Changes of glucagon–like peptide–1 (GLP–1) and effects of GLP–1 analogues in the type 2 diabetic patients with obstructive sleep apnea – hypopnea syndrome

Abstract

Objective To study the changes of glucagon–like peptide–1(GLP–1) and effects of GLP–1 analogues on sleep – disordered breathing in the type 2 diabetic patients with obstructive sleep apnea – hypopnea syndrome(OSAHS). Methods One hundred sixty–nine patients were enrolled as research subjects from in–patients and normal control from October 2012 to September 2014. Based on oral glucose tolerance test (OGTT) and polysomnography (PSG), patients were divided into the OSAHS–T2DM group (45), the OSAHS group (42), the T2DM group (47) and the control group (40). Fasting and postprandial GLP – 1 and 3 – nitrotyrosine were determined by enzyme linked immunosorbent assay (ELISA). The levels of GLP – 1 amongfour groups were compared by one–way ANOVA analysis. Patients with OSAHS and T2DM were treated with GLP–1 analogues or conventional oral hypoglycemic drugs. Independent sample t test and ANOVA test were used to analyze the data between two groups and among multiple groups, respectively. Multiple logistic regression was used to assess whether the treatment of GLP–1 analogues was independently associated with the improvement of sleep–disordered breathing. Results Compared with the control group, OSAHS group and T2DM group, the levels of fasting and post prandial GLP- 1 and △ GLP- 1 decreased in the OSAHS–T2DM group ((2.9±1.4),(6.4±2.7), (5.5±3.1), (3.6±1.4) μg/L, F=26.78, P<0.05). This research found the change of body weight and treatment of GLP–1 analogues was independently associated with the improvement of sleep–disordered breathing by binarylogistic regression (OR=1.27, 95% CI 1.13–1.72; OR=3.52, 95% CI 1.82- 9.74). Compared with patients treated with conventional oral hypoglycemic drugs, the level of blood flow velocity increased(t=5.86, P<0.05) and the level of 3–nitrotyrosine decreased in the patients treated with GLP-1 analogues (t=- 12.32, P<0.05). Conclusion The level of GLP- Idecrease in the patients with OSAHS and T2DM.The treatment of GLP – 1 analogues can improve sleep – disordered breathing in the patients with OSAHS and T2DM. Key words: Sleep apnea, obstructive; Diabetes mellitus, type 2; Glucagon–like peptide–1; 3- Nitrotyrosine