Effect Of Nasal Continuous Positive Airway Pressure Therapy On Insulin Resistance In Patients With Obstructive Sleep Apnea-hypopnea Syndrome

1 .Background:Obstructive sleep apnea-hypopnea syndrome, OSAHS, has been studied thus far and identified to be closely related to overweight and obesity, often accompanied by insulin resistance(IR). However, few reports have been delivered about if insulin resistance is related to other factors besides the two factors of overweight and obesity in patients with OSAHS.Nasal continuous positive airway pressure(nCPAP) is a preferential and effective method for the treatment of patients with OSAHS. So far, also few reports have been made about if nCPAP treatment could contribute to the obvious improvement of insulin resistance in OSAHSpatients and what factors could directly alleviate insulin resistance.2. The relationship between obstructive sleep apnea-hypopnea syndrome and insulin resistanceObjective: To explore the relationship between obstructive sleep apnea-hypopnea syndrome (OSAHS) and insulin resistance (IR).Methods: 75 OSAHS patients with overweight (group A), 66 OSAHS patients healthy adults (group D) were enrolled in this research, in which the values of apnea hypopnea index (AHI), minimal pulse oxygen saturation (miniSpOa), fasting plasma glucose, and fasting insulin were measured, and the insulin sensitive index (ISI) was computed.Results: The average values of ISI in group A (-4.8 + 0.7), that in group B ( -4.5 + 0.4 ) and that in group C (-4.5 + 0.3) were decreased significantly when compared with that in group D (-4.0 + 0.3, all P<0.05). Compared with group C , the average value of ISI in the group A was without overweight (group B), 25 patients with overweight (group C), and 26 significantly decreased (PO.05). There existed the negative correlation between ISI and AHI (r=-0.352, P <0.01;r=-0.267, PO.05 respectively) , and the positive correlation between ISI and miniSpO2 (r=0.379, PO.01;r=0.314, P<0.05 respectively) in both the group A and the. group B.Conclusion: There exists the clear insulin resistance in the OSAHS patients, and such insulin resistance is closely associated with overweight, apnea hypopnea index, and minimal pulse oxygen saturation.3. Effect of nasal continuous positive airway pressure therapy on insulin resistance in patients with obstructive sleep apnea-hypopnea syndromeObjective: To explore the therapeutic effect of nasal continuous positive airway pressure (nCPAP) on insulin resistance (IR) in patients with obstructive sleep apnea-hypopne syndrome (OSAHS).Methods : 115 subjects with moderate and severe OSAHS (apnea-hypopnea index or AHI ^21 events/hour) underwent overnight polysomnographic (PSG) examinations, of which 65 patients (control group) were treated with synthetic intervention treatment for six months, and the other 50 patients (pilot group) were treated with nCPAP as well as the same synthetic intervention treatment. The values of Body mass index (BMI), AHI, minimal pulse oxygen saturation (miniSpO2), fasting plasma glucose, and fasting insulin were measured, and the insulin sensitive index(ISI) was calculated in all subjects at baseline and six months later.Results: The average values of ISI in pilot group (-4.75 + 0.44 ) and in control group (-4.78 + 0.37 ) were not significantly different at baseline (P>0.05), while the average values of ISI were significantly higher in pilot group than in control group six months later: -4.19 + 0.28 versus -4.52 + 0.47 (PO.001). There was a negative correlation between ISI and BMI ( r =-0.451,P<0.01;r=-0.422, PO.01;respectively ), ISI and AHI ( r =-0.866,P<0.001;r=-0.829, P<0.001;respectively ), and a positive correlation between ISI and miniSpO2 in pilot group and control group ( r=0.771, PO.001;r=0.809, PO.001;respectively ).Conclusions: nCPAP therapy could significantly relieve the degree of IR in patients with OSAHS. MBI,AHI and miniSpO2 may be effective predictors of nCPAP therapy on IR in patients with OSAHS.