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Am. J. Respir. Crit. Care Med., Volume 165, Number 5, March 2002, 677-682

Sleep-disordered Breathing and Insulin Resistance in Middle-aged and Overweight Men

NARESH M. PUNJABI, JOHN D. SORKIN, LESLIE I. KATZEL, ANDREW P. GOLDBERG, ALAN R. SCHWARTZ, and PHILIP L. SMITH

Division of Pulmonary and Critical Care Medicine, Johns Hopkins University School of Medicine; Division of Gerontology, Department of Medicine, University of Maryland School of Medicine; and Baltimore VA Geriatric Research Education and Clinical Center, Baltimore, Maryland

Sleep-disordered breathing is a prevalent condition associated with impairment of daytime function and may predispose individuals to metabolic abnormalities independent of obesity. The primary objective of this study was to determine the metabolic consequences and community prevalence of sleep-disordered breathing in mildly obese, but otherwise healthy, individuals. One hundred and fifty healthy men, without diabetes or cardiopulmonary disease, were recruited from the community. Measurements included polysomnography, a multiple sleep latency test, an oral glucose tolerance test, determination of body fat by hydrodensitometry, and fasting insulin and lipids. The prevalence of sleep-disordered breathing, depending on the apnea-hypopnea index (AHI) cutoff, ranged from 40 to 60%. After adjusting for body mass index (BMI) and percent body fat, an AHI >=  5 events/h was associated with an increased risk of having impaired or diabetic glucose tolerance (odds ratio, 2.15; 95% CI, 1.05-4.38). The impairment in glucose tolerance was related to the severity of oxygen desaturation (Delta SaO2) associated with sleep-disordered breathing. For a 4% decrease in oxygen saturation, the associated odds ratio for worsening glucose tolerance was 1.99 (95% CI, 1.11 to 3.56) after adjusting for percent body fat, BMI, and AHI. Multivariable linear regression analyses revealed that increasing AHI was associated with worsening insulin resistance independent of obesity. Thus, sleep-disordered breathing is a prevalent condition in mildly obese men and is independently associated with glucose intolerance and insulin resistance.




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 J. Physiol.Home page
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Home page
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Home page
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[Abstract] [Full Text] [PDF]

Home page
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[Abstract] [Full Text] [PDF]

Home page
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[Abstract] [Full Text] [PDF]

Home page
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[Abstract] [Full Text] [PDF]

Home page
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[Abstract] [Full Text] [PDF]

Home page
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[Abstract] [Full Text] [PDF]

Home page
 J. Appl. Physiol.Home page
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Disorders of glucose metabolism in sleep apnea
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[Abstract] [Full Text] [PDF]

Home page
 J. Appl. Physiol.Home page
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Chronic intermittent hypoxia upregulates genes of lipid biosynthesis in obese mice
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[Abstract] [Full Text] [PDF]

Home page
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[Abstract] [Full Text] [PDF]

Home page
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Obstructive Sleep Apnea
Focus, October 1, 2005; 3(4): 557 - 567.
[Full Text] [PDF]

Home page
 J. Appl. Physiol.Home page
T. Young, P. E. Peppard, and S. Taheri
Excess weight and sleep-disordered breathing
J Appl Physiol, October 1, 2005; 99(4): 1592 - 1599.
[Abstract] [Full Text] [PDF]

Home page
 Circ. Res.Home page
J. Li, L. N. Thorne, N. M. Punjabi, C.-K. Sun, A. R. Schwartz, P. L. Smith, R. L. Marino, A. Rodriguez, W. C. Hubbard, C. P. O'Donnell, et al.
Intermittent Hypoxia Induces Hyperlipidemia in Lean Mice
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[Abstract] [Full Text] [PDF]

Home page
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Chest, September 1, 2005; 128(3): 1357 - 1363.
[Abstract] [Full Text] [PDF]

Home page
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Pediatrics, July 1, 2005; 116(1): e66 - e73.
[Abstract] [Full Text] [PDF]

Home page
 ANN INTERN MEDHome page
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Ann Intern Med, May 17, 2005; 142(10): 877 - 880.
[Full Text] [PDF]

Home page
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Association of Sleep Time With Diabetes Mellitus and Impaired Glucose Tolerance
Arch Intern Med, April 25, 2005; 165(8): 863 - 867.
[Abstract] [Full Text] [PDF]

Home page
 West J Nurs ResHome page
E. R. Chasens, A. I. Pack, G. Maislin, D. F. Dinges, and T. E. Weaver
Claustrophobia and Adherence to CPAP Treatment
West J Nurs Res, April 1, 2005; 27(3): 307 - 321.
[Abstract] [PDF]

Home page
 ChestHome page
K. Tatsumi, Y. Kasahara, K. Kurosu, N. Tanabe, Y. Takiguchi, and T. Kuriyama
Sleep Oxygen Desaturation and Circulating Leptin in Obstructive Sleep Apnea-Hypopnea Syndrome
Chest, March 1, 2005; 127(3): 716 - 721.
[Abstract] [Full Text] [PDF]

Home page
 Arch Intern MedHome page
A. R. Babu, J. Herdegen, L. Fogelfeld, S. Shott, and T. Mazzone
Type 2 Diabetes, Glycemic Control, and Continuous Positive Airway Pressure in Obstructive Sleep Apnea
Arch Intern Med, February 28, 2005; 165(4): 447 - 452.
[Abstract] [Full Text] [PDF]

Home page
 Am. J. Respir. Crit. Care Med.Home page
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Am. J. Respir. Crit. Care Med., February 1, 2005; 171(3): 202 - 203.
[Full Text] [PDF]

Home page
 ANN INTERN MEDHome page
S. M. Caples, A. S. Gami, and V. K. Somers
Obstructive Sleep Apnea
Ann Intern Med, February 1, 2005; 142(3): 187 - 197.
[Full Text] [PDF]

Home page
 Am. J. Respir. Crit. Care Med.Home page
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Association of Habitual Snoring with Glucose and Insulin Metabolism in Nonobese Korean Adult Men
Am. J. Respir. Crit. Care Med., February 1, 2005; 171(3): 287 - 291.
[Abstract] [Full Text] [PDF]

Home page
 CirculationHome page
I. D. Caterson, V. Hubbard, G. A. Bray, R. Grunstein, B. C. Hansen, Y. Hong, D. Labarthe, J. C. Seidell, and S. C. Smith Jr
Prevention Conference VII: Obesity, a Worldwide Epidemic Related to Heart Disease and Stroke: Group III: Worldwide Comorbidities of Obesity
Circulation, November 2, 2004; 110(18): e476 - e483.
[Full Text] [PDF]

Home page
 Diabetes CareHome page
P. M. Nilsson, M. Roost, G. Engstrom, B. Hedblad, and G. Berglund
Incidence of Diabetes in Middle-Aged Men Is Related to Sleep Disturbances
Diabetes Care, October 1, 2004; 27(10): 2464 - 2469.
[Abstract] [Full Text] [PDF]

Home page
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Sleep-Disordered Breathing, Glucose Intolerance, and Insulin Resistance: The Sleep Heart Health Study
Am. J. Epidemiol., September 15, 2004; 160(6): 521 - 530.
[Abstract] [Full Text] [PDF]

Home page
 Am. J. Respir. Crit. Care Med.Home page
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Whole Genome Scan for Obstructive Sleep Apnea and Obesity in African-American Families
Am. J. Respir. Crit. Care Med., June 15, 2004; 169(12): 1314 - 1321.
[Abstract] [Full Text] [PDF]

Home page
 Am. J. Respir. Crit. Care Med.Home page
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Hypoxia Causes Glucose Intolerance in Humans
Am. J. Respir. Crit. Care Med., June 1, 2004; 169(11): 1231 - 1237.
[Abstract] [Full Text] [PDF]

Home page
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Obstructive sleep apnoea is independently associated with an increased prevalence of metabolic syndrome
Eur. Heart J., May 1, 2004; 25(9): 735 - 741.
[Abstract] [Full Text] [PDF]

Home page
 JAMAHome page
T. Young, J. Skatrud, and P. E. Peppard
Risk Factors for Obstructive Sleep Apnea in Adults
JAMA, April 28, 2004; 291(16): 2013 - 2016.
[Full Text] [PDF]