However, until 2 years ago, it was unclear whether metabolic syndrome could be reversed by treatment of OSA with continuous positive airway pressure (CPAP). Studies were uncontrolled, small in size and confl icting in their results.…”