Systemic inflammation and sympathetic activation in gestational diabetes mellitus with obstructive sleep apnea
Background Although some evidence suggests an association between obstructive sleep apnea (OSA) and gestational diabetes mellitus (GDM), its consequences still remain largely unknown. We sought to determine whether OSA is associated with higher inflammation and sympathetic levels in GDM, and to rela...
| Autores: | , , , , , , , , , , , , , , , , , , , , |
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| Formato: | artículo |
| Fecha de publicación: | 2022 |
| País: | España |
| Recursos: | Conselleria de Salut i Consum del Govern de les Illes Balears |
| Repositorio: | Docusalut |
| Idioma: | inglés |
| OAI Identifier: | oai:docusalut.com:20.500.13003/19842 |
| Acesso em linha: | https://hdl.handle.net/20.500.13003/19842 |
| Access Level: | acceso abierto |
| Palavra-chave: | Pregnancy Polysomnography Infant, Newborn Female Sleep Apnea, Obstructive Humans Inflammation Diabetes, Gestational Insulin Resistance Diabetes Gestacional Apnea Obstructiva del Sueño Humanos Inflamación Embarazo Recién Nacido Femenino Resistencia a la Insulina Polisomnografía Gestational diabetes mellitus Fetal outcomes Cytokine inflammation Metanephrine Normetanephrine Obstructive sleep apnea |
| Resumo: | Background Although some evidence suggests an association between obstructive sleep apnea (OSA) and gestational diabetes mellitus (GDM), its consequences still remain largely unknown. We sought to determine whether OSA is associated with higher inflammation and sympathetic levels in GDM, and to relate them with insulin resistance and perinatal outcomes. Methods OSA was identified by polysomnography and defined as an apnea-hypopnea index of >= 5 h(-1). Plasma cytokines (TNF-alpha, IL-1 beta, IL-6, IL-8, IL-10), metanephrine, and normetanephrine were determined by immunoassays. Results We included 17 patients with GDM and OSA and 34 without OSA. Women with GDM and OSA had higher normetanephrine concentrations [81 IQR (59-134) vs. 68 (51-81) pg/mL]. No differences in the inflammatory profile were found, while IL-1 beta was higher in patients with mean nocturnal oxyhemoglobin saturation <= 94%. We found positive correlations between increased sympathetic activation and IL-1 beta, with obstructive apneas, while time in REM showed an inverse relationship with IL-1 beta and metanephrine. Furthermore, IL-10 was inversely related with time in sleep stages 1-2, and with the arousal index, and it was positively related with time in slow-wave sleep. Significant correlations were also found between IL-1 beta and insulin resistance. There were no significant differences in neonatal characteristics; however, we found inverse relationships between IL-10 and birth weight (BW), and percentile of BW. Conclusions OSA increased sympathetic activity, and IL-1 beta concentration was higher in patients with GDM with lower nocturnal oxygenation, all of which were related with obstructive events, and time in REM. Moreover, IL-1 beta was related with insulin resistance, and IL-10 inversely correlated with neonatal BW. |
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