D Monneret1, R Tamisier2, V Ducros3, P Faure4, S Halimi5, J P Baguet6, P Lévy2, J L Pépin2, A L Borel7. 1. HP2 Laboratory, Inserm U1042, Grenoble Alpes University, Grenoble, France; Department of Biochemistry Toxicology and Pharmacology, Biology & Pathology Institute, Grenoble University Hospital, Grenoble, France. Electronic address: dmonneret2@gmail.com. 2. HP2 Laboratory, Inserm U1042, Grenoble Alpes University, Grenoble, France; Sleep, Exercise and Physiology Laboratory, EFCR, Grenoble University Hospital, Grenoble, France. 3. Department of Biochemistry Toxicology and Pharmacology, Biology & Pathology Institute, Grenoble University Hospital, Grenoble, France. 4. HP2 Laboratory, Inserm U1042, Grenoble Alpes University, Grenoble, France; Department of Biochemistry Toxicology and Pharmacology, Biology & Pathology Institute, Grenoble University Hospital, Grenoble, France. 5. Department of Endocrinology, Pole DIGIDUNE, Grenoble University Hospital, Grenoble, France. 6. Department of Cardiology, Grenoble University Hospital, Grenoble, France. 7. HP2 Laboratory, Inserm U1042, Grenoble Alpes University, Grenoble, France; Department of Endocrinology, Pole DIGIDUNE, Grenoble University Hospital, Grenoble, France.
Abstract
BACKGROUND: Insulin resistance, glucose dyshomeostasis and oxidative stress are associated to the cardiovascular consequences of obstructive sleep apnea (OSA). The effects of a long-term continuous positive airway pressure (LT-CPAP) treatment on such mechanisms still remain conflicting. OBJECTIVE: To investigate the effect of LT-CPAP on glucose tolerance, insulin sensitivity, oxidative stress and cardiovascular biomarkers in non-obese non-diabetic OSA patients. PATIENTS & METHODS: Twenty-eight apneic, otherwise healthy, men suffering from OSA (mean age = 48.9 ± 9.4 years; apnea-hypopnea index = 41.1 ± 16.1 events/h; BMI = 26.6 ± 2.8 kg/m(2); fasting glucose = 4.98 ± 0.37 mmol/L) were evaluated before and after LT-CPAP by an oral glucose tolerance test (OGTT), measuring plasma glucose, insulin and proinsulin. Glycated hemoglobin, homeostasis model assessment resistance insulin, blood lipids, oxidative stress, homocysteine and NT-pro-brain natriuretic peptide (NT-proBNP) were also measured. RESULTS: LT-CPAP treatment lasted 13.9 ± 6.5 months. At baseline, the time spent at SaO2<90%, minimal and mean SaO2 were associated with insulin area under the curve during OGTT (r = 0.448, P = 0.011; r = -0.382; P = 0.047 and r = -0.424; P = 0.028, respectively) and most other glucose/insulin homeostasis biomarkers, as well as with homocysteine (r = 0.531, P = 0.006; r = -0.487; P = 0.011 and r = -0.409; P = 0.034, respectively). LT-CPAP had no effect on all the OGTT-related measurements, but increased plasma total antioxidant status (+7.74%; P = 0.035) in a duration-dependent manner (r = 0.607; P < 0.001), and decreased both homocysteine (-15.2%; P = 0.002) and NT-proBNP levels (-39.3%; P = 0.002). CONCLUSIONS: In non-obese non-diabetic OSA patients, nocturnal oxygen desaturation is strongly associated to insulin resistance. LT-CPAP does not improve glucose homeostasis nor insulin sensitivity but has a favorable effect on antioxidant capacity and cardiovascular risk biomarkers.
BACKGROUND:Insulin resistance, glucose dyshomeostasis and oxidative stress are associated to the cardiovascular consequences of obstructive sleep apnea (OSA). The effects of a long-term continuous positive airway pressure (LT-CPAP) treatment on such mechanisms still remain conflicting. OBJECTIVE: To investigate the effect of LT-CPAP on glucose tolerance, insulin sensitivity, oxidative stress and cardiovascular biomarkers in non-obese non-diabetic OSA patients. PATIENTS & METHODS: Twenty-eight apneic, otherwise healthy, men suffering from OSA (mean age = 48.9 ± 9.4 years; apnea-hypopnea index = 41.1 ± 16.1 events/h; BMI = 26.6 ± 2.8 kg/m(2); fasting glucose = 4.98 ± 0.37 mmol/L) were evaluated before and after LT-CPAP by an oral glucose tolerance test (OGTT), measuring plasma glucose, insulin and proinsulin. Glycated hemoglobin, homeostasis model assessment resistance insulin, blood lipids, oxidative stress, homocysteine and NT-pro-brain natriuretic peptide (NT-proBNP) were also measured. RESULTS: LT-CPAP treatment lasted 13.9 ± 6.5 months. At baseline, the time spent at SaO2<90%, minimal and mean SaO2 were associated with insulin area under the curve during OGTT (r = 0.448, P = 0.011; r = -0.382; P = 0.047 and r = -0.424; P = 0.028, respectively) and most other glucose/insulin homeostasis biomarkers, as well as with homocysteine (r = 0.531, P = 0.006; r = -0.487; P = 0.011 and r = -0.409; P = 0.034, respectively). LT-CPAP had no effect on all the OGTT-related measurements, but increased plasma total antioxidant status (+7.74%; P = 0.035) in a duration-dependent manner (r = 0.607; P < 0.001), and decreased both homocysteine (-15.2%; P = 0.002) and NT-proBNP levels (-39.3%; P = 0.002). CONCLUSIONS: In non-obese non-diabetic OSA patients, nocturnal oxygen desaturation is strongly associated to insulin resistance. LT-CPAP does not improve glucose homeostasis nor insulin sensitivity but has a favorable effect on antioxidant capacity and cardiovascular risk biomarkers.
Authors: Julia A M Uniken Venema; Grietje E Knol-de Vries; Harry van Goor; Johanna Westra; Aarnoud Hoekema; Peter J Wijkstra Journal: J Clin Sleep Med Date: 2022-06-01 Impact factor: 4.324
Authors: Liyue Xu; Brendan T Keenan; David Maislin; Thorarinn Gislason; Bryndís Benediktsdóttir; Sigrun Gudmundsdóttir; Marianna Gardarsdottir; Bethany Staley; Frances M Pack; Xiaofeng Guo; Yuan Feng; Jugal Chahwala; Pritika Manaktala; Anila Hussein; Maheshwara Reddy-Koppula; Zeba Hashmath; Jonathan Lee; Raymond R Townsend; Richard J Schwab; Allan I Pack; Samuel T Kuna; Julio A Chirinos Journal: Hypertension Date: 2021-01-19 Impact factor: 10.190