The Effect of Sleep Apnea and Insomnia on Blood Levels of Leptin, Insulin Resistance, IP-10, and Hydrogen Sulfide in Type 2 Diabetic Patients
The Effect of Sleep Apnea and Insomnia on Blood Levels of Leptin, Insulin Resistance, IP-10, and Hydrogen Sulfide in Type 2 Diabetic Patients
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DOI：
10.1089/met.2012.0045
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发表时间：
2012-10-01
影响因子：
2.1
通讯作者：
Levine, Steven N.
中科院分区：
文献类型：
--
作者：
Jain, Sushil K.;Kahlon, Gunjan;Levine, Steven N.
睡眠不足与睡眠呼吸暂停和失眠相关，会增加血管炎症和胰岛素抵抗的风险。这项研究检验了一种假设，即与没有任何睡眠障碍史的糖尿病患者相比，患有睡眠不足的糖尿病患者的炎症标志物更高。方法：81例在路易斯安那州立大学健康科学中心就诊的2型糖尿病患者，经知情同意后取空腹血，并收集睡眠障碍病史。结果：2型糖尿病患者体重与瘦素存在显著相关性，而瘦素又与10-kDa干扰素- γ诱导蛋白（IP-10）水平及胰岛素抵抗显著相关。与睡眠模式正常的糖尿病患者相比，睡眠不足患者的空腹血清瘦素、IP-10和胰岛素抵抗水平显著升高。与睡眠模式正常的患者相比，睡眠不足患者的糖化血红蛋白（HbA1c）或空腹血糖没有差异。与无睡眠困难的糖尿病患者相比，睡眠不足会增加瘦素、IP-10和胰岛素抵抗的循环水平。与睡眠模式正常的患者或失眠患者相比，睡眠呼吸暂停患者的硫化氢（H2S）水平明显较低。低水平的循环H2S可能导致睡眠呼吸暂停患者血管炎症加重。结论：这些结果表明，睡眠呼吸暂停与循环H2S减少有关，睡眠障碍增加炎症和胰岛素抵抗的风险，这可能导致2型糖尿病患者血管疾病的风险增加。
Introduction: Sleep deficits associated with sleep apnea and insomnia increase the risk of vascular inflammation and insulin resistance. This study examined the hypothesis that inflammation markers are higher in those diabetic patients who experience sleep deficits compared with those without any history of a sleep disorder. Methods: Fasting blood was obtained after written informed consent, and sleep disorder histories were obtained from type 2 diabetic patients (n = 81) attending clinics of the Louisiana State University Health Sciences Center. Results: There was a significant correlation between body weight and leptin, and leptin in turn was significantly correlated with 10-kDa interferon-gamma-induced protein (IP-10) levels and insulin resistance in type 2 diabetic patients. Fasting blood levels of leptin, IP-10, and insulin resistance were significantly elevated in patients with sleep deficits compared with diabetics with normal sleep patterns. There were no differences in glycosylated hemoglobin (HbA1c) or fasting glucose in patients with sleep deficits compared with those with normal sleep patterns. Sleep deficits increase circulating levels of leptin, IP-10, and insulin resistance compared to levels seen in patients with diabetes who reported no difficulty with sleep. Patients with sleep apnea had significantly lower hydrogen sulfide (H2S) levels compared with patients with normal sleep patterns or patients with insomnia. Low levels of circulating H2S could contribute to higher vascular inflammation in patients with sleep apnea. Conclusions: These results suggest that sleep apnea is associated with a decrease in circulating H2S and sleep disorders increase the risk of inflammation and insulin resistance, which can contribute to the increased risk of vascular disease in subjects with type 2 diabetes.