CPAP treatment does not affect glucose–insulin metabolism in sleep apneic patients

Smurra, M; Philip, Pierre; Taillard, Jacques; Guilleminault, Christian; Bioulac, Bernard; Gin, H.

doi:10.1016/s1389-9457(00)00079-4

Cited by 103 publications

(61 citation statements)

References 25 publications

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“…The small sample size, the small range of AHI and the use of a simplified monitoring technique may limit the conclusions of this study. Another study [20] reported no relationship between sleep-disordered breathing and insulin resistance, as the authors did not find any effect of CPAP treatment on glucose-insulin metabolism in sleep apnoeic patients. The very small sample size and the short duration of CPAP treatment and the lack of information concerning actual use of the CPAP equipment may also limit the conclusions of this study.…”

Section: Resultsmentioning

confidence: 90%

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Impaired glucose-insulin metabolism in males with obstructive sleep apnoea syndrome

Meslier¹,

Gagnadoux²,

Giraud³

et al. 2003

Eur Respir J

268

159

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The aim of this cross-sectional study was to evaluate the frequency of type-2 diabetes and impaired glucose tolerance (IGT) in a large clinic-based male population presenting various degrees of obstructive sleep apnoea syndrome (OSAS) and to analyse the relationship between OSAS and glucose-insulin metabolism.Male patients (n=595) with suspected OSAS underwent both nocturnal polysomnography and a 2-h oral glucose-tolerance test with measurements of fasting and postload blood glucose and plasma insulin. Insulin sensitivity was evaluated by the ratio of fasting glucose to fasting insulin.OSAS was diagnosed in 494 patients, while 101 patients were nonapnoeic snorers. Type-2 diabetes was present in 30.1% of OSAS patients and 13.9% of nonapnoeic snorers. IGT was diagnosed in 20.0% of OSAS patients and 13.9% of nonapnoeic snorers. Fasting and postload blood glucose increased with severity of sleep apnoea. Insulin sensitivity decreased with increasing severity of sleep apnoea. In addition to body mass index and age, the apnoea/hypopnoea index independently influenced postload blood glucose and insulin sensitivity.The authors conclude that in a clinic-based sample of patients, obstructive sleep apnoea syndrome is associated with a high frequency of type-2 diabetes and impaired glucose tolerance. The relationship between sleep-disordered breathing and impaired glucose-insulin metabolism is independent of obesity and age. Eur Respir J 2003; 22: 156-160.

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Section: Resultsmentioning

confidence: 90%

“…Furthermore, there is evidence that insulin resistance predisposes to cardiovascular disease [12][13][14]. Previous studies on the relationship between insulin resistance and OSAS [15][16][17][18] and on the effect of continuous positive airway pressure (CPAP) treatment on insulin resistance [19,20] have yielded conflicting results.…”

mentioning

confidence: 99%

Impaired glucose-insulin metabolism in males with obstructive sleep apnoea syndrome

Meslier¹,

Gagnadoux²,

Giraud³

et al. 2003

Eur Respir J

268

159

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“…As shown above, additional analyses using only obese individuals in our cohort (n ϭ 70) failed to reveal the presence of any significant association between SDB severity and insulin resistance. In this context, it is noteworthy that even in adult populations, the effect of CPAP on insulin resistance has yielded conflicting results, 25,26,[29][30][31][32]62,63 thereby raising the possibility that although SDB may induce an adverse effect on glucose regulatory mechanisms, this effect is small at most. Indeed, the effect of CPAP on insulin sensitivity was found to be smaller in obese patients than in nonobese patients, suggesting that in obese individuals, insulin sensitivity is determined primarily by obesity and to a smaller extent by respiratory disturbances during sleep.…”

mentioning

confidence: 99%

“…27,28 Moreover, the effect of continuous positive airway pressure (CPAP) on the metabolic disturbances associated with SDB has yielded conflicting results. [29][30][31][32] SDB in children is associated with increased sympathetic activity, [33][34][35] elevated blood pressure, and left ventricular geometry changes. [36][37][38] In addition, we recently reported on altered plasma C-reactive protein (CRP) levels, a marker of inflammation and atherogenesis, as a consequence of SDB in children.…”

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confidence: 99%

Obesity Rather Than Severity of Sleep-Disordered Breathing as the Major Determinant of Insulin Resistance and Altered Lipidemia in Snoring Children

et al. 2005

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ABSTRACT. Objective. Sleep-disordered breathing (SDB) is associated with insulin resistance and dyslipidemia in adults and in obese children. However, the prevalence of such metabolic abnormalities among snoring children is unknown. This study was done to prospectively assess the relative contribution of SDB and obesity to metabolic disturbances in a large cohort of snoring children.Methods. Measurements of fasting serum glucose, insulin, and lipids were obtained after polysomnographic evaluation in 116 snoring children and in 19 control subjects. Insulin resistance was assessed using the insulin/glucose ratio (I/G ratio) and homeostasis model assessment (HOMA).Results. A total of 135 children (79 boys; mean age: 8.9 ؎ 3.5 years) were studied. Sixty-four children had moderate to severe SDB (AHI ‫؍‬ 5 per hour of total sleep time [TST]), 52 had mild SDB (AHI ‫؍‬ 1 but <5 per hour of TST), and 19 were control subjects (AHI <1 per hour of TST). Seventy of these children were obese. No significant correlations were found between AHI, lowest arterial oxygen saturation, or arousal index and serum insulin, serum glucose, I/G ratio, HOMA, or serum lipids for either the whole group or the obese children only. However, significant positive correlations were found between I/G ratio and relative BMI (relBMI; r ‫؍‬ 0.58), HOMA and relBMI (r ‫؍‬ 0.52), triglycerides and relBMI (r ‫؍‬ 0.30), and high-density lipoprotein and relBMI (r ‫؍‬ 0.50). No significant differences were found in relBMI, I/G ratio, and lipid levels between boys and girls.Conclusions. Among children with suspected SDB, insulin resistance and dyslipidemia seem to be determined primarily by the degree of body adiposity rather than by the severity of SDB. Pediatrics 2005;116:e66-e73. URL: www.pediatrics.org/cgi/doi/10.1542/peds.2004-2527; metabolic syndrome, sleep apnea, pediatrics, obesity, diabetes.ABBREVIATIONS. SDB, sleep-disordered breathing; CPAP, continuous positive airway pressure; CRP, C-reactive protein; Spo 2 , arterial oxygen saturation; AHI, apnea hypopnea index; TST, total sleep time; relBMI, relative BMI; HOMA, homeostasis model assessment; I/G ratio, insulin/glucose ratio; HDL, high-density lipoprotein; TG, triglyceride.T he incidence of childhood obesity has been increasing steadily in Western countries. 1 Recent reports place the prevalence of obesity and overweight in children at levels ranging from 7% up to 22% in various countries, 2-9 and such elevated figures will undoubtedly impose major health implications, particularly on the development of insulin resistance, type 2 diabetes, and cardiovascular morbidity. [10][11][12] The term "metabolic syndrome" is a known risk factor for cardiovascular disease in adults and refers to the clustering of insulin resistance, dyslipidemia, hypertension, and obesity. Elevation of fasting insulin levels and increased BMI during childhood are the strongest predictors of the metabolic syndrome in adulthood, 13,14 possibly through the combination of altered insulin signaling and adrenocortical function, in...

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“…(2005) [13], где исход-ный уровень HbA1с составил 7,8 ± 1,4%. При этом в других работах, с исходным уровнем HbA1с 6,4 ± 0,7% и 5,1 ± 0,4%, изменения были незначительными [14,15]. Следовательно, во-первых, СиПАП-терапия оказывает свой эффект у пациентов с более выраженными нару-шениями углеводного обмена, во-вторых, она безопасна с точки зрения собственного гипогликемического эффекта.…”

Section: обсуждение сипап и углеводный обменunclassified

Cpap-Therapy Decreases Glycated Hemoglobin in Patients With Type 2 Diabetes Mellitus and Sleep Apnoea

Бурчаков¹,

Майоров²

2017

Med. sov.

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CPAP treatment does not affect glucose–insulin metabolism in sleep apneic patients

Cited by 103 publications

References 25 publications

Impaired glucose-insulin metabolism in males with obstructive sleep apnoea syndrome

Impaired glucose-insulin metabolism in males with obstructive sleep apnoea syndrome

Obesity Rather Than Severity of Sleep-Disordered Breathing as the Major Determinant of Insulin Resistance and Altered Lipidemia in Snoring Children

Cpap-Therapy Decreases Glycated Hemoglobin in Patients With Type 2 Diabetes Mellitus and Sleep Apnoea

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