title: Relationship between sleep parameters, insulin resistance and age-adjusted insulin like growth factor-1 score in non diabetic older patients.
abstract: BACKGROUND
  Sleep complaints are prevalent in older patients. Sleepiness, short or long sleep duration and obstructive sleep apnea (OSA) are associated with insulin resistance (IR). These parameters have not yet been considered together in the same study exploring the possible association between IR and sleep in older patients. IR is involved in cardiovascular and metabolic diseases, pathologies which are highly prevalent in older patients. Here we assess, in older non-diabetic patients with sleep complaints, the associations between IR and sleep parameters objectively recorded by polysomnography (PSG) rather than self-report. The Growth Hormone/Insulin like growth factor-1 axis could play a role in the development of IR during sleep disorders. The second objective of this study was to analyze the association between sleep parameters and age-adjusted IGF-1 score, which could explain the association between OSA and IR.
  
  
  METHODS
  72 non-diabetic older patients, mean age 74.5 ± 7.8 years, were included in this observational study. We evaluated anthropometric measures, subjective and objective sleepiness, polysomnography, Homeostatic Model Assessment for IR (HOMA-IR) and age-adjusted IGF-1 score. A multivariate regression was used to determine factors associated with HOMA-IR.
  
  
  RESULTS
  The 47 OSA patients were over-weight but not obese and had higher IR than the non-OSA patients. In multilinear regression analysis, apnea-hypopnea index was independently associated with IR after adjustment for several confounding factors. Neither IGF-1 level nor IGF-1 score were different in the two groups.
  
  
  CONCLUSIONS
  We demonstrate that in non-diabetic older patients with sleep complaints, OSA is independently associated with IR, regardless of anthropometric measurements and sleep parameters (sleep duration/sleepiness/arousals). Targeting OSA to reduce IR could be useful in the elderly, although further exploration is required.
authors.affiliation: Assistance Publique-Hôpitaux de Paris (APHP), DHU FAST, Functional Exploration Unit of older patients, Groupe hospitalier Pitié-Salpêtrière-Charles Foix, Paris, France.|Sorbonne Universités, UPMC Univ Paris 06, UMR 8256, Biological Adaptation and Aging, Paris, France.|Università degli Studi di Milano, Milan, Italy.
authors.forename: Sarah
authors.initials: S
authors.lastname: Damanti
authors.affiliation: Assistance Publique-Hôpitaux de Paris (APHP), Diabetology Department, Pitié Salpétrière Hospital, Paris, France.|Sorbonne Universités, UPMC Univ Paris 06, Paris, France.|INSERM, UMR_S 1138, Centre de recherche des Cordeliers, Paris, France.
authors.forename: Olivier
authors.initials: O
authors.lastname: Bourron
authors.affiliation: Sorbonne Universités, UPMC Univ Paris 06, UMR 8256, Biological Adaptation and Aging, Paris, France.|CNRS, UMR 8256, Biological Adaptation and Aging, Paris, France.
authors.forename: Mohamed
authors.initials: M
authors.lastname: Doulazmi
authors.affiliation: Assistance Publique-Hôpitaux de Paris (APHP), DHU FAST, Functional Exploration Unit of older patients, Groupe hospitalier Pitié-Salpêtrière-Charles Foix, Paris, France.|Sorbonne Universités, UPMC Univ Paris 06, UMR 8256, Biological Adaptation and Aging, Paris, France.|CNRS, UMR 8256, Biological Adaptation and Aging, Paris, France.
authors.forename: Anne-Laure
authors.initials: AL
authors.lastname: Mandengue Sosso
authors.affiliation: Assistance Publique-Hôpitaux de Paris (APHP), DHU FAST, Functional Exploration Unit of older patients, Groupe hospitalier Pitié-Salpêtrière-Charles Foix, Paris, France.
authors.forename: Vi-Huong
authors.initials: VH
authors.lastname: Nguyen-Michel
authors.affiliation: Assistance Publique-Hôpitaux de Paris (APHP), DHU FAST, Functional Exploration Unit of older patients, Groupe hospitalier Pitié-Salpêtrière-Charles Foix, Paris, France.|Sorbonne Universités, UPMC Univ Paris 06, UMR 8256, Biological Adaptation and Aging, Paris, France.|CNRS, UMR 8256, Biological Adaptation and Aging, Paris, France.
authors.forename: Jean
authors.initials: J
authors.lastname: Mariani
authors.affiliation: Assistance Publique-Hôpitaux de Paris (APHP), DHU FAST, Functional Exploration Unit of older patients, Groupe hospitalier Pitié-Salpêtrière-Charles Foix, Paris, France.|Sorbonne Universités, UPMC Univ Paris 06, UMR 8256, Biological Adaptation and Aging, Paris, France.|CNRS, UMR 8256, Biological Adaptation and Aging, Paris, France.
authors.forename: Kiyoka
authors.initials: K
authors.lastname: Kinugawa
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D007333:Insulin Resistance; D007334:Insulin-Like Growth Factor I / Q000378:metabolism*; D008297:Male; D008875:Middle Aged; D050177:Overweight; D017286:Polysomnography; D012890:Sleep; D020181:Sleep Apnea, Obstructive / Q000503:physiopathology
chemical_list: D007334:Insulin-Like Growth Factor I