Glucose tolerance and cardiovascular risk biomarkers in non-diabetic non-obese obstructive sleep apnea patients: Effects of long-term continuous positive airway pressure. (March 2016)

• Record Type: Journal Article
• Authors: Monneret, D.; Tamisier, R.; Ducros, V.; Faure, P.; Halimi, S.; Baguet, J.P.; Lévy, P.; Pépin, J.L.; Borel, A.L.
• Is Part Of: Respiratory medicine. Volume 112(2016)
• Page Start: 119
• Page End: 125
• Publication Date: 2016-03
• Subjects: Obstructive sleep apnea -- Glucose tolerance -- Oxidative stress -- Long-term CPAP -- Cardiovascular risk -- Biomarkers; AHI apnea-hypopnea index -- AUC area under curve -- BMI body mass index -- CPAP continuous positive airway pressure -- CIMT carotid intima-media thickness -- DBP diastolic blood pressure -- GPX glutathione peroxidase -- HbA1c glycated hemoglobin A1c -- HOMA-RI homeostasis model assessment resistance insulin -- hsCRP high-sensitive C-reactive protein -- LC/MS/MS liquid chromatography-tandem mass spectrometry -- NT-proBNP N-terminal pro-brain natriuretic peptide -- OGTT oral glucose tolerance test -- OSA obstructive sleep apnea -- PTAS plasma total antioxidant status -- RDI respiratory disturbance index -- SaO2 arterial oxygen saturation -- SaO2<90%TST sleep time spent at SaO2<90% -- SBP systolic blood pressure -- TST total sleep time; Chest -- Diseases -- Periodicals; Chest -- Diseases -- Great Britain -- Periodicals; Respiratory organs -- Diseases -- Periodicals; Respiratory Tract Diseases -- Periodicals; Appareil respiratoire -- Maladies -- Périodiques; Thorax -- Maladies -- Périodiques; Appareil respiratoire -- Maladies -- Traitement -- Périodiques; Electronic journals; 616.2
• DOI: 10.1016/j.rmed.2016.01.015
• Languages: English
• ISSNs: 0954-6111

Abstract

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 &amp; 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 &lt;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 &lt; 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. Highlights: Insulin resistance and raised oxidative stress are linked to obstructive sleep apnea. These metabolic disorders lead to the deleterious cardiovascular consequences of OSA. The effects of long-term CPAP in non-obese non-diabetic OSA patients are studied. Long-term CPAP does not improve glucose homeostasis nor insulin sensitivity. But it has a favorable effect on antioxidant capacity and cardiovascular biomarkers.