File Download

There are no files associated with this item.

  Links for fulltext
     (May Require Subscription)
Supplementary

Article: Obstructive sleep apnea is independently associated with insulin resistance

TitleObstructive sleep apnea is independently associated with insulin resistance
Authors
Issue Date2002
PublisherAmerican Thoracic Society. The Journal's web site is located at http://ajrccm.atsjournals.org
Citation
American Journal Of Respiratory And Critical Care Medicine, 2002, v. 165 n. 5, p. 670-676 How to Cite?
AbstractEpidemiological studies have implicated obstructive sleep apnea (OSA) as an independent comorbid factor in cardiovascular and cerebrovascular diseases. It is postulated that recurrent episodes of occlusion of upper airways during sleep result in pathophysiological changes that may predispose to vascular diseases. Insulin resistance is a known risk factor for atherosclerosis, and we postulate that OSA represents a stress that promotes insulin resistance, hence atherogenesis. This study investigated the relationship between sleep-disordered breathing and insulin resistance, indicated by fasting serum insulin level and insulin resistance index based on the homeostasis model assessment method (HOMA-IR). A total of 270 consecutive subjects (197 male) who were referred for polysomnography and who did not have known diabetes mellitus were included, and 185 were documented to have OSA defined as an apnea-hypopnea index (AHI) ≥ 5. OSA subjects were more insulin resistant, as indicated by higher levels of fasting serum insulin (p = 0.001) and HOMA-IR (p < 0.001); they were also older and more obese. Stepwise multiple linear regression analysis showed that obesity was the major determinant of insulin resistance but sleep-disordered breathing parameters (AHI and minimum oxygen saturation) were also independent determinants of insulin resistance (fasting insulin: AHI, p = 0.02, minimum O2, p = 0.041; HOMA-IR: AHI, p = 0.044, minimum O2, p = 0.022); this association between OSA and insulin resistance was seen in both obese and nonobese subjects. Each additional apnea or hypopnea per sleep hour increased the fasting insulin level and HOMA-IR by about 0.5%. Further analysis of the relationship of insulin resistance and hypertension confirmed that insulin resistance was a significant factor for hypertension in this cohort. Our findings suggest that OSA is independently associated with insulin resistance, and its role in the atherogenic potential of sleep disordered breathing is worthy of further exploration.
Persistent Identifierhttp://hdl.handle.net/10722/162617
ISSN
2015 Impact Factor: 13.118
2015 SCImago Journal Rankings: 5.832
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorIp, MSMen_US
dc.contributor.authorLam, Ben_US
dc.contributor.authorNg, MMTen_US
dc.contributor.authorLam, WKen_US
dc.contributor.authorTsang, KWTen_US
dc.contributor.authorLam, KSLen_US
dc.date.accessioned2012-09-05T05:21:42Z-
dc.date.available2012-09-05T05:21:42Z-
dc.date.issued2002en_US
dc.identifier.citationAmerican Journal Of Respiratory And Critical Care Medicine, 2002, v. 165 n. 5, p. 670-676en_US
dc.identifier.issn1073-449Xen_US
dc.identifier.urihttp://hdl.handle.net/10722/162617-
dc.description.abstractEpidemiological studies have implicated obstructive sleep apnea (OSA) as an independent comorbid factor in cardiovascular and cerebrovascular diseases. It is postulated that recurrent episodes of occlusion of upper airways during sleep result in pathophysiological changes that may predispose to vascular diseases. Insulin resistance is a known risk factor for atherosclerosis, and we postulate that OSA represents a stress that promotes insulin resistance, hence atherogenesis. This study investigated the relationship between sleep-disordered breathing and insulin resistance, indicated by fasting serum insulin level and insulin resistance index based on the homeostasis model assessment method (HOMA-IR). A total of 270 consecutive subjects (197 male) who were referred for polysomnography and who did not have known diabetes mellitus were included, and 185 were documented to have OSA defined as an apnea-hypopnea index (AHI) ≥ 5. OSA subjects were more insulin resistant, as indicated by higher levels of fasting serum insulin (p = 0.001) and HOMA-IR (p < 0.001); they were also older and more obese. Stepwise multiple linear regression analysis showed that obesity was the major determinant of insulin resistance but sleep-disordered breathing parameters (AHI and minimum oxygen saturation) were also independent determinants of insulin resistance (fasting insulin: AHI, p = 0.02, minimum O2, p = 0.041; HOMA-IR: AHI, p = 0.044, minimum O2, p = 0.022); this association between OSA and insulin resistance was seen in both obese and nonobese subjects. Each additional apnea or hypopnea per sleep hour increased the fasting insulin level and HOMA-IR by about 0.5%. Further analysis of the relationship of insulin resistance and hypertension confirmed that insulin resistance was a significant factor for hypertension in this cohort. Our findings suggest that OSA is independently associated with insulin resistance, and its role in the atherogenic potential of sleep disordered breathing is worthy of further exploration.en_US
dc.languageengen_US
dc.publisherAmerican Thoracic Society. The Journal's web site is located at http://ajrccm.atsjournals.orgen_US
dc.relation.ispartofAmerican Journal of Respiratory and Critical Care Medicineen_US
dc.subject.meshAdulten_US
dc.subject.meshAnthropometryen_US
dc.subject.meshBlood Glucose - Metabolismen_US
dc.subject.meshComorbidityen_US
dc.subject.meshCross-Sectional Studiesen_US
dc.subject.meshFemaleen_US
dc.subject.meshHumansen_US
dc.subject.meshInsulin Resistance - Physiologyen_US
dc.subject.meshMaleen_US
dc.subject.meshMetabolic Syndrome X - Physiologyen_US
dc.subject.meshMiddle Ageden_US
dc.subject.meshObesity - Epidemiology - Etiology - Physiopathologyen_US
dc.subject.meshPolysomnographyen_US
dc.subject.meshRisk Factorsen_US
dc.subject.meshSleep Apnea, Obstructive - Complications - Epidemiology - Physiopathologyen_US
dc.titleObstructive sleep apnea is independently associated with insulin resistanceen_US
dc.typeArticleen_US
dc.identifier.emailIp, MSM:msmip@hku.hken_US
dc.identifier.emailLam, KSL:ksllam@hku.hken_US
dc.identifier.authorityIp, MSM=rp00347en_US
dc.identifier.authorityLam, KSL=rp00343en_US
dc.description.naturelink_to_subscribed_fulltexten_US
dc.identifier.pmid11874812-
dc.identifier.scopuseid_2-s2.0-0036499482en_US
dc.identifier.hkuros69086-
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-0036499482&selection=ref&src=s&origin=recordpageen_US
dc.identifier.volume165en_US
dc.identifier.issue5en_US
dc.identifier.spage670en_US
dc.identifier.epage676en_US
dc.identifier.isiWOS:000174131200011-
dc.publisher.placeUnited Statesen_US
dc.identifier.scopusauthoridIp, MSM=7102423259en_US
dc.identifier.scopusauthoridLam, B=9246012800en_US
dc.identifier.scopusauthoridNg, MMT=7202076310en_US
dc.identifier.scopusauthoridLam, WK=7203021937en_US
dc.identifier.scopusauthoridTsang, KWT=7201555024en_US
dc.identifier.scopusauthoridLam, KSL=8082870600en_US

Export via OAI-PMH Interface in XML Formats


OR


Export to Other Non-XML Formats