Abstract
PurposeObstructive sleep apnea (OSA) is associated with obesity and risk for type 2 diabetes. In this community-based study, we thoroughly investigated fatty acid metabolism, incretin response, glucose tolerance, insulin secretion and insulin sensitivity, and autonomic nerve activity in men with or without OSA.MethodsFifteen men without diabetes but with signs of severe OSA, defined as apnea–hypopnea index (AHI) >30, and 15 age- and BMI-matched men without OSA (AHI < 5) were recruited from a community-based cohort. Assessments included clinical and anthropometric measurements, a 2-h oral glucose tolerance test (OGTT), and autonomic nerve activity using heart rate variability (HRV).ResultsMen with OSA had higher body fat % than BMI-matched men without OSA (p = 0.046) and it was associated with markers of insulin resistance. The area under the curve for nonesterified fatty acids (NEFA) during OGTT was higher in men with OSA (p = 0.021) and fasting NEFA levels were numerically higher (p = 0.097). The plasma glucose at fasting and during OGTT was higher in men with OSA (p < 0.001). Incretin response was similar between groups. Fasting and OGTT-derived indices indicated impaired insulin sensitivity in men with OSA. Compared with men without OSA, Matsuda index (p = 0.068) and Gutt index (p < 0.01) were lower in men with OSA. The HRV measures did not differ between groups.ConclusionsOur study suggests that fatty acid handling, glucose tolerance, and insulin sensitivity are impaired in men with severe OSA. This might partly be explained by the increased body fat percentage.
Highlights
Obstructive sleep apnea (OSA) is characterized by repetitive narrowing causing hypopnea and collapse causing apnea ofData from previous research suggest that OSA, independent of obesity, can cause metabolic disturbances through the effects of sleep fragmentation, intermittent hypoxia, sympathetic overactivity, and adipose tissue inflammation [9, 10], and several epidemiological studiesEndocrine (2020) 70:48–57 have reported associations between OSA and impaired glucose metabolism [11, 12]
Some data indicate that OSA during rapid eye movement (REM) sleep is more important than nonrapid eye movement when it comes to diabetes risk [13]
We performed a comprehensive investigation of fatty acid metabolism, insulin and incretin response to oral glucose tolerance test (OGTT), glucose tolerance, insulin sensitivity, and autonomic nervous system activity in men found to have severe OSA compared with men without sleep apnea, and this was done under normal daytime conditions regardless of recent OSA episodes
Summary
Data from previous research suggest that OSA, independent of obesity, can cause metabolic disturbances through the effects of sleep fragmentation, intermittent hypoxia, sympathetic overactivity, and adipose tissue inflammation [9, 10], and several epidemiological studies. Endocrine (2020) 70:48–57 have reported associations between OSA and impaired glucose metabolism [11, 12]. In addition to intermittent hypoxia, an autonomic imbalance has been reported to be involved in cardiovascular risk associated with OSA. REM-AHI is associated with elevated sympathetic activity and adverse cardiovascular events in patients with OSA [14, 15]. Studies thoroughly assessing glucose and lipid metabolism in individuals with OSA identified by community-based screening are lacking. We assessed the association between OSA in REM sleep and metabolic measures
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
