PURPOSE: OSA has been known to be associated with metabolic syndrome and insulin resistance. However it is not clear whether metabolic syndrome, insulin resistance are independently associated with OSA. This study is designed to determine whether OSA is associated with increased insulin resistance and the metabolic risk factors in Korean snoring subjects.
METHODS: Thirty seven adult habitual snorers who visited the hospital for examination of polysomnography were prospectively enrolled. Anthropometric data, fasting serum samples and blood pressure were measured in the morning after their overnight polysomnography. Samples were tested for the following circulating cytokines: leptin, adiponectin, high molecular weight adiponectin (HMWA). Insulin resistance was measured as homeostasis model assessment (HOMA-IR). Metabolic syndrome was diagnosed according to the National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP III) criteria.
RESULTS: The prevalence of the metabolic syndrome was higher in OSA group compared with non OSA subjects (P = 0.053). OSA subjects with metabolic syndrome had a greater AHI, total arousal index and HOMA-IR, lower lowest oxygen saturation, adiponectin and HMWA than in OSA subjects without metabolic syndrome. Lowest oxygen saturation was predictive of insulin resistance (t = -2.751, P = 0.010). Multiple regression analysis demonstrated that plasma adiponectin (β = -0.299, P = 0.006) and leptin (β = 0.294, P = 0.009) were independently related with HOMA-IR in patients with OSA.
CONCLUSION: OSA is associated with the metabolic syndrome. OSA subject with metabolic syndrome has more severe indices of OSA. Lowest oxygen saturation is associated with insulin resistance. The plasma adiponectin and leptin level are significant factors that affect insulin resistance in OSA patients after controlling the variables for age, BMI, and other confounding factors.
CLINICAL IMPLICATIONS: OSA is significantly associated with metabolic syndrome. Adiponectin and leptin are related with insulin resistance in patients with OSA. Thus further study is necessary to confirm this suggestion.
DISCLOSURE: Hwa Sik Moon, No Financial Disclosure Information; No Product/Research Disclosure Information