Obstructive Sleep Apnea, Glucose Tolerance, and β-Cell Function in Adults With Prediabetes or Untreated Type 2 Diabetes in the Restoring Insulin Secretion (RISE) Study
Obstructive sleep apnea (OSA) is associated with insulin resistance and has been described as a risk factor for type 2 diabetes. Whether OSA adversely impacts pancreatic islet β-cell function remains unclear. We aimed to investigate the association of OSA and short sleep duration with β-cell functio...
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Published in | Diabetes care Vol. 44; no. 4; pp. 993 - 1001 |
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Main Authors | , , , , , , , , , , , |
Format | Journal Article |
Language | English |
Published |
United States
American Diabetes Association
01.04.2021
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Abstract | Obstructive sleep apnea (OSA) is associated with insulin resistance and has been described as a risk factor for type 2 diabetes. Whether OSA adversely impacts pancreatic islet β-cell function remains unclear. We aimed to investigate the association of OSA and short sleep duration with β-cell function in overweight/obese adults with prediabetes or recently diagnosed, treatment-naive type 2 diabetes.
Two hundred twenty-one adults (57.5% men, age 54.5 ± 8.7 years, BMI 35.1 ± 5.5 kg/m
) completed 1 week of wrist actigraphy and 1 night of polysomnography before undergoing a 3-h oral glucose tolerance test (OGTT) and a two-step hyperglycemic clamp. Associations of measures of OSA and actigraphy-derived sleep duration with HbA
, OGTT-derived outcomes, and clamp-derived outcomes were evaluated with adjusted regression models.
Mean ± SD objective sleep duration by actigraphy was 6.6 ± 1.0 h/night. OSA, defined as an apnea-hypopnea index (AHI) of five or more events per hour, was present in 89% of the participants (20% mild, 28% moderate, 41% severe). Higher AHI was associated with higher HbA
(
= 0.007). However, OSA severity, measured either by AHI as a continuous variable or by categories of OSA severity, and sleep duration (continuous or <6 vs. ≥6 h) were not associated with fasting glucose, 2-h glucose, insulin sensitivity, or β-cell responses.
In this baseline cross-sectional analysis of the RISE clinical trial of adults with prediabetes or recently diagnosed, untreated type 2 diabetes, the prevalence of OSA was high. Although some measures of OSA severity were associated with HbA
, OSA severity and sleep duration were not associated with measures of insulin sensitivity or β-cell responses. |
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AbstractList | Obstructive sleep apnea (OSA) is associated with insulin resistance and has been described as a risk factor for type 2 diabetes. Whether OSA adversely impacts pancreatic islet β-cell function remains unclear. We aimed to investigate the association of OSA and short sleep duration with β-cell function in overweight/obese adults with prediabetes or recently diagnosed, treatment-naive type 2 diabetes.
Two hundred twenty-one adults (57.5% men, age 54.5 ± 8.7 years, BMI 35.1 ± 5.5 kg/m
) completed 1 week of wrist actigraphy and 1 night of polysomnography before undergoing a 3-h oral glucose tolerance test (OGTT) and a two-step hyperglycemic clamp. Associations of measures of OSA and actigraphy-derived sleep duration with HbA
, OGTT-derived outcomes, and clamp-derived outcomes were evaluated with adjusted regression models.
Mean ± SD objective sleep duration by actigraphy was 6.6 ± 1.0 h/night. OSA, defined as an apnea-hypopnea index (AHI) of five or more events per hour, was present in 89% of the participants (20% mild, 28% moderate, 41% severe). Higher AHI was associated with higher HbA
(
= 0.007). However, OSA severity, measured either by AHI as a continuous variable or by categories of OSA severity, and sleep duration (continuous or <6 vs. ≥6 h) were not associated with fasting glucose, 2-h glucose, insulin sensitivity, or β-cell responses.
In this baseline cross-sectional analysis of the RISE clinical trial of adults with prediabetes or recently diagnosed, untreated type 2 diabetes, the prevalence of OSA was high. Although some measures of OSA severity were associated with HbA
, OSA severity and sleep duration were not associated with measures of insulin sensitivity or β-cell responses. OBJECTIVE Obstructive sleep apnea (OSA) is associated with insulin resistance and has been described as a risk factor for type 2 diabetes. Whether OSA adversely impacts pancreatic islet β-cell function remains unclear. We aimed to investigate the association of OSA and short sleep duration with β-cell function in overweight/obese adults with prediabetes or recently diagnosed, treatment-naive type 2 diabetes. RESEARCH DESIGN AND METHODS Two hundred twenty-one adults (57.5% men, age 54.5 ± 8.7 years, BMI 35.1 ± 5.5 kg/m2) completed 1 week of wrist actigraphy and 1 night of polysomnography before undergoing a 3-h oral glucose tolerance test (OGTT) and a two-step hyperglycemic clamp. Associations of measures of OSA and actigraphy-derived sleep duration with HbA1c, OGTT-derived outcomes, and clamp-derived outcomes were evaluated with adjusted regression models. RESULTS Mean ± SD objective sleep duration by actigraphy was 6.6 ± 1.0 h/night. OSA, defined as an apnea-hypopnea index (AHI) of five or more events per hour, was present in 89% of the participants (20% mild, 28% moderate, 41% severe). Higher AHI was associated with higher HbA1c (P = 0.007). However, OSA severity, measured either by AHI as a continuous variable or by categories of OSA severity, and sleep duration (continuous or <6 vs. ≥6 h) were not associated with fasting glucose, 2-h glucose, insulin sensitivity, or β-cell responses. CONCLUSIONS In this baseline cross-sectional analysis of the RISE clinical trial of adults with prediabetes or recently diagnosed, untreated type 2 diabetes, the prevalence of OSA was high. Although some measures of OSA severity were associated with HbA1c, OSA severity and sleep duration were not associated with measures of insulin sensitivity or β-cell responses. OBJECTIVE Obstructive sleep apnea (OSA) is associated with insulin resistance and has been described as a risk factor for type 2 diabetes. Whether OSA adversely impacts pancreatic islet β-cell function remains unclear. We aimed to investigate the association of OSA and short sleep duration with β-cell function in overweight/obese adults with prediabetes or recently diagnosed, treatment-naive type 2 diabetes. RESEARCH DESIGN AND METHODS Two hundred twenty-one adults (57.5% men, age 54.5 ± 8.7 years, BMI 35.1 ± 5.5 kg/m2) completed 1 week of wrist actigraphy and 1 night of polysomnography before undergoing a 3-h oral glucose tolerance test (OGTT) and a two-step hyperglycemic clamp. Associations of measures of OSA and actigraphy-derived sleep duration with HbA1c, OGTT-derived outcomes, and clamp-derived outcomes were evaluated with adjusted regression models. RESULTS Mean ± SD objective sleep duration by actigraphy was 6.6 ± 1.0 h/night. OSA, defined as an apnea-hypopnea index (AHI) of five or more events per hour, was present in 89% of the participants (20% mild, 28% moderate, 41% severe). Higher AHI was associated with higher HbA1c (P = 0.007). However, OSA severity, measured either by AHI as a continuous variable or by categories of OSA severity, and sleep duration (continuous or <6 vs. ≥6 h) were not associated with fasting glucose, 2-h glucose, insulin sensitivity, or β-cell responses. CONCLUSIONS In this baseline cross-sectional analysis of the RISE clinical trial of adults with prediabetes or recently diagnosed, untreated type 2 diabetes, the prevalence of OSA was high. Although some measures of OSA severity were associated with HbA1c, OSA severity and sleep duration were not associated with measures of insulin sensitivity or β-cell responses. OBJECTIVEObstructive sleep apnea (OSA) is associated with insulin resistance and has been described as a risk factor for type 2 diabetes. Whether OSA adversely impacts pancreatic islet β-cell function remains unclear. We aimed to investigate the association of OSA and short sleep duration with β-cell function in overweight/obese adults with prediabetes or recently diagnosed, treatment-naive type 2 diabetes. RESEARCH DESIGN AND METHODSTwo hundred twenty-one adults (57.5% men, age 54.5 ± 8.7 years, BMI 35.1 ± 5.5 kg/m2) completed 1 week of wrist actigraphy and 1 night of polysomnography before undergoing a 3-h oral glucose tolerance test (OGTT) and a two-step hyperglycemic clamp. Associations of measures of OSA and actigraphy-derived sleep duration with HbA1c, OGTT-derived outcomes, and clamp-derived outcomes were evaluated with adjusted regression models. RESULTSMean ± SD objective sleep duration by actigraphy was 6.6 ± 1.0 h/night. OSA, defined as an apnea-hypopnea index (AHI) of five or more events per hour, was present in 89% of the participants (20% mild, 28% moderate, 41% severe). Higher AHI was associated with higher HbA1c (P = 0.007). However, OSA severity, measured either by AHI as a continuous variable or by categories of OSA severity, and sleep duration (continuous or <6 vs. ≥6 h) were not associated with fasting glucose, 2-h glucose, insulin sensitivity, or β-cell responses. CONCLUSIONSIn this baseline cross-sectional analysis of the RISE clinical trial of adults with prediabetes or recently diagnosed, untreated type 2 diabetes, the prevalence of OSA was high. Although some measures of OSA severity were associated with HbA1c, OSA severity and sleep duration were not associated with measures of insulin sensitivity or β-cell responses. |
Author | Temple, Karla A Tjaden, Ashley H Manchanda, Shalini Nadeau, Kristen J Ehrmann, David A Mokhlesi, Babak Sam, Susan Hannon, Tamara S Edelstein, Sharon L Mather, Kieren J Kahn, Steven E Van Cauter, Eve |
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ContentType | Journal Article |
Contributor | Temple, Karla A Chisholm, Robin Nayak, Krishan Buchanan, Thomas A Rue, Abby Williams, Jayne Albers, John Martinez, Mayra Ehrmann, David A Lteif, Amale Sam, Susan Patel, Aniket Hendee, Fadi N Porter, Kristin Kernan-Schloss, Abigail Palmer, Jerry P Savoye, Mary Pierpont, Bridget Miller, M Annette Leschek, Ellen W Moore, Karen Barengolts, Elena Montgomery, Brenda K Kozedub, Alexandra Pirics, Vivian Caprio, Sonia Guerra, Nancy Montgomery, Cortney Garrett, Tammy Atkinson, Karen M Trigo, Enrique Lachin, John M Hannon, Tamara S Mokhlesi, Babak Mather, Kieren J Gross, Susan Wang, Xinhui Katkhouda, Namir Van Cauter, Eve Xiang, Anny H Gebremedhin, Tsige Beale, Elizabeth Edelstein, Sharon L Tjaden, Ashley Hogan Pratt, Linda Arslanian, Silva A Tjaden, Ashley H Nadeau, Kristen J Marcovina, Santica Harting, Jessica Kahn, Steven E Cree-Green, Melanie Morse, Emily J Brown, Kathleen Savage, Peter J Hill, Dave Utzschneider, Kristina M Vissat, Krista Zeitler, Philip S Reyes, Yesenia Garcia |
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Copyright | 2021 by the American Diabetes Association. Copyright American Diabetes Association Apr 1, 2021 2021 by the American Diabetes Association 2021 |
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References | Temple (2022031309374996400_B13) 2019; 42 Loffler (2022031309374996400_B39) 2020; 43 Mokhlesi (2022031309374996400_B36) 2017; 19 Patel (2022031309374996400_B12) 2015; 38 Yano (2022031309374996400_B25) 2020; 9 Shaw (2022031309374996400_B32) 2016; 194 Seicean (2022031309374996400_B24) 2008; 31 Reutrakul (2022031309374996400_B4) 2017; 152 Louis (2022031309374996400_B8) 2009; 106 RISE Consortium (2022031309374996400_B15) 2018; 41 Hales (2022031309374996400_B2) 2018; 319 Seltzer (2022031309374996400_B18) 1967; 46 2022031309374996400_B1 Phillips (2022031309374996400_B17) 1994; 11 Anothaisintawee (2022031309374996400_B22) 2016; 30 Pamidi (2022031309374996400_B37) 2015; 192 Harsch (2022031309374996400_B30) 2004; 169 RISE Consortium (2022031309374996400_B11) 2014; 37 Tasali (2022031309374996400_B7) 2008; 105 Punjabi (2022031309374996400_B26) 2009; 179 Cappuccio (2022031309374996400_B23) 2010; 33 Kahn (2022031309374996400_B21) 1993; 42 Hannon (2022031309374996400_B14) 2018; 20 Broussard (2022031309374996400_B6) 2012; 157 Grimaldi (2022031309374996400_B38) 2014; 37 RISE Consortium (2022031309374996400_B10) 2019; 42 Mokhlesi (2022031309374996400_B35) 2016; 194 Morariu (2022031309374996400_B33) 2017; 21 Elahi (2022031309374996400_B20) 1996; 19 Reichmuth (2022031309374996400_B29) 2005; 172 Martínez-Cerón (2022031309374996400_B31) 2016; 194 Heinzer (2022031309374996400_B3) 2015; 3 Spiegel (2022031309374996400_B5) 1999; 354 Kahn (2022031309374996400_B9) 2006; 444 Matthews (2022031309374996400_B19) 1985; 28 Lam (2022031309374996400_B34) 2017; 21 Botros (2022031309374996400_B27) 2009; 122 Marshall (2022031309374996400_B28) 2009; 5 American Diabetes Association (2022031309374996400_B16) 2018; 41 |
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A method for assessment of beta-cell sensitivity and insulin resistance publication-title: Diabetes Care doi: 10.2337/diacare.19.3.278 contributor: fullname: Elahi – volume: 169 start-page: 156 year: 2004 ident: 2022031309374996400_B30 article-title: Continuous positive airway pressure treatment rapidly improves insulin sensitivity in patients with obstructive sleep apnea syndrome publication-title: Am J Respir Crit Care Med doi: 10.1164/rccm.200302-206OC contributor: fullname: Harsch – volume: 354 start-page: 1435 year: 1999 ident: 2022031309374996400_B5 article-title: Impact of sleep debt on metabolic and endocrine function publication-title: Lancet doi: 10.1016/S0140-6736(99)01376-8 contributor: fullname: Spiegel – ident: 2022031309374996400_B1 – volume: 179 start-page: 235 year: 2009 ident: 2022031309374996400_B26 article-title: Alterations in glucose disposal in sleep-disordered breathing publication-title: Am J Respir Crit Care Med doi: 10.1164/rccm.200809-1392OC contributor: fullname: Punjabi – volume: 5 start-page: 15 year: 2009 ident: 2022031309374996400_B28 article-title: Is sleep apnea an independent risk factor for prevalent and incident diabetes in the Busselton Health Study publication-title: J Clin Sleep Med doi: 10.5664/jcsm.27387 contributor: fullname: Marshall – volume: 319 start-page: 1723 year: 2018 ident: 2022031309374996400_B2 article-title: Trends in obesity and severe obesity prevalence in US youth and adults by sex and age, 2007-2008 to 2015-2016 publication-title: JAMA doi: 10.1001/jama.2018.3060 contributor: fullname: Hales – volume: 194 start-page: 516 year: 2016 ident: 2022031309374996400_B35 article-title: Effect of one week of 8-hour nightly continuous positive airway pressure treatment of obstructive sleep apnea on glycemic control in type 2 diabetes: a proof-of-concept study publication-title: Am J Respir Crit Care Med doi: 10.1164/rccm.201602-0396LE contributor: fullname: Mokhlesi – volume: 194 start-page: 476 year: 2016 ident: 2022031309374996400_B31 article-title: Effect of continuous positive airway pressure on glycemic control in patients with obstructive sleep apnea and type 2 diabetes. 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Snippet | Obstructive sleep apnea (OSA) is associated with insulin resistance and has been described as a risk factor for type 2 diabetes. Whether OSA adversely impacts... OBJECTIVE Obstructive sleep apnea (OSA) is associated with insulin resistance and has been described as a risk factor for type 2 diabetes. Whether OSA... OBJECTIVE Obstructive sleep apnea (OSA) is associated with insulin resistance and has been described as a risk factor for type 2 diabetes. Whether OSA... OBJECTIVEObstructive sleep apnea (OSA) is associated with insulin resistance and has been described as a risk factor for type 2 diabetes. Whether OSA adversely... |
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SubjectTerms | Adult Adults Apnea Beta cells Blood Glucose Body weight Continuity (mathematics) Cross-Sectional Studies Diabetes Diabetes mellitus Diabetes mellitus (non-insulin dependent) Diabetes Mellitus, Type 2 Female Glucose Glucose tolerance Humans Insulin Insulin resistance Insulin Secretion Male Middle Aged Night Pancreas Pathophysiology/Complications Prediabetic State Regression analysis Regression models Research design Risk analysis Risk factors Sleep Sleep apnea Sleep Apnea, Obstructive Sleep disorders Wrist |
Title | Obstructive Sleep Apnea, Glucose Tolerance, and β-Cell Function in Adults With Prediabetes or Untreated Type 2 Diabetes in the Restoring Insulin Secretion (RISE) Study |
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