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Sleep Disorders |

Insulin Resistance and Nocturnal Oxyhemoglobin Levels in Obese Patients With Obstructive Sleep Apnea

Stefan Dumitrache-Rujinski, MD; Ionela Erhan; George Calcaianu; Alexandru Cocieru; Ioana Dinu; Dragos Zaharia; Claudia Toma, MD; Miron Bogdan, MD
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Marius Nasta Pneumology Institute, Bucharest, Romania


Chest. 2014;146(4_MeetingAbstracts):956A. doi:10.1378/chest.1993466
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Abstract

SESSION TITLE: Consequences of Sleep Disorders

SESSION TYPE: Original Investigation Slide

PRESENTED ON: Tuesday, October 28, 2014 at 02:45 PM - 04:15 PM

PURPOSE: Obstructive Sleep Apnea Syndrome (OSAS) is increasingly recognized as a risk factor for metabolic abnormalities, and nocturnal hypoxemia may be one of the involved mechanisms. The aim of the study is to asses the correlation between insulin resistance (IR) and nocturnal oxyhaemoglobin levels in obese patients with OSAS.

METHODS: We evaluated 64 obese (IMC>30Kg/m2), nondiabetic patients (fasting glycemia< 126mg/dL, without hypoglycemic or hypolipemiant medication), diagnosed with insulin resistance ((serum triglycerides (TG) / high density lipoprotein-cholesterol (HDL-C) ratio>3)) and OSAS ((AHI>5/hour (six channel cardio-respiratory polygraphy) and daytime sleepiness (Epworth sleepiness scale>10/24)). The correlations between insulin resistance (IR) and oxygen desaturation index (ODI), Apnea Hipopnea Index (AHI), the average and lowest oxyhaemoglobin saturation (SaO2) were assessed.The cut-off for the independent desaturation was set at 3%.

RESULTS: Out of the 64 patients (44 men and 20 women), 48 (75%) had severe, 7 (11%) moderate and 9 (14%) mild OSAS. Mean age was 52 ± 10.6 years and mean BMI: 38.54 ± 6.67Kg/m2. Mean AHI: 49.65 ± 25.55/hour (range 7-110). The mean ODI was 47.69 ± 24.95/ hour (range 4-98), mean average SaO2: 89.42% ± 4.61% and mean lowest SaO2: 68.4% ± 13.8%. Mean TG/HDL-C ratio was 5.27 ± 2.03. Insulin resistance negatively correlated with mean lowest SaO2 (p: 0.045; r: -0.25) and with BMI>40Kg/m2 (p: 0.05 and r: 0.39). No significant statistically correlations were found between IR and ODI (p: 0.19), AHI (p:0.58) or average SaO2 (p: 0.08).

CONCLUSIONS: The level of nocturnal oxyhaemoglobin saturation rather than OSAS severity (assessed as Apnea Hypopnea Index or Oxygen Desaturation Index) seems to be involved in the occurrence of insulin resistance in nondiabetic obese patients with OSAS.

CLINICAL IMPLICATIONS: Monitoring oxyhaemoglobin levels by nocturnal continuous pulseoximetry may evaluate cardiometabolic risk in obese patients

DISCLOSURE: The following authors have nothing to disclose: Stefan Dumitrache-Rujinski, Ionela Erhan, George Calcaianu, Alexandru Cocieru, Ioana Dinu, Dragos Zaharia, Claudia Toma, Miron Bogdan

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