Sleep apnoea, insulin resistance and diabetes: the first step is in the fat

Almendros, Isaac; García‐Río, Francisco

doi:10.1183/13993003.00179-2017

Cited by 29 publications

(23 citation statements)

References 33 publications

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“…A review by Kent et al concluded that intermittent hypoxia (IH) and sleep deprivation likely play crucial roles in the pathogenesis of glucose metabolic dysfunction in OSA, thus contributing to various pathways synergistic with obesity [69]. The evidence from epidemiological and experimental studies concluded that OSA results in glucose intolerance, which leads to T2DM [70,71,72,73]. Sleep deprivation has been associated with multiple physiological changes including increased cortisol and ghrelin levels, decreased leptin levels, and impaired glucose metabolism [74].…”

Section: Discussionmentioning

confidence: 99%

The Interlinked Rising Epidemic of Insufficient Sleep and Diabetes Mellitus

Chattu

Burman

et al. 2019

Healthcare

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For healthy existence, humans need to spend one-third of their time sleeping. Any qualitative or quantitative disturbances in sleep would result in an increased prevalence of obesity, metabolic disorders, diabetes, cardiovascular diseases, and hypertension. The paper aims to highlight the growing global problem of insufficient sleep and its significant impact on the rising incidence of diabetes mellitus. An extensive literature search was done in all major databases for “insufficient sleep” and “Diabetes Mellitus” for this review. Shorter (<6 h) and longer (>9 h) durations of sleep have been adversely related to insulin resistance. Though the relation between insufficient sleep and diabetes mellitus is more or less understood, little is known about how oversleeping or hypersomnia (10–12 h) increases the risk of diabetes. The relationship between sleep disturbances and diabetes is dual-sided, as chronic sleep disturbances would elevate the risk of developing insulin resistance, while diabetes would worsen the quality of sleep. Both the qualitative and quantitative disturbances in sleep significantly increase the risk of developing diabetes, which is supported by numerous community-based and hospital-based epidemiological studies discussed in this review. Obstructive sleep apnea is one of the most common sleep disorders and is characterized by chronic intermittent hypoxia and increased sympathetic activity, thus leading to a higher prevalence of diabetes. Sleep therapy may serve as a low-cost method for fighting against the rising epidemic of diabetes.

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Section: Discussionmentioning

confidence: 99%

The Interlinked Rising Epidemic of Insufficient Sleep and Diabetes Mellitus

Chattu

Burman

et al. 2019

Healthcare

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“…Several possible pathways may explain how sleep apnea causes a higher risk of type 2 diabetes. Previous studies have shown that intermittent hypoxia due to sleep apnea and snoring might lead to a reduced response to insulin-stimulated glucose uptake in adipose tissue [37]. Furthermore, sleep fragmentation from recurrent arousals in sleep apnea and snoring may result in poor sleep quality and sleep loss, which are both well-defined risk factors of obesity.…”

Section: Possible Mechanismsmentioning

confidence: 99%

Causal associations of sleep apnea and snoring with type 2 diabetes and glycemic traits and the role of BMI

Wang

Campos

García-Marín

et al. 2023

Obesity

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Objective: Sleep apnea and snoring have been associated with type 2 diabetes, with BMI playing a role in the pathway, but the directions of causality are unclear. This study examined the causal associations of sleep apnea and snoring with type 2 diabetes while assessing the role of BMI using multiple genetic methods.Methods: Five genetic methods were used: two-sample; bidirectional univariable Mendelian randomization (MR) inverse variance-weighted (MR-IVW); multivariable MR-IVW; network MR; and latent causal variable method.Results: Compared with univariable MR-IVW, the odds ratio (95% CI) of type 2 diabetes for genetically predicted sleep apnea and snoring using the largest genome-wide association study decreased dramatically, from 1.61 (95% CI: 1.16-2.23) to 1.08 (95% CI: 0.59-1.97) and from 1.98 (95% CI: 1.25-3.13) to 1.09 (95% CI: 0.64-1.86) after adjustment for BMI. Network MR showed that BMI accounts for 67% and 62% of the total effect of sleep apnea and snoring on type 2 diabetes, respectively. The latent causal variable suggested that sleep apnea and snoring have no direct causal effect on type 2 diabetes.Conclusions: These results first suggest that the associations of sleep apnea and snoring with type 2 diabetes were mainly driven by BMI. The possible indirect effects of sleep apnea and snoring on type 2 diabetes through BMI cannot be ruled out.

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“…In overweight males, after controlling for confounders, OSA is specifically associated with a higher amount of visceral adiposity whereas in females, OSA is associated with global adiposity [53,54]. Independently of BMI, OSA is involved in the development of ectopic fat depots contributing to the progression of insulin resistance in the different metabolic organs, including the pancreas, liver and muscle (figure 2) [23,24,55]. The local fat depots might contribute differently to some of the deleterious consequences of OSA.…”

Section: Adipose Tissue and Ih: Insight From Rodent And Reductionist mentioning

confidence: 99%

Adipose tissue as a key player in obstructive sleep apnoea

et al. 2019

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Obstructive sleep apnoea (OSA) is a major health concern worldwide and adversely affects multiple organs and systems. OSA is associated with obesity in >60% of cases and is independently linked with the development of numerous comorbidities including hypertension, arrhythmia, stroke, coronary heart disease and metabolic dysfunction. The complex interaction between these conditions has a significant impact on patient care and mortality. The pathophysiology of cardiometabolic complications in OSA is still incompletely understood; however, the particular form of intermittent hypoxia (IH) observed in OSA, with repetitive short cycles of desaturation and re-oxygenation, probably plays a pivotal role. There is fast growing evidence that IH mediates some of its detrimental effects through adipose tissue inflammation and dysfunction. This article aims to summarise the effects of IH on adipose tissue in experimental models in a comprehensive way. Data from well-designed controlled trials are also reported with the final goal of proposing new avenues for improving phenotyping and personalised care in OSA.

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Sleep apnoea, insulin resistance and diabetes: the first step is in the fat

Cited by 29 publications

References 33 publications

The Interlinked Rising Epidemic of Insufficient Sleep and Diabetes Mellitus

The Interlinked Rising Epidemic of Insufficient Sleep and Diabetes Mellitus

Causal associations of sleep apnea and snoring with type 2 diabetes and glycemic traits and the role of BMI

Adipose tissue as a key player in obstructive sleep apnoea

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