Clinical and laboratory markers for assessing insulin resistance in patients with mild obstructive sleep apnea
https://doi.org/10.36604/1998-5029-2026-100-46-55
Abstract
Aim. Based on the analysis of clinical and instrumental data in patients with mild obstructive sleep apnea (OSA) (n = 102), to identify markers associated with insulin resistance and evaluate their prognostic significance.
Materials and methods. The retrospective study included 102 men aged 30–55 years (median 44 [40–50]) with mild OSA (apneahypopnea index [AHI] ≥5 and <15 events/hour) and metabolic disorders, examined between 2018 and 2020. Markers of insulin resistance were identified using simple logistic regression with stepwise inclusion and exclusion of predictors.
Results. The most informative indicators of insulin resistance in patients with mild OSA were: excessive daytime sleepiness ≥9 points; AHI ≥11/hour; nocturnal desaturation index ≥3.6/hour; time spent with oxygen saturation below 90% ≥0.9% of total sleep time; mean nocturnal oxygen saturation ≤94%; minimum nocturnal oxygen saturation ≤85%; maximum nocturnal heart rate ≥95 bpm; and reactive hyperemia index ≤1.7.
Conclusion. These parameters may be considered accessible markers of insulin resistance in patients with mild OSA.
About the Authors
V. S. Borovitsky
Federal State Institution "Research Institute of the Federal Penitentiary Service"
Russian Federation
Russian Federation
Vladislav S. Borovitsky, MD, PhD, DSc (Med.), Main Staff Scientist
building 1, 15a Narvskaya Str., Moscow, 125130
S. L. Babak
Federal State Budgetary Educational Institution of Higher Education "Russian University of Medicine" of the Ministry of Health of the Russian Federation
Russian Federation
Russian Federation
Sergey L. Babak, MD, PhD, DSc (Med.), Associate Professor, Pulmonologist, Professor of the Department of Phthisiology and Pulmonology of the N.A. Semashko
4 Dolgorukovskaya Str., Moscow, 127006
M. V. Gorbunova
Federal State Budgetary Educational Institution of Higher Education "Russian University of Medicine" of the Ministry of Health of the Russian Federation
Russian Federation
Russian Federation
Marina V. Gorbunova, MD, PhD, DSc (Med.), Pulmonologist, Associate Professor of the Department of Phthisiology and Pulmonology, N.A. Semashko
4 Dolgorukovskaya Str., Moscow, 127006
References
1. Lombardi C., Tobaldini E., Montano N., Losurdo A., Parati G. Obstructive sleep apnea syndrome (OSAS) and cardiovascular system. Med. Lav. 2017; 108(4):276–282. https://doi.org/10.23749/mdl.v108i4.6427
2. Sateia M.J. International classification of sleep disorders-third edition: highlights and modifications. Chest 2014; 146(5):1387–1394. https://doi.org/10.1378/chest.14-0970
3. Lombardi C., Pengo M.F., Parati G. Systemic hypertension in obstructive sleep apnea. J. Thorac. Dis. 2018; 10(Suppl 34):S4231–S4243. https://doi.org/10.21037/jtd.2018.12.57
4. Floras J.S. Hypertension and sleep apnea. Can. J. Cardiol. 2015; 31(7):889–897. https://doi.org/10.1016/j.cjca.2015.05.003
5. Oscullo G., Sapiña-Beltrán E., Torres G., Zaldivar E., Barbé F., Martinez-Garcia M.A. The potential role of obstructive sleep apnoea in refractory hypertension. Curr. Hypertens. Rep. 2019; 21(8):57. https://doi.org/10.1007/s11906-019-0963-6
6. Jin Z.N., Wei Y.X. Meta-analysis of effects of obstructive sleep apnea on the renin-angiotensin-aldosterone system. J. Geriatr. Cardiol. 2016; 13(4):333–343. https://doi.org/10.11909/j.issn.1671-5411.2016.03.020
7. Adeva-Andany M.M., Domínguez-Montero A., Castro-Quintela E., Funcasta-Calderón R., Fernández-Fernández C. Hypoxia-induced insulin resistance mediates the elevated cardiovascular risk in patients with obstructive sleep apnea: a comprehensive review. Rev. Cardiovasc. Med. 2024; 25(6):231. https://doi.org/10.31083/j.rcm2506231
8. Chung F., Abdullah H.R., Liao P. STOP-bang questionnaire: a practical approach to screen for obstructive sleep apnea. Chest 2016; 149(3):631–618. https://doi.org/10.1378/chest.15-0903
9. Kapur V.K., Auckley D.H., Chowdhuri S., Kuhlmann D.C., Mehra R., Ramar K., Harrod C.G. Clinical practice guideline for diagnostic testing for adult obstructive sleep apnea: An American Academy of Sleep Medicine clinical practice guideline. J. Clin. Sleep Med. 2017; 13(3):479–504. https://doi.org/10.5664/jcsm.6506
10. Kuvin J.T., Patel A.R., Sliney K.A., Pandian N.G., Sheffy J., Schnall R.P., Karas R.H., Udelson J.E. Assessment of peripheral vascular endothelial function with finger arterial pulse wave amplitude. Am. Heart J. 2003; 146(1):168–174. https://doi.org/10.1016/S0002-8703(03)00094-2
11. Tripathi A., Obata Y., Ruzankin P., Askaryar N., Berkowitz D.E., Steppan J., Barodka V. A pulse wave velocity based method to assess the mean arterial blood pressure limits of autoregulation in peripheral arteries. Front. Physiol. 2017; 8:855. https://doi.org/10.3389/fphys.2017.00855
12. Nick T.G., Campbell K.M. Logistic regression. Methods Mol. Biol. 2007; 404:273–301. https://doi.org/10.1007/978-1-59745-530-5_14
13. Kakutani-Hatayama M., Kadoya M., Morimoto A., Miyoshi A., Kosaka-Hamamoto K., Kusunoki Y., Shoji T., Koyama H. Associations of sleep quality, sleep apnea and autonomic function with insulin secretion and sensitivity: HSCAA study. Metabol. Open 2020; 6:100033. https://doi.org/10.1016/j.metop.2020.100033
14. Chasens E.R., Imes C.C., Kariuki J.K., Luyster F.S., Morris J.L., Di Nardo M.M., Godzik C.M., Jeon B., Yang K. Sleep and metabolic syndrome. Nurs. Clin. North Am. 2021; 56(2):203–217. https://doi.org/10.1016/j.cnur.2020.10.012
15. Wei R., Gao Z., Xu H., Jiang C., Li X., Liu Y., Zou J., Zhu H., Yi H., Guan J., Yin S. Body fat indices as effective predictors of insulin resistance in obstructive sleep apnea: evidence from a cross-sectional and longitudinal study: BFI as predictors of IR in OSA. Obes. Surg. 2021; 31(5):2219–2230. https://doi.org/10.1007/s11695-021-05261-9
16. Behnoush A.H, Khalaji A., Ghondaghsaz E., Masrour M., Shokri Varniab Z., Khalaji S., Cannavo A. Triglycerideglucose index and obstructive sleep apnea: a systematic review and meta-analysis. Lipids Health Dis. 2024; 23(1):4. https://doi.org/10.1186/s12944-024-02005-3
17. Yang W., Cai X., Hu J., Wen W., Mulalibieke H., Yao X., Yao L., Zhu Q., Hong J., Luo Q., Liu S., Li N. The metabolic score for insulin resistance (METS-IR) predicts cardiovascular disease and its subtype sin patients with hypertension and obstructive sleep apnea. Clin. Epidemiol. 2023; 15:177–189. https://doi.org/10.2147/CLEP.S395938
18. Li X., Wang F., Xu H., Qian Y., Zou J., Yang M., Zhu H., Yi H., Guan J., Yin S. Interrelationships among common predictors of cardiovascular diseases inpatients of OSA: A large-scale observational study. Nutr. Metab. Cardiovasc. Dis. 2020; 30(1):23–32. https://doi.org/10.1016/j.numecd.2019.07.016
Review
For citations:
Borovitsky V.S., Babak S.L., Gorbunova M.V. Clinical and laboratory markers for assessing insulin resistance in patients with mild obstructive sleep apnea. Bulletin Physiology and Pathology of Respiration. 2026;(100):46-55. (In Russ.) https://doi.org/10.36604/1998-5029-2026-100-46-55
Views:
41
JATS XML
Email this article 