Blood Antioxidant Status, Dysglycemia and Obstructive Sleep Apnea

  • Ewa Wysocka
  • Szczepan Cofta
  • Tomasz Piorunek
  • Sylwia Dziegielewska-Gesiak
  • Wieslaw Bryl
  • Lech Torlinski
Conference paper
Part of the Advances in Experimental Medicine and Biology book series (AEMB, volume 756)


Obstructive sleep apnea (OSA) patients present increased cardiovascular morbidity and mortality. Oxidative stress is involved in OSA and cardiovascular pathology. The aim of the study was to assess oxidative stress markers in the blood of OSA males during oral glucose tolerance test (OGTT). The study involved OSA-suspected obese males (BMI ≥ 25 kg/m2) aged 35–64, with no acute or chronic disorders, appointed for polysomnography to diagnose OSA (AHI ≥ 5). The results of OGTT allowed to select prediabetic (Pre) subjects and normal glucose tolerance (N), excluding newly diagnosed diabetes. Blood was collected at 0 min (fasting) and 120 min of the test. Plasma glucose, total antioxidant status (TAS), thiobarbituric acid-reacting substances (TBARS), and activity of superoxide dismutase-1 (SOD) in erythrocytes, were determined at the two time points and the difference (D) between the 120 and 0 min time points was calculated for either oxidative stress variable (D-TAS, D-SOD and D-TBARS). Fasting serum insulin and lipids also were measured fasting. There were four groups of subjects, each consisting of 22 individuals N-OSA-neg(ative), N-OSA-pos(itive), Pre-OSA-neg and Pre-OSA-pos. The N-OSA-pos and Pre-OSA-pos subjects demonstrated decreased SOD-0 compared with OSA-negative groups. In N-OSA-neg and N-OSA-pos groups, the positive differences D-SOD and D-TAS were observed, while Pre-OSA subjects presented negative differences. In conclusion, prediabetic OSA patients may consume blood antioxidant factors to counter the effects of oxidative stress, more than individuals with normal glucose tolerance.


Cardiovascular morbidity Obstructive sleep apnea Oxidative stress Prediabetes Oral glucose tolerance Obesity Antioxidant status 



  1. Alberti, K. G. M. M., Eckel, R. H., Grundy, S. M., Zimmet, P. Z., Cleeman, J. I., Donato, K. A., Fruchart, J.-C., James, W. P. T., Loria, C. M., & Smith, S. C., Jr. (2009). Harmonizing the metabolic syndrome: A join interim statement of the International Diabetes Federation Task Force on Epidemiology and Prevention; National Heart, Lung, and Blood Institute; American Heart Association; World Heart Federation; International Atherosclerosis Society; and International Association for the Study of Obesity. Circulation, 120, 1640–1645.PubMedCrossRefGoogle Scholar
  2. American Diabetes Association. (2011). The expert committee on the diagnosis and classification of diabetes: Diagnosis and classification of diabetes mellitus. Diabetes Care, 34, S62–S69.CrossRefGoogle Scholar
  3. Barceló, A., Barbé, F., de la Peňa, M., Vila, M., Pérez, G., Piérola, J., Durán, J., & Agustí, A. G. (2006). Antioxidant status in patients with sleep apnoea and impact of continuous positive airway pressure treatment. European Respiratory Journal, 27, 756–760.PubMedCrossRefGoogle Scholar
  4. Ceriello, A., & Motz, E. (2004). Is oxidative stress the pathogenic mechanism underlying insulin resistance, diabetes, and cardiovascular disease? The common soil hypothesis revisited. Arteriosclerosis, Thrombosis, and Vascular Biology, 24, 816–823.PubMedCrossRefGoogle Scholar
  5. Dorkova, Z., Petrasova, D., Molcanyiova, A., Popovnakova, M., & Tkacova, R. (2008). Effects of continuous positive airway pressure on cardiovascular risk profile in patients with severe obstructive sleep apnea and metabolic syndrome. Chest, 134, 686–692.PubMedCrossRefGoogle Scholar
  6. Edge, D., Skelly, J. R., Bradford, A., & O’Halloran, K. D. (2010). Respiratory plasticity in the behaving rat following chronic intermittent hypoxia. Advances in Experimental Medicine and Biology, 669, 267–270.PubMedCrossRefGoogle Scholar
  7. Habdous, M., Herbeth, B., Vincent-Viry, M., Lamont, J. V., Fitzgerald, P. S., Visvikis, S., & Siest, G. (2003). Serum total antioxidant status, erythrocyte superoxide dismutase and whole-blood glutathione peroxidase activities in the Stanislas cohort: Influencing factors and reference intervals. Clinical Chemistry and Laboratory Medicine, 41, 209–215.PubMedCrossRefGoogle Scholar
  8. Kiely, J. L., & McNicholas, W. T. (2000). Cardiovascular risk factors in patients with obstructive sleep apnoea syndrome. European Respiratory Journal, 16, 128–133.PubMedCrossRefGoogle Scholar
  9. Lavie, L. (2003). Obstructive sleep apnoea syndrome–an oxidative stress disorder. Sleep Medicine Reviews, 7, 35–51.PubMedCrossRefGoogle Scholar
  10. Lavie, L., & Lavie, P. (2009). Molecular mechanisms of cardiovascular disease in OSAHS: The oxidative stress link. European Respiratory Journal, 33, 1467–1484.PubMedCrossRefGoogle Scholar
  11. Lévy, P., Bonsignore, M. R., & Eckel, J. (2009). Sleep, sleep-disordered breathing and metabolic consequences. European Respiratory Journal, 34, 243–260.PubMedCrossRefGoogle Scholar
  12. McNicholas, W. T., Bonsignore, M. R., & The Management Committee of the COST Action B26. (2007). Sleep apnoea as an independent risk factor for cardiovascular disease: Current evidence, basic mechanisms and research priorities. European Respiratory Journal, 29, 156–178.PubMedCrossRefGoogle Scholar
  13. Okhawa, H., Ohishi, N., & Yagi, K. (1979). Assay for lipid peroxides in animal tissues by thiobarbituric acid reaction. Analytical Biochemistry, 95, 351–358.CrossRefGoogle Scholar
  14. Peker, Y., Hedner, J., Norum, J., Kraiczi, H., & Carlson, J. (2002). Increased incidence of cardiovascular disease in middle-aged men with obstructive sleep apnea: A 7-year follow up. American Journal of Respiratory and Critical Care Medicine, 166, 159–165.PubMedCrossRefGoogle Scholar
  15. Peppard, P. E., Young, T., Palta, M., & Skatrud, J. (2000). Prospective study of the association between sleep-disordered breathing and hypertension. The New England Journal of Medicine, 342, 1378–1384.PubMedCrossRefGoogle Scholar
  16. Punjabi, N. M. (2008). The epidemiology of adult obstructive sleep apnea. Proceedings of the American Thoracic Society, 5, 136–143.PubMedCrossRefGoogle Scholar
  17. Punjabi, N. M., Shahar, E., Redline, S., Gottlieb, D. J., Givelber, R., Resnick, H. E., & Sleep Heart Health Study Investigators. (2004). Sleep-disordered breathing, glucose intolerance, and insulin resistance: The Sleep Heart Health Study. American Journal of Epidemiology, 160, 521–530.PubMedCrossRefGoogle Scholar
  18. Rabbani, N., Chittari, M. V., Bodmer, C. W., Zehnder, D., Ceriello, A., & Thornalley, P. J. (2010). Increased glycation and oxidative damage to apolipoprotein B100 of LDL cholesterol in patients with type 2 diabetes and effect of metformin. Diabetes, 59, 1038–1045.PubMedCrossRefGoogle Scholar
  19. Raport of a WHO Study Group. (1994). Prevention of diabetes mellitus. WHO Technical Report Series, Vol. 844. Geneva: World Health Organization.Google Scholar
  20. Rasche, K., Keller, T., Tautz, B., Hader, C., Hergenc, G., Antosiewicz, J., Di Giulio, C., & Pokorski, M. (2010). Obstructive sleep apnea and type 2 diabetes. European Journal of Medical Research, 15(Suppl. II), 152–156.PubMedGoogle Scholar
  21. Schulz, R., Mahmoudi, S., Hattar, K., Sibelius, U., Olschewski, H., Mayer, K., Seeger, W., & Grimminger, F. (2000). Enhanced release of superoxide from polymorphonuclear neutrophils in obstructive sleep apnea. American Journal of Respiratory and Critical Care Medicine, 162, 566–570.PubMedGoogle Scholar
  22. Shahar, E., Whitney, C. W., Redline, S., Lee, E. T., Newman, A. B., Javier Nieto, F., O’Connor, G. T., Boland, L. L., Schwartz, J. E., & Samet, J. M. (2001). Sleep-disordered breathing and cardiovascular disease: Cross sectional results of the Sleep Heart Health Study. American Journal of Respiratory and Critical Care Medicine, 163, 19–25.PubMedGoogle Scholar
  23. Shaw, J. E., Punjabi, N. M., Wilding, J. P., Alberti, K. G., Zimmet, P. Z., & International Diabetes Federation Taskforce on Epidemiology and Prevention. (2008). Sleep-disordered breathing and type 2 diabetes: A report from the International Diabetes Federation Taskforce on Epidemiology and Prevention. Diabetes Research and Clinical Practice, 81, 2–12.PubMedCrossRefGoogle Scholar
  24. Song, F., Jia, W., Yao, Y., Hu, Y., Lei, L., Lin, J., Sun, X., & Liu, L. (2007). Oxidative stress, antioxidant status and DNA damage in patients with impaired glucose regulation and newly diagnosed type 2 diabetes. Clinical Science, 112, 599–606.PubMedCrossRefGoogle Scholar
  25. Tamura, A., Kawano, Y., Watanabe, T., & Kadota, J. (2008). Relationship between the severity of obstructive sleep apnea and impaired glucose metabolism in patients with obstructive sleep apnea. Respiratory Medicine, 102, 1412–1416.PubMedCrossRefGoogle Scholar
  26. Tasali, E., Mokhlesi, B., & Van Cauter, E. (2008). Obstructive sleep apnea and type 2 diabetes: Interacting epidemics. Chest, 133, 496–506.PubMedCrossRefGoogle Scholar
  27. Theorell-Haglöw, J., Berne, C., Janson, C., & Lindberg, E. (2008). Obstructive sleep apnoea is associated with decreased insulin sensitivity in females. European Respiratory Journal, 31, 1054–1060.PubMedCrossRefGoogle Scholar
  28. Wysocka, E., Cofta, S., Cymerys, M., Gozdzik, J., Torlinski, L., & Batura-Gabryel, H. (2008). The impact of the sleep apnea syndrome on oxidant-antioxidant balance in the blood of overweight and obese patients. Journal of Physiology and Pharmacology, 59(Suppl 6), 761–769.PubMedGoogle Scholar
  29. Yaggi, H. K., Concato, J., Kernan, W. N., Lichtman, J. H., Brass, L. M., & Mohsenin, V. (2005). Obstructive sleep apnea as a risk factor for stroke and death. The New England Journal of Medicine, 353, 2034–2041.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media Dordrecht 2013

Authors and Affiliations

  • Ewa Wysocka
    • 1
  • Szczepan Cofta
    • 2
  • Tomasz Piorunek
    • 2
  • Sylwia Dziegielewska-Gesiak
    • 1
  • Wieslaw Bryl
    • 3
  • Lech Torlinski
    • 1
  1. 1.Department of Clinical Biochemistry and Laboratory MedicinePoznan University of Medical SciencesPoznanPoland
  2. 2.Department of Pneumology, Allergology and Respiratory OncologyPoznan University of Medical SciencesPoznanPoland
  3. 3.Department of Internal Medicine, Hypertension and Metabolic DisordersPoznan University of Medical SciencesPoznanPoland

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