Evaluation of Plasma Ghrelin, Omentin–1 Levels and Insulin Resistance in Patients With Obstructive Sleep Apnea Syndrome
Abstract
Objective: Available studies support the occurrence of a bidirectional association between obstructive sleep apnea syndrome (OSAS) and cardiovascular disorders. In this study, we aimed to evaluate the plasma ghrelin, omentin–1 levels, insulin resistance (IR) in patients with OSAS, and its cardiovascular consequences.
Methods: This study was performed on 150 individuals who applied to the sleep laboratory with complaints such as snoring and sleep-breathing pause. Polysomnographic (PSG) evaluation was applied to every patient. Seventy-five individuals with Apnea-Hypopnea Index (AHI) ≥5 were diagnosed as OSAS and seventy-five individuals with AHI<5 were included as the without OSAS.
Results: The median omentin-1 level was 59.0 ng/mL in the OSAS group and 105.0 ng/mL in without OSAS (p<0.001). The median ghrelin level in the OSAS group was 229.0 pg/ml and 180.0 pg/ml in the without OSAS group (p<0.001). The prevalence of OSAS was 2.667 times higher in males than females (OR=2.667). HOMA-IR scores were not different between OSAS and without OSAS groups (p=0.218). Patients with OSAS had higher BMI, neck circumference, and median ESS values compared to those without OSAS group (p<0.001). In obese, the risk of OSAS was found 3.058 times higher (OR= 3.058) (p<0.001).
Conclusions: Median omentin-1 level was lower in the OSAS group than the without OSAS group, whereas median ghrelin level was higher in the OSAS and obese individuals. Due to the high prevalence of OSAS in hypertensive and obese individuals, effective screening, diagnosis, and treatment of OSAS are required to reduce cardiovascular risk.
References
- REFERENCES 1. Arnold J, Sunilkumar M, Krishna V, et al. Obstructive Sleep Apnea. J Pharm Bioallied Sci. 2017;9(Suppl 1):26-28. 2. Gonzaga C, Bertolami A, Bertolami M, et al. Obstructive sleep apnea, hypertension and cardiovascular diseases. J Hum Hypertens. 2015;29(12):705-12. 3. Lombardi C, Tobaldini E, Montano N, et al. Obstructive Sleep Apnea Syndrome (OSAS) and Cardiovascular System. Med Lav. 2017;108(4):276-282. 4. Archontogeorgis K, Papanas N, Nena E, et al. Insulin Sensitivity and Insulin Resistance in Non-Diabetic Middle-Aged Patients with Obstructive Sleep Apnoea Syndrome. Open Cardiovasc Med J. 2017;11:159-168. 5. Spiegel K, Tasali E, Penev P, et al. Brief communication: Sleep curtailment in healthy young men is associated with decreased leptin levels, elevated ghrelin levels, and increased hunger and appetite. Ann Intern Med. 2004;141(11):846-50. 6. Taheri S, Lin L, Austin D, et al. Short sleep duration is associated with reduced leptin, elevated ghrelin, and increased body mass index. PLoS Med. 2004;1(3):e62. 7. Kojima M, Kangawa Structure and function of ghrelin. Results Probl Cell Differ. 2008;46:89-115. 8. Yang RZ, Lee MJ, Hu H, et al. Identification of omentin as a novel depot-specific adipokine in human adipose tissue: possible role in modulating insulin action. Am J Physiol Endocrinol Metab. 2006;290:E1253–61. 9. Cummings DE. Ghrelin and the short and long-term regulation of appetite and body weight. Physiol Behav. 2006;89(1):71-84. 10. Knaus C. Diagnosis and Treatment of Obstructive Sleep Apnea Syndrome. Ther Umsch. 2016;73(4):209-12. 11. National Task Force on the Prevention and Treatment of Obesity. Overweight, Obesity, and Health Risk. Arch Intern Med.2000;160:898-904. 12. Auguet T, Quintero Y, Riesco D, et al. New adipokines vaspin and omentin. Circulating levels and gene expression in adipose tissue from morbidly obese women. BMC Med Genet 2011;28:12(1):60-8. 13. Berry RB, Budhiraja R, Gottlieb DJ, et al. Rules for scoring respiratory events in sleep: update of the 2007 AASM Manual for the Scoring of Sleep and Associated Events. Deliberations of the Sleep Apnea Definitions Task Force of the American Academy of Sleep Medicine. J Clin Sleep Med. 2012;8(5):597-619. 14. Kwon Y, Khan T, Pritzker M, et al. Circulation time measurement from sleep studies in patients with obstructive sleep apnea. J Clin Sleep Med. 2014;10(7):759-65. 15. Izci B, Ardic S, Firat H, et al. Reliability and validity studies of the Turkish version of the Epworth sleepiness Scale. Sleep Breath 2008;12(2):161–8. 16. Zirlik S, Hildner KM, Targosz A, et al. Melatonin and omentin: influence factors in the obstructive sleep apnoea syndrome? J Physiol Pharmacol. 2013;64(3):353-60. 17. de Souza Batista CM1, Yang RZ, Lee MJ, et al. Omentin plasma levels and gene expression are decreased in obesity. Diabetes. 2007;56(6):1655-61. 18. Ishii S, Kamegai J, Tamura H, et al. Role of Ghrelin in streptozotocin-induced diabetic hyperphagia. Endocrinology 2002; 143(12): 4934-7. 19. Purnell JQ, Weigle DS, Breen P, et al. Ghrelin levels correlate with insulin levels, insulin resistance, and high-density lipoprotein cholesterol, but not with gender, menopausal status, or cortisol levels in humans. J Clin Endocrinol Metab 2003; 88(12): 5747-52. 20. Tschöp M, Weyer C, Tataranni PA, et al. Circulating ghrelin levels are decreased in human obesity. Diabetes 2001;50(4):707-9. 21. Harsch IA1, Konturek PC, Koebnick C, et al. Leptin and ghrelin levels in patients with obstructive sleep apnoea: effect of CPAP treatment. Eur Respir J. 2003;22(2):251-7. 22. Ursavas A, Ilcol YO, Nalci N, et al. Ghrelin, leptin, adiponectin, and resistin levels in sleep apnea syndrome: Role of obesity. Ann Thorac Med. 2010;5:161-5. 23. Sharma SK, Kumpawat S, Goel A, et al. Obesity, and not obstructive sleep apnea, is responsible for metabolic abnormalities in a cohort with sleep-disordered breathing. Sleep Med. 2007;8(1):12–7. 24. Davies RJ, Turner R, Crosby J, et al. Plasma insulin and lipid levels in untreated obstructive sleep apnoea and snoring; their comparison with matched controls and response to treatment. J Sleep Res. 1994;3(3):180-5. 25. Stoohs RA, Facchini F, Guilleminault C. Insulin resistance and sleep-disordered breathing in healthy humans. Am J Respir Crit Care Med. 1996;154(1):170–4. 26. Makino S, Handa H, Suzukawa K, et al. Obstructive sleep apnoea syndrome, plasma adiponectin levels, and insulin resistance. Clin Endocrinol (Oxf). 2006;64(1):12-9. 27. Bulcun E, Ekici M, Ekici A. Disorders of glucose metabolism and insulin resistance in patients with obstructive sleep apnoea syndrome. Int J Clin Pract.2012;66(1):91-7.
Obstrüktif Uyku Apne Sendromlu Hastalarda Plazma Ghrelin, Omentin-1 Düzeyleri ve İnsülin Dirençlerinin Değerlendirilmesi
Abstract
Amaç: Mevcut çalışmalar, obstrüktif uyku apne sendromu (OUAS) ile kardiyovasküler bozukluklar arasında çift yönlü bir ilişki olmasını desteklemektedir. Bu çalışmada OUAS'lı hastalarda plazma ghrelin, omentin-1 düzeyleri, insülin direnci (IR) ve kardiyovasküler sonuçları değerlendirildi.
Gereç ve Yöntem: Bu çalışma uyku laboratuvarına horlama ve uykuda solunum duraklaması gibi şikayetlerle başvuran 150 kişi üzerinde gerçekleştirildi. Her hastaya polisomnografik (PSG) değerlendirme uygulandı. Apne-Hipopne İndeksi (AHI) ≥5 olan yetmiş beş hastaya OUAS tanısı konuldu ve AHI <5 olan yetmiş beş hasta OUAS olmayanlar olarak alındı.
Bulgular: Ortanca omentin-1 seviyesi OUAS grubunda 59,0 ng/mL ve OUAS olmayanlarda 105,0 ng/mL idi (p<0,001). OUAS'larda ortanca ghrelin seviyesi 229,0 pg/ml, OUAS olmayanlarda 180,0 pg/ml idi (p<0,001). OUAS prevalansı erkeklerde kadınlardan 2,667 kat daha fazla idi (OR=2,667). OUAS ile HOMA-IR skorları arasında bir fark bulunmadı (p=0,218). OUAS'lı hastalar OUAS olmayanlara göre daha yüksek BMI, boyun çevresi ve ortanca ESS değerlerine sahipti (p<0,001). Obezlerde OUAS riski 3,058 kat daha fazla bulundu (OR=3,058) (p<0,001).
Sonuç: OUAS olanlarda omentin-1 ortanca değerleri OUAS olmayanlardan daha düşük iken, OUAS ve obez bireylerde ortanca ghrelin düzeyi daha yüksekti. Hipertansif ve obez bireylerde OUAS prevalansının yüksek olmasından dolayı, kardiyovasküler riski azaltmak için bunlarda OUAS'ın etkili taraması, tanı ve tedavisi gereklidir.
References
- REFERENCES 1. Arnold J, Sunilkumar M, Krishna V, et al. Obstructive Sleep Apnea. J Pharm Bioallied Sci. 2017;9(Suppl 1):26-28. 2. Gonzaga C, Bertolami A, Bertolami M, et al. Obstructive sleep apnea, hypertension and cardiovascular diseases. J Hum Hypertens. 2015;29(12):705-12. 3. Lombardi C, Tobaldini E, Montano N, et al. Obstructive Sleep Apnea Syndrome (OSAS) and Cardiovascular System. Med Lav. 2017;108(4):276-282. 4. Archontogeorgis K, Papanas N, Nena E, et al. Insulin Sensitivity and Insulin Resistance in Non-Diabetic Middle-Aged Patients with Obstructive Sleep Apnoea Syndrome. Open Cardiovasc Med J. 2017;11:159-168. 5. Spiegel K, Tasali E, Penev P, et al. Brief communication: Sleep curtailment in healthy young men is associated with decreased leptin levels, elevated ghrelin levels, and increased hunger and appetite. Ann Intern Med. 2004;141(11):846-50. 6. Taheri S, Lin L, Austin D, et al. Short sleep duration is associated with reduced leptin, elevated ghrelin, and increased body mass index. PLoS Med. 2004;1(3):e62. 7. Kojima M, Kangawa Structure and function of ghrelin. Results Probl Cell Differ. 2008;46:89-115. 8. Yang RZ, Lee MJ, Hu H, et al. Identification of omentin as a novel depot-specific adipokine in human adipose tissue: possible role in modulating insulin action. Am J Physiol Endocrinol Metab. 2006;290:E1253–61. 9. Cummings DE. Ghrelin and the short and long-term regulation of appetite and body weight. Physiol Behav. 2006;89(1):71-84. 10. Knaus C. Diagnosis and Treatment of Obstructive Sleep Apnea Syndrome. Ther Umsch. 2016;73(4):209-12. 11. National Task Force on the Prevention and Treatment of Obesity. Overweight, Obesity, and Health Risk. Arch Intern Med.2000;160:898-904. 12. Auguet T, Quintero Y, Riesco D, et al. New adipokines vaspin and omentin. Circulating levels and gene expression in adipose tissue from morbidly obese women. BMC Med Genet 2011;28:12(1):60-8. 13. Berry RB, Budhiraja R, Gottlieb DJ, et al. Rules for scoring respiratory events in sleep: update of the 2007 AASM Manual for the Scoring of Sleep and Associated Events. Deliberations of the Sleep Apnea Definitions Task Force of the American Academy of Sleep Medicine. J Clin Sleep Med. 2012;8(5):597-619. 14. Kwon Y, Khan T, Pritzker M, et al. Circulation time measurement from sleep studies in patients with obstructive sleep apnea. J Clin Sleep Med. 2014;10(7):759-65. 15. Izci B, Ardic S, Firat H, et al. Reliability and validity studies of the Turkish version of the Epworth sleepiness Scale. Sleep Breath 2008;12(2):161–8. 16. Zirlik S, Hildner KM, Targosz A, et al. Melatonin and omentin: influence factors in the obstructive sleep apnoea syndrome? J Physiol Pharmacol. 2013;64(3):353-60. 17. de Souza Batista CM1, Yang RZ, Lee MJ, et al. Omentin plasma levels and gene expression are decreased in obesity. Diabetes. 2007;56(6):1655-61. 18. Ishii S, Kamegai J, Tamura H, et al. Role of Ghrelin in streptozotocin-induced diabetic hyperphagia. Endocrinology 2002; 143(12): 4934-7. 19. Purnell JQ, Weigle DS, Breen P, et al. Ghrelin levels correlate with insulin levels, insulin resistance, and high-density lipoprotein cholesterol, but not with gender, menopausal status, or cortisol levels in humans. J Clin Endocrinol Metab 2003; 88(12): 5747-52. 20. Tschöp M, Weyer C, Tataranni PA, et al. Circulating ghrelin levels are decreased in human obesity. Diabetes 2001;50(4):707-9. 21. Harsch IA1, Konturek PC, Koebnick C, et al. Leptin and ghrelin levels in patients with obstructive sleep apnoea: effect of CPAP treatment. Eur Respir J. 2003;22(2):251-7. 22. Ursavas A, Ilcol YO, Nalci N, et al. Ghrelin, leptin, adiponectin, and resistin levels in sleep apnea syndrome: Role of obesity. Ann Thorac Med. 2010;5:161-5. 23. Sharma SK, Kumpawat S, Goel A, et al. Obesity, and not obstructive sleep apnea, is responsible for metabolic abnormalities in a cohort with sleep-disordered breathing. Sleep Med. 2007;8(1):12–7. 24. Davies RJ, Turner R, Crosby J, et al. Plasma insulin and lipid levels in untreated obstructive sleep apnoea and snoring; their comparison with matched controls and response to treatment. J Sleep Res. 1994;3(3):180-5. 25. Stoohs RA, Facchini F, Guilleminault C. Insulin resistance and sleep-disordered breathing in healthy humans. Am J Respir Crit Care Med. 1996;154(1):170–4. 26. Makino S, Handa H, Suzukawa K, et al. Obstructive sleep apnoea syndrome, plasma adiponectin levels, and insulin resistance. Clin Endocrinol (Oxf). 2006;64(1):12-9. 27. Bulcun E, Ekici M, Ekici A. Disorders of glucose metabolism and insulin resistance in patients with obstructive sleep apnoea syndrome. Int J Clin Pract.2012;66(1):91-7.
Details
| Primary Language | English |
|---|---|
| Subjects | Health Care Administration |
| Journal Section | Articles |
| Authors | |
| Publication Date | March 11, 2021 |
| Acceptance Date | November 2, 2020 |
| Published in Issue | Year 2021 |