Section on Neuroendocrinology of Obesity, National Institute of Diabetes, Digestive, and Kidney Disease, Bethesda, Maryland, USA.
PLoS One. 2013 May 29;8(5):e65400. doi: 10.1371/journal.pone.0065400. Print 2013.
Sleep abnormalities, including obstructive sleep apnea (OSA), have been associated with insulin resistance.
To determine the relationship between sleep, including OSA, and glucose parameters in a prospectively assembled cohort of chronically sleep-deprived obese subjects.
Cross-sectional evaluation of a prospective cohort study.
Tertiary Referral Research Clinical Center.
Sleep duration and quality assessed by actigraphy, sleep diaries and questionnaires, OSA determined by a portable device; glucose metabolism assessed by oral glucose tolerance test (oGTT), and HbA1c concentrations in 96 obese individuals reporting sleeping less than 6.5 h on a regular basis.
Sixty % of subjects had an abnormal respiratory disturbance index (RDI≥5) and 44% of these subjects had abnormal oGTT results. Severity of OSA as assessed by RDI score was associated with fasting glucose (R = 0.325, p = 0.001) and fasting insulin levels (ρ = 0.217, p = 0.033). Subjects with moderate to severe OSA (RDI>15) had higher glucose concentrations at 120 min than those without OSA (RDI<5) (p = 0.017). Subjects with OSA also had significantly higher concentrations of plasma ACTH (p = 0.009). Several pro-inflammatory cytokines were higher in subjects with OSA (p<0.050). CRP levels were elevated in this sample, suggesting increased cardiovascular risk.
OSA is associated with impaired glucose metabolism in obese, sleep deprived individuals. Since sleep apnea is common and frequently undiagnosed, health care providers should be aware of its occurrence and associated risks.
This study was conducted under the NIDDK protocol 06-DK-0036 and is listed in ClinicalTrials.gov NCT00261898.
睡眠异常，包括阻塞性睡眠呼吸暂停（OSA），与胰岛素抵抗有关。
在一组前瞻性、慢性睡眠剥夺肥胖受试者队列中，确定睡眠（包括 OSA）与葡萄糖参数之间的关系。
前瞻性队列研究的横断面评估。
三级转诊研究临床中心。
通过活动记录仪、睡眠日记和问卷调查评估睡眠持续时间和质量，通过便携式设备确定 OSA；通过口服葡萄糖耐量试验（oGTT）评估葡萄糖代谢，并在 96 名经常睡眠不足 6.5 小时的肥胖个体中评估 HbA1c 浓度。
60%的受试者存在异常呼吸紊乱指数（RDI≥5），其中 44%的受试者存在异常 oGTT 结果。以 RDI 评分评估的 OSA 严重程度与空腹血糖（R=0.325，p=0.001）和空腹胰岛素水平相关（ρ=0.217，p=0.033）。与无 OSA（RDI<5）的受试者相比，中重度 OSA（RDI>15）的受试者在 120 分钟时的血糖浓度更高（p=0.017）。OSA 受试者的血浆 ACTH 浓度也显著升高（p=0.009）。OSA 受试者的几种促炎细胞因子水平升高（p<0.050）。该样本中的 CRP 水平升高，提示心血管风险增加。
OSA 与肥胖、睡眠剥夺个体的葡萄糖代谢受损有关。由于睡眠呼吸暂停很常见且经常未被诊断，因此医疗保健提供者应意识到其发生及其相关风险。
本研究是在 NIDDK 方案 06-DK-0036 下进行的，并在 ClinicalTrials.gov 注册，编号为 NCT00261898。
