[Factors influencing glucose metabolism in young obese subjects with obstructive sleep apnea hypopnea syndrome].
OBJECTIVE
To explore the factors influencing glucose metabolism in young obese subjects with obstructive sleep apnea hypopnea syndrome (OSAHS).


METHODS
A total of 106 young obese subjects[18-44 years old, body mass index (BMI) ≥30 kg/m(2)]were enrolled and divided into two groups based on full-night polysomnography (PSG), OSAHS group[apnea hypopnea index (AHI) ≥5 events/h]and non-OSAHS group (AHI<5 events/h). Oral glucose tolerance-insulin releasing test (OGTT-IRT) was performed and serum glycosylated hemoglobin A1 (HbA1c) levels were measured after an overnight fast. Homeostasis model assessment-IR (HOMA-IR), Matsuda insulin sensitivity index (MI), homeostasis model assessment-β (HOMA-β), the early phase insulinogenic index (ΔI(30)/ΔG(30)), total area under the curve of insulin in 180 minutes (AUC-I180) and oral disposition index (DIo) were calculated to evaluate insulin resistance and pancreatic β cell function. Stepwise multiple linear regressions were conducted to determine the independent linear correlation of glucose measurements with PSG parameters.


RESULTS
Prevalence of diabetes was higher in OSAHS than in non-OSAHS group (22.0% vs 4.3%, P=0.009). OGTT 0, 30, 60 min glucose and HbA1c levels were higher in OSAHS group than those in non-OASHS group (all P<0.05). DIo were lower in OSAHS group than those in non-OASHS group (P=0.024), HOMA-IR, MI, HOMA-β, ΔI(30)/ΔG(30), and AUC-I(180) were similar between two groups (all P>0.05). In stepwise multiple linear regressions, OGTT 0, 30 and 60 min glucose were positively correlated with oxygen desaturation index (ODI) (β=0.243, 0.273 and 0.371 respectively, all P<0.05). HOMA-β was negatively correlated with AHI (β=-0.243, P=0.011). DIo was negatively correlated with ODI (β=-0.234, P=0.031).


CONCLUSIONS
OSAHS worsens glucose metabolism and compensatory pancreatic β-cell function in young obese subjects, which could probably be attributed to sleep apnea related oxygen desaturation during sleep.
Department of Respiratory Medicine, Shanghai Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200025, China.
C J
CJ
Gu
Q Y
QY
Li
M
M
Li
J
J
Zhou
J
J
Du
H H
HH
Yi
J
J
Feng
L N
LN
Zhou
Q
Q
Wang
D000293:Adolescent; D000328:Adult; D001784:Blood Gas Analysis; D015992:Body Mass Index; D003920:Diabetes Mellitus / Q000175:diagnosis*; D005947:Glucose / Q000378:metabolism*; D005951:Glucose Tolerance Test; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D007328:Insulin; D007333:Insulin Resistance; D050417:Insulin-Secreting Cells / Q000473:pathology; D009765:Obesity / Q000150:complications / Q000378:metabolism*; D017286:Polysomnography; D012890:Sleep; D020181:Sleep Apnea, Obstructive / Q000150:complications / Q000378:metabolism*; D055815:Young Adult
D005947:Glucose; D006442:Glycated Hemoglobin; D007328:Insulin; C517652:hemoglobin A1c protein, human