Relationship between sleep parameters, insulin resistance and age-adjusted insulin like growth factor-1 score in non diabetic older patients

Abstract

BackgroundSleep complaints are prevalent in older patients. Sleepiness, short or long sleep duration and obstructive sleep apnea (OSA) are associated with insulin resistance (IR). These parameters have not yet been considered together in the same study exploring the possible association between IR and sleep in older patients. IR is involved in cardiovascular and metabolic diseases, pathologies which are highly prevalent in older patients. Here we assess, in older non-diabetic patients with sleep complaints, the associations between IR and sleep parameters objectively recorded by polysomnography (PSG) rather than self-report. The Growth Hormone/Insulin like growth factor-1 axis could play a role in the development of IR during sleep disorders. The second objective of this study was to analyze the association between sleep parameters and age-adjusted IGF-1 score, which could explain the association between OSA and IR.Methods72 non-diabetic older patients, mean age 74.5 ± 7.8 years, were included in this observational study. We evaluated anthropometric measures, subjective and objective sleepiness, polysomnography, Homeostatic Model Assessment for IR (HOMA-IR) and age-adjusted IGF-1 score. A multivariate regression was used to determine factors associated with HOMA-IR.ResultsThe 47 OSA patients were over-weight but not obese and had higher IR than the non-OSA patients. In multilinear regression analysis, apnea-hypopnea index was independently associated with IR after adjustment for several confounding factors. Neither IGF-1 level nor IGF-1 score were different in the two groups.ConclusionsWe demonstrate that in non-diabetic older patients with sleep complaints, OSA is independently associated with IR, regardless of anthropometric measurements and sleep parameters (sleep duration/sleepiness/arousals). Targeting OSA to reduce IR could be useful in the elderly, although further exploration is required.

The Association between Daytime Napping Characteristics and Bone Mineral Density in Elderly Thai Women without Osteoporosis

“…Thirdly, insulin-like growth factor 1 (IGF-1), known to reduce osteoblast apoptosis and promote osteoblastogenesis 23 , possibly plays a role. Excessive daytime sleepiness, frequently reported in elderly patients who habitually napped 24 , was found to be related to lower IGF-1 levels 25 . However, there has been no study to date that directly examines the association between naps and IGF-1 levels in humans.…”

Interaction between obstructive sleep apnea and short sleep duration on insulin resistance: a large-scale study

“…Other clinical studies reported contradictory findings. One study indicated that neither short nor long sleep duration was correlated with insulin resistance in older non-diabetic patients [30]. Another study showed that long, but not short, sleep duration was associated with insulin resistance in non-diabetic subjects with or without sleep disorders, such as sleep apnea and insomnia [31].…”

The Somatotropic Axis in the Sleep Apnea-Obesity Comorbid Duo

“…Namely, we have evidenced that IH induces a proinflammatory phenotype of the adipose tissue, which may be a crucial link between OSA, central obesity and the development of insulin resistance (51). The association in human literature between IGF-1 and insulin resistance is more conflicting but seem to exist in non-diabetic patients with sleep apnea (52). The interaction between IGF-1, central obesity and insulin resistance is difficult to dissect precisely in clinical studies but is certainly playing a major role in OSA-related cardio metabolic comorbidities (43,53).…”