Metabolic profile and insulin resistance in patients with obstructive sleep apnea syndrome

Abstract

Introduction: Obstructive sleep apnea syndrome (OSAS) is a common disorder characterized by excessive daytime sleepness and repeated epizodes of upper airway obstruction during sleep and nokturnal hypoxemia. Metabolic abnormalites and increased sympathetic activity are frequent in patient with OSAS. Materials and methods: In our study, OSAS patients diagnosed by Polisomnography (PSG) were investigated according to metabolic aspect. We investigated leptin levels, impaired fasting glucose (IFG), thyroid function tests, thyroid autoantibodies, lipid parameters, insulin levels, HOMA-IR index, CRP, obesity, and metabolic syndrome frequency in these patients. We compared three patient groups which were divided according to AHI (Apnea-Hypoapnea Index) levels, with our two control groups. The control groups were normal control (n = 30) and obese control (n = 30) with similar BMI and age with OSAS groups. Patient groups were defined by PSG results. Group I included patients with simple snoring and mild OSAS (n = 30); Group II with moderate OSAS (n = 29); and Group III with severe OSAS (n = 29). The control group consisted of healthy individuals with no signs of OSAS at Epworth Sleepiness Scale (ESS).We evaluated correlation between insulin resistance and obesity in OSAS patients. Results: We detected high metabolic syndrome and insulin resistance frequency in patients with OSAS. Obesity seems to have important role in OSAS patients for developing insulin resistance and metabolic syndrome. Coclusions: As a result, OSAS patients who have metabolic syndrome and insulin resistance, are in high risk for diadetes mellitus and cardiovascular diseases(CVD). Weight loss, and CPAP equipment using are important in OSAS therapy and decrease the risk of developing of DM and CVD. Multidisciplinary approach which include cardiology, endocrinology, psychiatry and diet programs, may be also important for OSAS therapy.