Glucose tolerance and weight loss in obese women with obstructive sleep apnea
The association of obstructive sleep apnea (OSA) with glucose intolerance and the beneficial effect of lifestyle intervention have been poorly investigated in women particularly before menopausal status. The study explored 1) whether OSA is associated with impaired glucose homeostasis in obese non d...
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| creator | Gilardini, Luisa Lombardi, Carolina Redaelli, Gabriella Vallone, Luciana Faini, Andrea Mattaliano, Paola Parati, Gianfranco Invitti, Cecilia |
| description | The association of obstructive sleep apnea (OSA) with glucose intolerance and the beneficial effect of lifestyle intervention have been poorly investigated in women particularly before menopausal status. The study explored 1) whether OSA is associated with impaired glucose homeostasis in obese non diabetic premenopausal and menopausal women and 2) the effects of a 3- month lifestyle intervention on glucose homeostasis in OSA women.
We consecutively recruited 98 obese women (39 premenopausal) from those referred for a weight loss intervention. Ambulatory nocturnal polysomnography, body composition, oral glucose tolerance test, insulin sensitivity and β cell function were assessed before and after intervention.
41% of premenopausal and 64% of menopausal women had OSA which was associated with worse glucose homeostasis before menopausal status. Mean and minimal nocturnal oxygen saturation (SaO2) was associated with neck/height ratio (NHR), independently of total and central obesity. Mean and minimal nocturnal SaO2 and NHR were correlated with insulin sensitivity and fasting glucose. In multivariate analyses, nocturnal mean SaO2 was negatively and independently correlated with fasting glucose (p |
| doi_str_mv | 10.1371/journal.pone.0061382 |
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We consecutively recruited 98 obese women (39 premenopausal) from those referred for a weight loss intervention. Ambulatory nocturnal polysomnography, body composition, oral glucose tolerance test, insulin sensitivity and β cell function were assessed before and after intervention.
41% of premenopausal and 64% of menopausal women had OSA which was associated with worse glucose homeostasis before menopausal status. Mean and minimal nocturnal oxygen saturation (SaO2) was associated with neck/height ratio (NHR), independently of total and central obesity. Mean and minimal nocturnal SaO2 and NHR were correlated with insulin sensitivity and fasting glucose. In multivariate analyses, nocturnal mean SaO2 was negatively and independently correlated with fasting glucose (p<0.0001) and NHR with insulin sensitivity (p<0.0001). In OSA women, the intervention induced a 5% weight reduction and a significant increase in minimal nocturnal SaO2, insulin sensitivity and β cell function. Changes in fasting glucose and insulin sensitivity were associated with those in minimal nocturnal SaO2 (p<0.05) and not with weight loss.
In obese women, glucose homeostasis worsens due to nocturnal hypoxia and increased neck circumference through mechanisms partially independent of obesity. OSA is more clearly associated with glucose intolerance in premenopausal than in menopausal women. In OSA women, the improvement of nocturnal hypoxia induced by lifestyle modifications is associated with that of glucose homeostasis.</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0061382</identifier><identifier>PMID: 23613841</identifier><language>eng</language><publisher>United States: Public Library of Science</publisher><subject>Adult ; Analysis ; Anthropometry ; Apnea ; Body composition ; Body weight loss ; Diabetes mellitus ; Fasting ; Female ; Glucose ; Glucose tolerance ; Glucose Tolerance Test ; Homeostasis ; Humans ; Hypoxia ; Insulin ; Insulin resistance ; Intervention ; Intolerance ; Laboratory testing ; Life Style ; Medicine ; Menopause ; Middle Aged ; Neck ; Obesity ; Obesity - complications ; Obesity - physiopathology ; Oxygen ; Oxygen content ; Physiological aspects ; Polysomnography ; Sensitivity ; Sensitivity analysis ; Sleep ; Sleep apnea ; Sleep Apnea, Obstructive - complications ; Sleep Apnea, Obstructive - physiopathology ; Sleep disorders ; Type 2 diabetes ; Weight Loss ; Weight reduction</subject><ispartof>PloS one, 2013-04, Vol.8 (4), p.e61382-e61382</ispartof><rights>COPYRIGHT 2013 Public Library of Science</rights><rights>2013 Gilardini et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License: https://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2013 Gilardini et al 2013 Gilardini et al</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c692t-dd1bf071430425b7c88600f3676a5862c6b0002466971d89603868a992f9fcd53</citedby><cites>FETCH-LOGICAL-c692t-dd1bf071430425b7c88600f3676a5862c6b0002466971d89603868a992f9fcd53</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC3629198/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC3629198/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,864,885,2102,2928,23866,27924,27925,53791,53793,79600,79601</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/23613841$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><contributor>Pasquali, Renato</contributor><creatorcontrib>Gilardini, Luisa</creatorcontrib><creatorcontrib>Lombardi, Carolina</creatorcontrib><creatorcontrib>Redaelli, Gabriella</creatorcontrib><creatorcontrib>Vallone, Luciana</creatorcontrib><creatorcontrib>Faini, Andrea</creatorcontrib><creatorcontrib>Mattaliano, Paola</creatorcontrib><creatorcontrib>Parati, Gianfranco</creatorcontrib><creatorcontrib>Invitti, Cecilia</creatorcontrib><title>Glucose tolerance and weight loss in obese women with obstructive sleep apnea</title><title>PloS one</title><addtitle>PLoS One</addtitle><description>The association of obstructive sleep apnea (OSA) with glucose intolerance and the beneficial effect of lifestyle intervention have been poorly investigated in women particularly before menopausal status. The study explored 1) whether OSA is associated with impaired glucose homeostasis in obese non diabetic premenopausal and menopausal women and 2) the effects of a 3- month lifestyle intervention on glucose homeostasis in OSA women.
We consecutively recruited 98 obese women (39 premenopausal) from those referred for a weight loss intervention. Ambulatory nocturnal polysomnography, body composition, oral glucose tolerance test, insulin sensitivity and β cell function were assessed before and after intervention.
41% of premenopausal and 64% of menopausal women had OSA which was associated with worse glucose homeostasis before menopausal status. Mean and minimal nocturnal oxygen saturation (SaO2) was associated with neck/height ratio (NHR), independently of total and central obesity. Mean and minimal nocturnal SaO2 and NHR were correlated with insulin sensitivity and fasting glucose. In multivariate analyses, nocturnal mean SaO2 was negatively and independently correlated with fasting glucose (p<0.0001) and NHR with insulin sensitivity (p<0.0001). In OSA women, the intervention induced a 5% weight reduction and a significant increase in minimal nocturnal SaO2, insulin sensitivity and β cell function. Changes in fasting glucose and insulin sensitivity were associated with those in minimal nocturnal SaO2 (p<0.05) and not with weight loss.
In obese women, glucose homeostasis worsens due to nocturnal hypoxia and increased neck circumference through mechanisms partially independent of obesity. OSA is more clearly associated with glucose intolerance in premenopausal than in menopausal women. In OSA women, the improvement of nocturnal hypoxia induced by lifestyle modifications is associated with that of glucose homeostasis.</description><subject>Adult</subject><subject>Analysis</subject><subject>Anthropometry</subject><subject>Apnea</subject><subject>Body composition</subject><subject>Body weight loss</subject><subject>Diabetes mellitus</subject><subject>Fasting</subject><subject>Female</subject><subject>Glucose</subject><subject>Glucose tolerance</subject><subject>Glucose Tolerance Test</subject><subject>Homeostasis</subject><subject>Humans</subject><subject>Hypoxia</subject><subject>Insulin</subject><subject>Insulin resistance</subject><subject>Intervention</subject><subject>Intolerance</subject><subject>Laboratory testing</subject><subject>Life Style</subject><subject>Medicine</subject><subject>Menopause</subject><subject>Middle Aged</subject><subject>Neck</subject><subject>Obesity</subject><subject>Obesity - complications</subject><subject>Obesity - physiopathology</subject><subject>Oxygen</subject><subject>Oxygen content</subject><subject>Physiological aspects</subject><subject>Polysomnography</subject><subject>Sensitivity</subject><subject>Sensitivity analysis</subject><subject>Sleep</subject><subject>Sleep apnea</subject><subject>Sleep Apnea, Obstructive - complications</subject><subject>Sleep Apnea, Obstructive - physiopathology</subject><subject>Sleep disorders</subject><subject>Type 2 diabetes</subject><subject>Weight Loss</subject><subject>Weight reduction</subject><issn>1932-6203</issn><issn>1932-6203</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2013</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><sourceid>DOA</sourceid><recordid>eNqNkl1rFDEUhgdRbK3-A9EBQfRi13xNZuZGKEXrQqXg123IJGd2U7LJNsl09d-b7U7LjvRCcpFw8pz3nJy8RfESozmmNf5w5YfgpJ1vvIM5QhzThjwqjnFLyYwTRB8fnI-KZzFeIVTRhvOnxRGhO5zh4-LruR2Uj1AmbyFIp6CUTpdbMMtVKq2PsTSu9B1kZOvX4MqtSasciCkMKpkbKKMF2JRy40A-L5700kZ4Me4nxc_Pn36cfZldXJ4vzk4vZoq3JM20xl2PaswoYqTqatU0HKGe8prLquFE8Q4hRBjnbY1103KU-25k25K-7ZWu6Enxeq-7yR2KcRJRYMooRzXlPBOLPaG9vBKbYNYy_BFeGnEb8GEpZEhGWRCM9bJTFCMiKWOokUpTXdU1qwiVGnDW-jhWG7o1aAUuBWknotMbZ1Zi6W8E5aTFbZMF3o0CwV8PEJNYm6jAWunAD7d9c4xr2tKMvvkHffh1I7WU-QHG9T7XVTtRccrqhjCK8W5K8weovDSsjcq26U2OTxLeTxIyk-B3WsohRrH4_u3_2ctfU_btAbsCadMqejsk412cgmwPqpCdF6C_HzJGYuf6u2mInevF6Pqc9urwg-6T7mxO_wKqcPpE</recordid><startdate>20130417</startdate><enddate>20130417</enddate><creator>Gilardini, Luisa</creator><creator>Lombardi, Carolina</creator><creator>Redaelli, Gabriella</creator><creator>Vallone, Luciana</creator><creator>Faini, Andrea</creator><creator>Mattaliano, Paola</creator><creator>Parati, Gianfranco</creator><creator>Invitti, Cecilia</creator><general>Public Library of Science</general><general>Public Library of Science (PLoS)</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>IOV</scope><scope>ISR</scope><scope>3V.</scope><scope>7QG</scope><scope>7QL</scope><scope>7QO</scope><scope>7RV</scope><scope>7SN</scope><scope>7SS</scope><scope>7T5</scope><scope>7TG</scope><scope>7TM</scope><scope>7U9</scope><scope>7X2</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8C1</scope><scope>8FD</scope><scope>8FE</scope><scope>8FG</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABJCF</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>ARAPS</scope><scope>ATCPS</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BGLVJ</scope><scope>BHPHI</scope><scope>C1K</scope><scope>CCPQU</scope><scope>D1I</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>H94</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>KB.</scope><scope>KB0</scope><scope>KL.</scope><scope>L6V</scope><scope>LK8</scope><scope>M0K</scope><scope>M0S</scope><scope>M1P</scope><scope>M7N</scope><scope>M7P</scope><scope>M7S</scope><scope>NAPCQ</scope><scope>P5Z</scope><scope>P62</scope><scope>P64</scope><scope>PATMY</scope><scope>PDBOC</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>PTHSS</scope><scope>PYCSY</scope><scope>RC3</scope><scope>7X8</scope><scope>5PM</scope><scope>DOA</scope></search><sort><creationdate>20130417</creationdate><title>Glucose tolerance and weight loss in obese women with obstructive sleep apnea</title><author>Gilardini, Luisa ; Lombardi, Carolina ; Redaelli, Gabriella ; Vallone, Luciana ; Faini, Andrea ; Mattaliano, Paola ; Parati, Gianfranco ; Invitti, Cecilia</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c692t-dd1bf071430425b7c88600f3676a5862c6b0002466971d89603868a992f9fcd53</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2013</creationdate><topic>Adult</topic><topic>Analysis</topic><topic>Anthropometry</topic><topic>Apnea</topic><topic>Body composition</topic><topic>Body weight loss</topic><topic>Diabetes mellitus</topic><topic>Fasting</topic><topic>Female</topic><topic>Glucose</topic><topic>Glucose tolerance</topic><topic>Glucose Tolerance Test</topic><topic>Homeostasis</topic><topic>Humans</topic><topic>Hypoxia</topic><topic>Insulin</topic><topic>Insulin resistance</topic><topic>Intervention</topic><topic>Intolerance</topic><topic>Laboratory testing</topic><topic>Life Style</topic><topic>Medicine</topic><topic>Menopause</topic><topic>Middle Aged</topic><topic>Neck</topic><topic>Obesity</topic><topic>Obesity - complications</topic><topic>Obesity - physiopathology</topic><topic>Oxygen</topic><topic>Oxygen content</topic><topic>Physiological aspects</topic><topic>Polysomnography</topic><topic>Sensitivity</topic><topic>Sensitivity analysis</topic><topic>Sleep</topic><topic>Sleep apnea</topic><topic>Sleep Apnea, Obstructive - complications</topic><topic>Sleep Apnea, Obstructive - physiopathology</topic><topic>Sleep disorders</topic><topic>Type 2 diabetes</topic><topic>Weight Loss</topic><topic>Weight reduction</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Gilardini, Luisa</creatorcontrib><creatorcontrib>Lombardi, Carolina</creatorcontrib><creatorcontrib>Redaelli, Gabriella</creatorcontrib><creatorcontrib>Vallone, Luciana</creatorcontrib><creatorcontrib>Faini, Andrea</creatorcontrib><creatorcontrib>Mattaliano, Paola</creatorcontrib><creatorcontrib>Parati, Gianfranco</creatorcontrib><creatorcontrib>Invitti, Cecilia</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Gale In Context: Opposing Viewpoints</collection><collection>Gale In Context: Science</collection><collection>ProQuest Central (Corporate)</collection><collection>Animal Behavior Abstracts</collection><collection>Bacteriology Abstracts (Microbiology B)</collection><collection>Biotechnology Research Abstracts</collection><collection>Nursing & Allied Health Database</collection><collection>Ecology Abstracts</collection><collection>Entomology Abstracts (Full archive)</collection><collection>Immunology Abstracts</collection><collection>Meteorological & Geoastrophysical Abstracts</collection><collection>Nucleic Acids Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>Agricultural Science Collection</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Public Health Database</collection><collection>Technology Research Database</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Technology Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Materials Science & Engineering Collection</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>Advanced Technologies & Aerospace Collection</collection><collection>Agricultural & Environmental Science Collection</collection><collection>ProQuest Central Essentials</collection><collection>Biological Science Collection</collection><collection>ProQuest Central</collection><collection>Technology Collection</collection><collection>Natural Science Collection</collection><collection>Environmental Sciences and Pollution Management</collection><collection>ProQuest One Community College</collection><collection>ProQuest Materials Science Collection</collection><collection>ProQuest Central Korea</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>SciTech Premium Collection</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Materials Science Database</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Meteorological & Geoastrophysical Abstracts - 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Academic</collection><collection>PubMed Central (Full Participant titles)</collection><collection>DOAJ Directory of Open Access Journals</collection><jtitle>PloS one</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Gilardini, Luisa</au><au>Lombardi, Carolina</au><au>Redaelli, Gabriella</au><au>Vallone, Luciana</au><au>Faini, Andrea</au><au>Mattaliano, Paola</au><au>Parati, Gianfranco</au><au>Invitti, Cecilia</au><au>Pasquali, Renato</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Glucose tolerance and weight loss in obese women with obstructive sleep apnea</atitle><jtitle>PloS one</jtitle><addtitle>PLoS One</addtitle><date>2013-04-17</date><risdate>2013</risdate><volume>8</volume><issue>4</issue><spage>e61382</spage><epage>e61382</epage><pages>e61382-e61382</pages><issn>1932-6203</issn><eissn>1932-6203</eissn><abstract>The association of obstructive sleep apnea (OSA) with glucose intolerance and the beneficial effect of lifestyle intervention have been poorly investigated in women particularly before menopausal status. The study explored 1) whether OSA is associated with impaired glucose homeostasis in obese non diabetic premenopausal and menopausal women and 2) the effects of a 3- month lifestyle intervention on glucose homeostasis in OSA women.
We consecutively recruited 98 obese women (39 premenopausal) from those referred for a weight loss intervention. Ambulatory nocturnal polysomnography, body composition, oral glucose tolerance test, insulin sensitivity and β cell function were assessed before and after intervention.
41% of premenopausal and 64% of menopausal women had OSA which was associated with worse glucose homeostasis before menopausal status. Mean and minimal nocturnal oxygen saturation (SaO2) was associated with neck/height ratio (NHR), independently of total and central obesity. Mean and minimal nocturnal SaO2 and NHR were correlated with insulin sensitivity and fasting glucose. In multivariate analyses, nocturnal mean SaO2 was negatively and independently correlated with fasting glucose (p<0.0001) and NHR with insulin sensitivity (p<0.0001). In OSA women, the intervention induced a 5% weight reduction and a significant increase in minimal nocturnal SaO2, insulin sensitivity and β cell function. Changes in fasting glucose and insulin sensitivity were associated with those in minimal nocturnal SaO2 (p<0.05) and not with weight loss.
In obese women, glucose homeostasis worsens due to nocturnal hypoxia and increased neck circumference through mechanisms partially independent of obesity. OSA is more clearly associated with glucose intolerance in premenopausal than in menopausal women. In OSA women, the improvement of nocturnal hypoxia induced by lifestyle modifications is associated with that of glucose homeostasis.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>23613841</pmid><doi>10.1371/journal.pone.0061382</doi><tpages>e61382</tpages><oa>free_for_read</oa></addata></record> |
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| source | Public Library of Science (PLoS) Journals Open Access; MEDLINE; DOAJ Directory of Open Access Journals; EZB-FREE-00999 freely available EZB journals; PubMed Central; Free Full-Text Journals in Chemistry |
| subjects | Adult Analysis Anthropometry Apnea Body composition Body weight loss Diabetes mellitus Fasting Female Glucose Glucose tolerance Glucose Tolerance Test Homeostasis Humans Hypoxia Insulin Insulin resistance Intervention Intolerance Laboratory testing Life Style Medicine Menopause Middle Aged Neck Obesity Obesity - complications Obesity - physiopathology Oxygen Oxygen content Physiological aspects Polysomnography Sensitivity Sensitivity analysis Sleep Sleep apnea Sleep Apnea, Obstructive - complications Sleep Apnea, Obstructive - physiopathology Sleep disorders Type 2 diabetes Weight Loss Weight reduction |
| title | Glucose tolerance and weight loss in obese women with obstructive sleep apnea |
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