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Obstructive sleep apnea may cause abnormal glycemic variability

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August 25, 2017

Adults with obstructive sleep apnea syndrome may have abnormal glycemic variability compared with their healthy counterparts, which may suggest a need for its earlier detection and control, according to findings published in Diabetes Research and Clinical Practice.

Glycemic variability plays an important role in the “target organ damage in metabolism disorders, believed to be mainly mediated by oxidated stress and damage of endothelial dysfunction,” according to the researchers. Thus, they added, detection and control of glycemic variability in obstructive sleep apnea “may be crucial for reducing the risk of organ damages and other associated disorders, such as coronary heart disease, heart failure, arrhythmias and sudden death at night and neurodegenerative changes.”

Lu Yang, MD, of the Naval General Hospital PLA special medical center in Beijing, and colleagues evaluated 86 adults with obstructive sleep apnea syndrome and 40 healthy controls to investigate glycemic variability among them.

Researchers continuously monitored blood glucose and analyzed the relationships among glycemic variability, insulin resistance index and the respiratory disturbance index.

The obstructive sleep apnea group had higher overall whole-day blood glucose curve compared with controls. Daily average plasma glucose was higher in the obstructive sleep apnea group compared with controls (P < .01).

Fourteen participants in the obstructive sleep apnea group had 2-hour postprandial hyperglycemia of more than 8 mmol/L at least twice compared with only two participants in the control group.

The obstructive sleep apnea group had higher values of blood glucose fluctuation coefficient, mean amplitude of glycemic excursions and night amplitude of glycemic excursions (P < .05 for all) compared with the control group.

Mean amplitude of glycemic excursions and night amplitude of glycemic excursions were positively correlated with insulin resistance index and severity of obstructive sleep apnea syndrome in the obstructive sleep apnea group. Insulin resistance index was positively correlated with severity of obstructive sleep apnea syndrome.

“Whole-day dynamic glycemic profile contains very rich information,” the researchers wrote. “It not only provides the blood glucose level at any specific time throughout the day, but more importantly shows the characteristics of all-day glucose fluctuations and trends, and reflects more systematically the conditions of glucose metabolism. Therefore, the establishment of all-day ‘blood spectrum’ and detailed analysis of its characteristics of fluctuation is an important method for studying abnormal glucose metabolism-related diseases.” – by Amber Cox

Disclosures: The authors report no relevant financial disclosures.