: dr. sc. BOŽIĆ JOŠKO dr. med.
"METABOLIC AND INFLAMMATORY CHANGES IN PATIENTS WITH OBSTRUCTIVE SLEEP APNEA"
prof. dr. sc. ĐOGAŠ ZORAN
Qualifying research publications:
Josko Bozic, Tea Galic, Daniela Supe-Domic, Natalija Ivkovic,
Tina Ticinovic Kurir, Zoran Valic, Josip Lesko, Zoran Dogas. Morning cortisol levels and glucose metabolism parameters in moderate and severe obstructive sleep apnea patients. Endocrine 2016;53(3):730-9.
IF (JCR 2015) 3.279
Obstructive sleep apnea (OSA) has been associated with dysregulation of the hypothalamic-pituitary-adrenal (HPA) axis and alterations in glucose metabolism. Many studies showed different metabolic and inflammatory alterations in patients with obstructive sleep apnea (OSA), but the role of adropin, novel peptide included in energy homeostasis, remains undetermined in this population.
The aim of the current study was to compare morning plasma cortisol levels, glucose metabolism parameters, plasma adropin levels, and systemic inflammation mediators between moderate and severe OSA patients, with respective controls.
A total of 56 male OSA patients; 24 moderate (AHI=21.1±5.3) and 32 severe (AHI=49.7±18.1) underwent a full-night polysomnography, oral glucose tolerance test (OGTT) and measurement of morning plasma cortisol levels, plasma adropin levels, and levels of systemic inflammation mediators (IL-6, TNF-alpha i hsCRP). These groups were compared to 20 male age-body mass index matched subjects in a control group.
Morning plasma cortisol levels were significantly lower in severe OSA group than in moderate OSA and control groups (303.7±93.5 vs. 423.9±145.1 vs. 417.5±99.8 pmol/L, P<0.001). Significant negative correlations were found between morning plasma cortisol levels and AHI (r=-0.444, P=0.002). Fasting plasma glucose and insulin levels, HbA1c and insulin resistance index were higher in the severe OSA group compared to moderate OSA and controls. Plasma adropin levels were significantly lower in severe OSA group compared with moderate OSA and control groups (4.34±1.50 vs. 6.58±1.84 vs. 7.95±1.69 ng/mL, P<0.001). Significant negative correlations were found between plasma adropin levels and AHI (r=-0.519, P<0.001). The group of patients with severe OSA had significantly higher values of IL-6, TNF-alpha and hsCRP, compared with patients with moderate OSA and controls.
In conclusion, our study showed that morning plasma cortisol and adropin levels were significantly lower in severe OSA patients, than in moderate OSA group and controls. Morning plasma cortisol and adropin levels showed a negative correlation with AHI. Additionally, this study confirmed the evidence of glucose metabolism impairment in OSA patients, with more pronounced effect in the severe OSA patients group. Furthermore, in patients with severe OSA were found higher concentrations of systemic inflammation mediators in comparison with moderate OSA and controls.