c-peptide and Sleep-Apnea--Obstructive

Type 2 diabetes mellitus and obstructive sleep apnea syndrome (OSAS) are serious comorbidities. Effects of OSAS on diabetic microvascular complications are ongoing research subjects. We evaluated the incidence of OSAS in Type 2 diabetes mellitus patients with nephropathy and with no renal involvement.. A total of 52 people with diabetes were enrolled in this study. Patients body mass indices were calculated and fasting glucose, glycosylated hemoglobin, urea, creatinine, total lipid profile, and urinary albumin excretion were evaluated. Full polysomnography was used to detect sleep disorders.. Baseline characteristics and laboratory results of the patients were similar. Meeting criteria for OSAS was detected in 35 of the 54 patients (67.3%). 25 patients (48%) had mild, six patients (11.5%) had moderate, and four patients (7.7%) had severe sleep disorders. There was no significant relationship between respiratory obstructive parameters and microalbuminuria (R=0.91, p=0.362). Substantial correlation was detected between lower values of serum triglyceride levels and lower respiratory indices (R=0.299, p=0.031).. In type 2 diabetes accompanying OSAS affects glucose regulation but its effect on nephropathy development is currently a subject of research.

Topics: Albuminuria; Biomarkers; Blood Glucose; Body Mass Index; C-Peptide; Creatinine; Diabetes Mellitus, Type 2; Diabetic Nephropathies; Female; Glycated Hemoglobin; Humans; Lipids; Male; Middle Aged; Polysomnography; Prospective Studies; Sleep Apnea, Obstructive; Turkey

Topics: Adult; C-Peptide; Female; Humans; Insulin; Male; Middle Aged; Sleep Apnea, Obstructive

Obstructive sleep apnea syndrome (OSAS) is associated with obesity and insulin resistance. Visfatin is an insulin-mimicking adipokine, which is considered a link between obesity and insulin resistance. Aim of this study was to evaluate levels of plasma visfatin in patients with severe OSAS and examine their potential correlation with sleep characteristics and several biochemical parameters.. Nondiabetic patients with severe OSAS (Apnea Hypopnea Index > 30/h, n = 32) and healthy controls (Apnea Hypopnea Index < 5/h, n = 12), examined with polysomnography, underwent a biochemical analysis to estimate fasting levels of visfatin, glucose, insulin, C-peptide, and lipid profile.. The two groups were matched for age and body mass index (BMI). OSAS patients had significantly higher fasting insulin levels (p = 0.045), but no difference was shown in visfatin between patients and controls (p = 0.585). In OSAS patients, visfatin levels correlated positively with sleep latency (r = 0.539, p = 0.01) and triglyceride levels (r = 0.584, p = 0.036) and negatively with total sleep time, percentage of stage 2 and REM sleep, and LDL-cholesterol levels (r = -0.659 and p = 0.001; r = -0.496 and p = 0.019; r = -0.577 and p = 0.005; r = -0.804 and p = 0.003, respectively). No association was found, however, between visfatin levels and HOMA index or indices of nocturnal hypoxia.. In patients with severe OSAS, visfatin levels are associated with characteristics of sleep architecture. However, there is no correlation between visfatin and insulin resistance or nocturnal hypoxia.

Topics: Blood Glucose; Body Mass Index; C-Peptide; Cholesterol, HDL; Cholesterol, LDL; Female; Humans; Insulin Resistance; Male; Middle Aged; Nicotinamide Phosphoribosyltransferase; Polysomnography; Sleep Apnea, Obstructive; Sleep Stages; Sleep, REM; Statistics as Topic; Triglycerides

Obstructive sleep apnea syndrome (OSAS) is associated with autonomic dysfunction and metabolic abnormalities including obesity, dyslipidemia, and insulin resistance. Heart rate recovery at 1min after exercise termination (HRR-1) is a marker of vagal tone. We hypothesized that patients with more severe OSAS would have a lower HRR-1, either due to the co-existing metabolic abnormalities or OSAS.. Sixty-three patients with untreated OSAS (49.2+/-9.8years) without glucose- or lipid-lowering or negatively chronotropic drugs underwent cardiopulmonary exercise testing including HRR-1 measurement and assessment of several metabolic parameters. Patients with severe OSAS (apnea-hypopnea index [AHI]>30h(-1); n=32) were compared to patients with mild to moderate OSAS (AHI 5-30h(-1); n=31).. Patients with severe OSAS were more likely to be male (25 vs. 3%; p=0.01) and to have hypertension (72 vs. 39%; p=0.01); they also had higher fasting glucose (5.4+/-0.5 vs. 5.1+/-0.4mmol/l; p=0.016) and C-peptide [905 (651-1353) vs. 749 (597-919)pmol/l; p=0.028] levels compared to patients with mild to moderate OSAS. The groups did not differ with respect to peak heart rate (p=0.2) or peak oxygen consumption (p=0.9), but HRR-1 was significantly lower in patients with severe OSAS compared to patients with mild and moderate OSAS [20 (15-25) vs. 24 (18-34)bpm; p=0.022]. Higher AHI (p=0.01) and lower peak heart rate (p=0.02), but not body mass index or insulin resistance, were independently associated with lower HRR-1.. The severity of OSAS expressed as higher AHI is independently associated with lower HRR-1, a measure of autonomic dysfunction.

Topics: Adult; Aged; Autonomic Nervous System; Blood Glucose; Blood Pressure; Body Composition; Body Mass Index; C-Peptide; Electrocardiography; Exercise Test; Female; Heart Rate; Humans; Hypertension; Insulin Resistance; Male; Middle Aged; Polysomnography; Retrospective Studies; Risk Factors; Sex Factors; Sleep Apnea, Obstructive; Vagus Nerve