Obstructive sleep apnoea increases lipolysis and deteriorates glucose homeostasis in patients with type 2 diabetes mellitus.

ABSTRACT: Obstructive sleep apnoea (OSA) is associated with type 2 diabetes mellitus (T2DM). However, mechanisms mediating association between these two conditions remain unclear. This study investigated, whether the OSA-associated changes in adipose tissue lipolysis might contribute to impaired glucose homeostasis in patient with T2DM. Thirty-five matched subjects were recruited into three groups: T2DM?+?severe OSA (T2DM?+?OSA, n?=?11), T2DM with mild/no OSA (T2DM, n?=?10) and healthy controls (n?=?14). Subcutaneous abdominal adipose tissue microdialysis assessed spontaneous, epinephrine- and isoprenaline-stimulated lipolysis. Glucose metabolism was assessed by intravenous glucose tolerance test. Spontaneous lipolysis was higher in the T2DM?+?OSA compared with the T2DM (60.34?±?23.40 vs. 42.53?±?10.16 ?mol/L, p?=?0.013), as well as epinephrine-stimulated lipolysis (236.84?±?103.90 vs. 167.39?±?52.17 µmol/L, p?2 anti-lipolytic effect was decreased in T2DM?+?OSA by 59% and 315% compared with T2DM and controls (p?=?0.045 and p?=?0.007, respectively). The severity of OSA (AHI) was positively associated with spontaneous (p?=?0.037) and epinephrine-stimulated (p?=?0.026) lipolysis. The ?₂-adrenergic anti-lipolytic effect (p?=?0.043) decreased with increasing AHI. Spontaneous lipolysis was positively associated with Insulin resistance (r?=?0.50, p?=?0.002). Epinephrine-stimulated lipolysis was negatively associated with the Disposition index (r?=??-?0.34, p?=?0.048). AHI was positively associated with Insulin resistance (p?=?0.017) and negatively with the Disposition index (p?=?0.038). Severe OSA in patients with T2DM increased adipose tissue lipolysis, probably due to inhibition of the ?₂-adrenergic anti-lipolytic effect. We suggest that dysregulated lipolysis might contribute to OSA-associated impairments in insulin secretion and sensitivity.

SUBMITTER: Trinh MD 

PROVIDER: S-EPMC7878919 | biostudies-literature | 2021 Feb

REPOSITORIES: biostudies-literature