Insulin resistance in obstructive sleep apnea

Abstract

OSA is a common condition that is primarily characterized by intermittent and recurrent pauses in respiration results in multiple cycles of hypoxia/reoxygenation with an increased production of reactive oxygen species (ROS). Aim of work: Is to assess serum insulin level &insulin resistance in obese patients with & without OSA. Study was performed on 51 obese subjects who had been referred to Chest Department of Kasr Alaini Hospital with clinical suspicion of OSA in order to perform Polysomnography. They were classified into two groups; Cases: consists of 33 obese patients who were diagnosed as obstructive sleep apnea (OSA) & Controls: consists of 18 obese subjects, without OSA as a control group. The two groups were subjected to Full history taking, Clinical examination, Epworth sleepiness scale (ESS), Anthrop-ometric measurements including body mass index (BMI in kg/m2) waist, hip circumferences, waist/hip ratio and neck circumference, Polysomno-graphic study, Serum Insulin by ELISA & Assessment of insulin resistance by calculation of HOMA index. It was found that cases included 10 females (30.3%) & 23 males (69.7%), while controls included 14 females (77.8%) & 4 (22.2%).There was statistically highly significant increase in Epworth slee-piness scale (ESS) among cases compared to controls. As regards the Polysonographic data, there was statistically highly significant increase in AHI, desaturation index & duration of desaturation <90%. among cases compared to control subjects. Regarding minimal O2 sat% & average O2 sat% were lower in cases than in the control subjects and this reduction was statistically significant also there was statistically significant increase in arrhythmias index among cases than control subjects & there was significant increase in snoring index among cases than control subjects. There was statistically highly significant increase in serum insulin, HOMA index among cases as compared to controls. Insulin resistance in OSA is related to sleep associated hypoxaemia & hypoxic stress. Chest Department, Faculty of Medicine Cai-ro University.