Obstructive Sleep Apnea Disrupts Glycemic Control in Obese Individuals

Abstract

The link between obstructive sleep apnea (OSA) and obesity, and their common comorbidities such as diabetes mellitus (DM) or cardiovascular diseases, is not fully understood. The aim of this study was to investigate the possible association of OSA severity in obese individuals with polysomnography-based sleep parameters, as well as C-reactive protein (CRP) and glycated hemoglobin (HbA1c) serum levels. Polysomnographic recordings and blood samples were retrospectively compared between a group of 23 adult obese individuals with mild OSA (apnea–hypopnea index (AHI) = 7.5 (5.5–12.5)/h, age = 42.57 ± 11.44 years, 16 male, 7 female, body mass index (BMI) = 37.35 ± 3.88 kg/m²) and an age-, sex-, and BMI-matched group of individuals with moderate or severe OSA (AHI 41.5 (25.7–71.8)/h, age = 43.43 ± 11.96 years, 16 male, 7 female, BMI = 37.87 ± 4.74 kg/m²). All respiratory sleep-associated parameters were significantly higher in individuals with moderate and severe OSA compared to those with mild OSA. CRP levels did not differ between the two OSA severity groups. However, serum levels of HbA1c were significantly higher in the moderate/severe OSA group. Therefore, OSA severity may have a significant impact on glycemic control in obese individuals. Additionally, OSA severity did not appear to be further associated with systemic inflammation in obese individuals. Obese individuals may benefit not only from lifestyle modification, but also from OSA screening and treatment, particularly to prevent DM-associated disorders and conditions.

Investigating the Relationship between Obstructive Sleep Apnoea, Inflammation and Cardio-Metabolic Diseases

“…OSA appears to be an independent risk factor for developing T2D, insulin resistance and glucose intolerance ( Figure 2 ) [ 139 , 140 ]. Thus, in patients with T2D, OSA and higher oxygen desaturation levels were associated with higher glycated haemoglobin (HbA1c) levels [ 141 , 142 , 143 , 144 ].…”

Serum Ferritin Levels in Severe Obstructive Sleep Apnea

“…Furthermore, OSA prevalence increases with growing age and is more frequently seen in males [ 4 , 5 ]. Previous studies have shown that OSA is related to risk of glaucoma [ 6 ], non-alcoholic hepatic steatosis [ 7 ], unfavorable oncologic outcomes following therapy for head and neck squamous cell carcinoma [ 8 ], coronary artery disease [ 9 ], stroke [ 10 ], arterial hypertension [ 11 ], and other adverse effects [ 12 ]; therefore, OSA is recognized as an important public health issue.…”

Retrospective Analysis of Real-World Data for the Treatment of Obstructive Sleep Apnea with Slow Maxillary Expansion Using a Unique Expansion Dental Appliance (DNA)

“…Intermittent hypoxemia results from increased sympathetic activity and is additionally associated with reductions in cerebral blood flow, dysregulated cerebral autoregulation, impaired endothelial function, increased intracerebral pressure, and platelet activation, inflammation, and oxidative stress, all of which exacerbate forms of neurological and cardiovascular injuries [ 2 ]. With these contributing factors, OSA has been convincingly linked to the intensification of several comorbid conditions, including cardiovascular disease [ 3 , 4 , 5 ], earlier mortality [ 6 , 7 ], cancer [ 8 ], insulin resistance [ 9 ], obesity [ 10 ], and greater stroke incidence [ 11 , 12 ]. Approximately 80% of OSA cases are considered ‘moderate to severe,’ and the disorder is highly underdiagnosed.…”