Obesity, and not obstructive sleep apnea, is responsible for metabolic abnormalities in a cohort with sleep-disordered breathing.
OBJECTIVE
To assess the profile of metabolic abnormalities in subjects with obstructive sleep apnea (OSA).


METHODS
In a case-control study conducted in two years, from April 2003 to March 2005, data obtained from polysomnography study, lipid profile, fasting blood sugar, serum insulin, insulin resistance, leptin and adiponectin levels, were compared between the various groups. Included in the study were OSA subjects from a sleep laboratory and matched controls from the community. Those with recent myocardial infarction, upper airway surgery, class III/IV heart failure, pregnancy, acromegaly, chronic renal failure, or who were on treatment for hyperthyroidism, on systemic steroid treatment, or on hormonal replacement therapy, were excluded from the study.


RESULTS
Forty apneic obese subjects (AHI=32.19, range 13-52.75) were compared with 40 non-apneic obese controls (AHI=1.3, range 0-2.45) and 40 normal weight control subjects (AHI=0.7, range 0-1). No significant difference was noted in levels of fasting blood sugar, insulin resistance (obese apneics 61.9, obese controls 47.8, non-obese controls 19.1), leptin (obese apneics 10.65 microg/L, obese controls 8.52 microg/L, non-obese controls 2.83 microg/L) or adiponectin (obese apneics 4959.3 ng/ml, obese controls 5706 ng/ml, non-obese controls 7412 ng/ml) in the OSA group compared to obese controls.


CONCLUSIONS
OSA has no independent association with lipid abnormalities, insulin resistance, serum leptin and adiponectin levels. In multivariate analysis, obesity was the major determinant of metabolic abnormalities in this cohort.
Sharma
S K
SK
Division of Pulmonary and Critical Care Medicine, Department of Medicine, All India Institute of Medical Sciences, New Delhi 110029, India. sksharma@aiims.ac.in
Kumpawat
Saket
S
Goel
Ashish
A
Banga
Amit
A
Ramakrishnan
Lakshmi
L
Chaturvedi
Pradeep
P
D000293:Adolescent; D000328:Adult; D002784:Cholesterol / Q000097:blood; D015331:Cohort Studies; D004569:Electroencephalography; D005260:Female; D006801:Humans; D007333:Insulin Resistance / Q000502:physiology*; D008297:Male; D024821:Metabolic Syndrome / Q000453:epidemiology* / Q000503:physiopathology*; D008875:Middle Aged; D009765:Obesity / Q000453:epidemiology* / Q000503:physiopathology*; D017286:Polysomnography; D012891:Sleep Apnea Syndromes / Q000175:diagnosis / Q000453:epidemiology* / Q000503:physiopathology; D012895:Sleep, REM / Q000502:physiology; D014280:Triglycerides / Q000097:blood
D014280:Triglycerides; D002784:Cholesterol