title: [Lower grade chronic inflammation is associated with obstructive sleep apnea syndrome in type 2 diabetes mellitus].
abstract: OBJECTIVE
  To investigate whether the existence of obstructive sleep apnea syndrome (OSAS) in patients with type 2 diabetes (T2DM) is associated with low grade chronic inflammation.
  
  
  METHODS
  Fifty-four patients hospitalized for poor glycemic control from 12/2008 to 12/2009 were divided into 2 groups, OSAS group (T2DM with OSAS, 27 cases) and NOSAS group (T2DM without OSAS, 27 cases). The control group consisted of 26 people from a health check-up program without diabetes and OSAS. Biochemical indexes were analyzed in central laboratory of the hospital. Serum tumor necrosis factor-α(TNF-α), lipopolysaccharides (LPS), monocyte chemoattractant protein-1 (MCP), and plasminogen activator inhibitor-1 (PAI) levels were determined with commercial ELISA kits. Apnea hypopnea index (AHI), the lowest pulse oxygen saturation (LSpO₂) at night were measured with a portable home sleep monitor.
  
  
  RESULTS
  Homeostasis model assessment insulin resistance index (HOMA-IR), AHI in OSAS group were higher than those in NOSAS group and control group [for HOMA-IR, 2.7 ± 1.5 vs 1.7 ± 0.9 vs 1.2 ± 0.7, and for AHI, (17.0 ± 13.0) vs (3.4 ± 1.3) vs (3.2 ± 1.2) per hour], and LSpO₂ was lower than that in NOSAS group and control group [(78 ± 11)% vs (87 ± 4)% vs (89 ± 6)%]. Compared with normal control, levels of TNF-α [(0.73 ± 0.19) vs (1.97 ± 0.13) vs (1.09 ± 0.29) ng/ml], LPS [(50 ± 11) vs (303 ± 70) vs (171 ± 49) pg/ml], MCP [(302 ± 41) vs (514 ± 122) vs (473 ± 134) pg/ml] and PAI [(0.89 ± 0.25) vs (2.27 ± 0.85) vs (1.59 ± 0.13) ng/ml] in patients with OSAS and with NOSAS group increased significantly. Pearson univariate correlation analysis revealed that TNF-α and PAI were both positively associated with HOMA-IR, FBG and AHI, and negatively with LSpO₂, LPS, MCP were both associated positively with FBG and AHI, and negatively with LSpO₂. Multiple linear regression stepwise analysis found that TNF-α and LPS were independently associated with AHI and FBG, MCP with LSpO₂, PAI with both AHI and HOMA-IR.
  
  
  CONCLUSIONS
  Patients with diabetes and OSAS show raised level of chronic inflammatory activity.
authors.affiliation: Department of Endocrinology and Metabolism, the Second Hospital of Dalian Medical University, Dalian 116023, China.
authors.forename: Hongxia
authors.initials: H
authors.lastname: Zhu
authors.affiliation: Department of Endocrinology and Metabolism, the Second Hospital of Dalian Medical University, Dalian 116023, China.
authors.forename: Zhenshan
authors.initials: Z
authors.lastname: Wang
authors.affiliation: Department of Endocrinology and Metabolism, the Second Hospital of Dalian Medical University, Dalian 116023, China.
authors.forename: Xin
authors.initials: X
authors.lastname: Xue
authors.affiliation: Department of Endocrinology and Metabolism, the Second Hospital of Dalian Medical University, Dalian 116023, China.
authors.forename: Ping
authors.initials: P
authors.lastname: Zhang
authors.affiliation: Department of Endocrinology and Metabolism, the Second Hospital of Dalian Medical University, Dalian 116023, China.
authors.forename: Chunmei
authors.initials: C
authors.lastname: Yang
authors.affiliation: Department of Endocrinology and Metabolism, the Second Hospital of Dalian Medical University, Dalian 116023, China. Email:dlbenlisu@163.com.
authors.forename: Benli
authors.initials: B
authors.lastname: Su
mesh_terms: D000368:Aged; D001786:Blood Glucose / Q000378:metabolism; D016022:Case-Control Studies; D018932:Chemokine CCL2 / Q000097:blood; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000150:complications*; D005260:Female; D006801:Humans; D007249:Inflammation / Q000097:blood* / Q000150:complications / Q000473:pathology; D007333:Insulin Resistance; D008070:Lipopolysaccharides / Q000097:blood; D008297:Male; D008875:Middle Aged; D010100:Oxygen / Q000097:blood; D017286:Polysomnography; D020181:Sleep Apnea, Obstructive / Q000097:blood* / Q000150:complications / Q000473:pathology; D014409:Tumor Necrosis Factor-alpha / Q000097:blood*
chemical_list: D001786:Blood Glucose; D018932:Chemokine CCL2; D008070:Lipopolysaccharides; D014409:Tumor Necrosis Factor-alpha; D010100:Oxygen