Association between sleep disordered breathing in early pregnancy and glucose metabolism

Sleep

article

Sanapo, Laura¹  Bublitz, Margaret H¹  Bai, Alice⁴  Mehta, Niharika¹  Messerlian, Geralyn M⁵  Catalano, Patrick⁶  Bourjeily, Ghada¹ 

[1] Women’s Medicine Collaborative, The Miriam Hospital;Department of Medicine, Warren Alpert School of Medicine at Brown University;Department of Psychiatry and Human Behavior, Warren Alpert School of Medicine at Brown University;Brown University;Departments of Pathology and Laboratory Medicine and Obstetrics and Gynecology, Women and Infants Hospital, Brown University;Mother Infant Research Institute, Department of Obstetrics and Gynecology, Tufts University School of Medicine, Friedman School of Nutrition Science and Policy

关键词: maternal sleep disordered breathing;    obstructive sleep apnea;    pregnancy;    maternal overweight;    maternal obesity;    insulin resistance;    sleep study;    gestational diabetes;    glucose metabolism;    -cell function;    HOMA;   

DOI  :  10.1093/sleep/zsab281

学科分类：生理学

来源: American Academy of Sleep Medicine

【 摘 要 】

Study Objectives To examine the association between maternal sleep disordered breathing (SDB) and glucose metabolism in early gestation.Methods Women with body mass index (BMI) ≥27 kg/m2 and singleton pregnancies underwent in-home sleep study (HSAT) and homeostatic model assessment (HOMA) in early pregnancy. Insulin resistance (HOMA-IR) and β-cell function (HOMA %B) were derived. Exclusion criteria included pregestational diabetes, use of continuous positive airway pressure and chronic steroid therapy. We performed linear regression analyses to evaluate the association between continuous measures of SDB (respiratory event index (REI), and oxygen desaturation index (ODI)) and glucose metabolism parameters (HOMA-IR and HOMA %B). Analyses were adjusted for a set of a priori selected variables which included gestational age, maternal age, BMI, ethnicity, race, and parity.Results One hundred and ninety-two pregnant women with median (interquartile range) BMI of 35.14 (8.30) kg/m2 underwent HSAT and HOMA assessment at 11.14 (3) and 15.35 (4.14) gestational weeks, respectively. REI and ODI, as continuous values, were associated with HOMA-IR after adjusting for covariates. OSA (obstructive sleep apnea) diagnosis (REI 5 events per hour) was not associated with HOMA-IR after adjusting for BMI (p ≥ 0.05). None of the parameters were associated with HOMA %B (p 0.07).Conclusions SDB and insulin resistance are associated in early pregnancy, with a dose response association between respiratory event index severity and insulin resistance. Further studies are needed to establish if pregnant women with overweight and obesity may benefit from early SDB screening to improve glucose metabolic outcome.

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