title: The effect of sleep apnea and insomnia on blood levels of leptin, insulin resistance, IP-10, and hydrogen sulfide in type 2 diabetic patients.
abstract: BACKGROUND
  Sleep deficits associated with sleep apnea and insomnia increase the risk of vascular inflammation and insulin resistance. This study examined the hypothesis that inflammation markers are higher in those diabetic patients who experience sleep deficits compared with those without any history of a sleep disorder.
  
  
  METHODS
  Fasting blood was obtained after written informed consent, and sleep disorder histories were obtained from type 2 diabetic patients (n=81) attending clinics of the Louisiana State University Health Sciences Center.
  
  
  RESULTS
  There was a significant correlation between body weight and leptin, and leptin in turn was significantly correlated with 10-kDa interferon-γ-induced protein (IP-10) levels and insulin resistance in type 2 diabetic patients. Fasting blood levels of leptin, IP-10, and insulin resistance were significantly elevated in patients with sleep deficits compared with diabetics with normal sleep patterns. There were no differences in glycosylated hemoglobin (HbA1c) or fasting glucose in patients with sleep deficits compared with those with normal sleep patterns. Sleep deficits increase circulating levels of leptin, IP-10, and insulin resistance compared to levels seen in patients with diabetes who reported no difficulty with sleep. Patients with sleep apnea had significantly lower hydrogen sulfide (H(2)S) levels compared with patients with normal sleep patterns or patients with insomnia. Low levels of circulating H(2)S could contribute to higher vascular inflammation in patients with sleep apnea.
  
  
  CONCLUSIONS
  These results suggest that sleep apnea is associated with a decrease in circulating H(2)S and sleep disorders increase the risk of inflammation and insulin resistance, which can contribute to the increased risk of vascular disease in subjects with type 2 diabetes.
authors: Department of Pediatrics, Louisiana State University Health Sciences Center, Shreveport, Louisiana 71130, USA. sjain@lsuhsc.edu
authors: Sushil K
authors: SK
authors: Jain
authors: Gunjan
authors: G
authors: Kahlon
authors: Lester
authors: L
authors: Morehead
authors: Benjamin
authors: B
authors: Lieblong
authors: Tommie
authors: T
authors: Stapleton
authors: Robert
authors: R
authors: Hoeldtke
authors: Pat Farrington
authors: PF
authors: Bass
authors: Steven N
authors: SN
authors: Levine
mesh_terms: D000328:Adult; D001835:Body Weight / Q000502:physiology; D016022:Case-Control Studies; D054357:Chemokine CXCL10 / Q000097:blood*; D003924:Diabetes Mellitus, Type 2 / Q000097:blood* / Q000150:complications / Q000453:epidemiology / Q000378:metabolism; D005260:Female; D006801:Humans; D006862:Hydrogen Sulfide / Q000097:blood*; D007333:Insulin Resistance / Q000502:physiology; D020738:Leptin / Q000097:blood*; D008297:Male; D008875:Middle Aged; D012891:Sleep Apnea Syndromes / Q000097:blood* / Q000150:complications / Q000453:epidemiology / Q000378:metabolism; D007319:Sleep Initiation and Maintenance Disorders / Q000097:blood* / Q000150:complications / Q000453:epidemiology / Q000378:metabolism
chemical_list: C114753:CXCL10 protein, human; D054357:Chemokine CXCL10; D020738:Leptin; D006862:Hydrogen Sulfide