Resistin - the link between adipose tissue dysfunction and insulin resistance in patients with obstructive sleep apnea

Abstract

Background

Resistin is an adipocytokine, associated with obesity and inflammation. Its exact role in insulin resistance and diabetes in the general population is still controversial. The relation between resistin plasma levels, insulin resistance and risk of impaired glucose metabolism in OSA patients has not been investigated.

Materials and methods

Plasma levels of resistin were measured in 67 patients with OSA and impaired glucose metabolism. 34,7% (23/67) had diabetes; 40% (27/67) patients had impаired glucose tolerance(IGT); 25,3%(17/67) had normal glucose metabolism (NGM). The association between resistin, BMI, obesity, markers of insulin resistance, oxidative stress and sleep study characteristics was analysed. The different groups of patients were compared in regards to glucometabolic parameters and biomarkers of oxidative stress – isoprostanes and insulin resistance – free fatty acids (FFA).

Results

Plasma levels of resistin were higher in patients with diabetes (6,12 ±5,93ng/ml), compared to those with IGT (3,85±2,81ng/ml, p-0,021) and NGM (3,77±3,23, p-0,043). Resistin did not differ between patients with IGT and NGM (p-0,954). In OSA patients with BMI>40 resistin plasma levels correlated neither to the clinical parameters (BMI, IRI, HOMA-I, HbA1C, AHI, desaturation index), nor to the biomarkers of oxidative stress and insulin resistance. Free fatty acids (0,232>0,177mmol/l, p-0,037) were higher in diabetics in comparison to NGM.

Conclusions

Plasma resistin levels in OSA patients with BMI>40 are independent of insulin resistance and are not associated with the parameters, characterising the oxidative stress or severity of OSA. Resistin could be used in a multiple panel of clinical and biomarkers to discern patients with diabetes from those with IGT; in OSA patients with BMI >40 resistin together with HbA1C could discern patients with diabetes from those with NGM. In OSA patients with BMI >40 FFA and HbA1C are useful clinical markers in assessing the risk of dysglycaemia among patients with normal and IGT.

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Abbreviations

OSA:

Obstructive Sleep Apnea

AHI:

Apnea+Hypopnea Index

BiPAP:

Bilevel Positive Airway Pressure

BMI:

Body Mass Index

HOMA-I:

Homeostasis Model Assessment Index

IRI:

Immuno Reactive Insulin

OGTT:

Oral Glucose Tolerance Test

RR:

Riva Rocchi

FFA:

Free Fatty Acids

IGT:

Impaired Glucose Tolerance

NGM:

Normal Glucose Metabolism.

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Acknowledgements

This work is supported by the Scientific Grant of the Medical University of Sofia, 2011; Contract 42/ Project 51 with the kind collaboration of the Department of Medical Chemistry and Biochemistry, Laboratory of Synthesis and Analysis of Bioactive Substances and the Central Clinical Laboratory.

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Correspondence to Radostina Vlaeva Cherneva.

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The authors declare that they have no competing interests.

Authors’ contributions

RCh, OG, VM and DP participated in the design of the study and in writing the manuscript. RCh recruited the patients and collected the data. TM,OG performed the PSG studies. SSR and VL performed the HRAM analysis and free fatty acids measurements. AC performed the ELISA for resistin and the enzymatic determination of urinary creatinine levels. All reviewed and approved the final version of the manuscript.

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Cherneva, R.V., Georgiev, O.B., Petrova, D.S. et al. Resistin - the link between adipose tissue dysfunction and insulin resistance in patients with obstructive sleep apnea. J Diabetes Metab Disord 12, 5 (2013). https://doi.org/10.1186/2251-6581-12-5

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Keywords

  • Resistin
  • Insulin resistance
  • OSA
  • Diabetes
  • Normal glucose metabolism
  • Impaired glucose tolerance