Insulin resistance and adipose-derived hormones in young men with untreated obstructive sleep apnea
Obstructive sleep apnea (OSA) increases the risk for insulin resistance (IR). The mechanisms that link the two are not clear and are frequently confounded by obesity. OSA is associated with alterations in adipose-derived hormones (adipokines) that increase IR; however, previous studies have focused on middle-aged and older adults. The objective of this study was to determine if IR and alterations in adipokines exist in young men with OSA, independent of obesity.
Subjects were assigned into the following groups based on body mass index and presence of OSA: obese with OSA (OSA, n = 12), obese without OSA (NOSA, n = 18), and normal weight without OSA (CON, n = 15). Fasting blood was obtained for batch analysis of biomarkers of IR. The homeostasis model assessment (HOMA) method was used to assess IR.
HOMA and leptin were higher in the OSA group than the CON group. There were no differences in insulin, tumor necrosis factor alpha (TNF-α), and interleukin-6 (IL-6) between the OSA and NOSA groups. Adiponectin was lower in the OSA group vs. NOSA and CON; however, when controlled for central abdominal fat (CAF), the difference was nullified. When controlled for total body adiposity, however, CAF was 24 % higher in the subjects with OSA vs. subjects without OSA.
These findings suggest that excess CAF in young men with OSA may contribute to risk for type 2 diabetes indirectly by a degree that would otherwise not be reached through obesity, although further research is needed.
KeywordsObstructive sleep apnea Insulin resistance Adiponectin Leptin Obesity
This research was supported, in part, by a grant from the ResMed Corporation in San Diego, CA and the ResMed Foundation in Yorba Linda, CA.
- 12.Kanbay A, Kokturk O, Ciftci TU, Tavil Y, Bukan N (2008) Comparison of serum adiponectin and tumor necrosis factor-alpha levels between patients with and without obstructive sleep apnea syndrome. Respir Int Rev Thorac Dis 76(3):324–330Google Scholar
- 13.Zhang XL, Yin KS, Mao H, Wang H, Yang Y (2004) Serum adiponectin level in patients with obstructive sleep apnea hypopnea syndrome. Chin Med J (Engl) 117(11):1603–1606Google Scholar
- 19.Anonymous (1999) Sleep-related breathing disorders in adults: recommendations for syndrome definition and measurement techniques in clinical research. The report of an American Academy of Sleep Medicine Task Force. Sleep 22(5):667–689Google Scholar
- 22.American College of Sports Medicine, Thompson WR, Gordon NF, Pescatello LS (2010) ACSM’s guidelines for exercise testing and prescription, 8th edn. Lippincott, PhiladelphiaGoogle Scholar
- 33.Sanchez-de-la-Torre M, Mediano O, Barcelo A, Pierola J, de la Pena M, Esquinas C, Miro A, Duran-Cantolla J, Agusti AG, Capote F, Marin JM, Montserrat JM, Garcia-Rio F, Barbe F (2011) The influence of obesity and obstructive sleep apnea on metabolic hormones. Sleep Breath. doi: 10.1007/s11325-011-0552-7
- 34.Canapari CA, Hoppin AG, Kinane TB, Thomas BJ, Torriani M, Katz ES (2011) Relationship between sleep apnea, fat distribution, and insulin resistance in obese children. J Clin Sleep Med JCSM 7(3):268–273Google Scholar
- 35.Masserini B, Morpurgo PS, Donadio F, Baldessari C, Bossi R, Beck-Peccoz P, Orsi E (2006) Reduced levels of adiponectin in sleep apnea syndrome. J Endocrinol Investig 29(8):700–705Google Scholar
- 42.Larsson B, Svardsudd K, Welin L, Wilhelmsen L, Bjorntorp P, Tibblin G (1984) Abdominal adipose tissue distribution, obesity, and risk of cardiovascular disease and death: 13 year follow up of participants in the study of men born in 1913. Br Med J (Clin Res Ed) 288(6428):1401–1404CrossRefGoogle Scholar
- 43.Despres JP, Couillard C, Gagnon J, Bergeron J, Leon AS, Rao DC, Skinner JS, Wilmore JH, Bouchard C (2000) Race, visceral adipose tissue, plasma lipids, and lipoprotein lipase activity in men and women: the Health, Risk Factors, Exercise Training, and Genetics (HERITAGE) Family Study. Arterioscler Thromb Vasc Biol 20(8):1932–1938PubMedCrossRefGoogle Scholar