The association of obstructive sleep apnea with insulin resistance in obese Egyptians

Abstract

Context Obstructive sleep apnea (OSA) is not a rare disease affecting obese people. It leads to cardiovascular diseases (CVDs). One of the proposed mechanisms leading to CVD is insulin resistance (IR). Aim To study the association of OSA with IR in obese participants. Settings and design A cross-section study was conducted. Participants and methods Sixty (44 males and 16 females) persons who were obese (BMI=39.62±6.97 kg/m2) with mean age of 52.88±11.23 years, were recruited. All were subjected to measurement of anthropometric parameters, serum insulin, fasting blood sugar, spirometry and polysomnography. Apnea/hypopnea index, flow limitation index, apnea attacks and O2 desaturation index were assessed. BMI and homeostatic model of insulin resistance (HOMA-IR) were calculated. According to the mean HOMA-IR (7.75), participants were divided into two groups: the IR group and the control group. Results The IR group showed higher BMI, neck circumference, serum insulin, apnea/hypopnea index and O2 desaturation index. The control group individuals were of older age than the IR group. BMI, neck circumference, serum insulin, obstructive apnea and O2 desaturation index were positively correlated with HOMA-IR. Age was negatively correlated with HOMA-IR. Age, BMI, neck circumference, smoking and O2 desaturation index were significantly associated with HOMA-IR in univariate logistic regression analysis. receiver operating characteristic (ROC) analysis demonstrated 55 events/h for the apnea/hypopnea index (sensitivity 43.48% and specificity 94.59%) and 32 for O2 desaturation index (sensitivity 78.26% and specificity 67.57%) as the best cutoff points associated with IR. Conclusion OSA is associated with IR in obese Egyptian population, which may increase risk of CVD. Apnea/hypopnea index of 55 and O2 desaturation index of 32 are alarming cutoff points indicating IR.

Keywords

• insulin resistance
• obstructive sleep apnea
• obesity