Skip to main content
SpringerLink
Log in

Reduced levels of adiponectin in sleep apnea syndrome

  • Original Articles
  • Published:
Journal of Endocrinological Investigation Aims and scope Submit manuscript

Abstract

Background: To investigate adiponectin levels in an obese population with and without obstructive sleep apnea syndrome (OSAS) and the acute modifications in adiponectin after a whole-night control by auto continuous positive air pressure (CPAP). Methods: 46 obese subjects [22 males, 24 females, age 55.1±11.4 yr, body mass index (BMI) 38.9±6.5 kg/m2]: 11 OSAS with apnea/hypopnea index (AHI) from 10/h to 30/h, 14 OSAS with AHI >30/h and 21 without OSAS. Thirty-seven normal weight healthy subjects (20 males, 17 females, age 31.3±9.5 yr, BMI 21.5±1.8 kg/m2). Serum adiponectin levels, biochemical parameters, anthropometric measurements, pulmonary function, pulse-oxymetry and polisomnography. Results: The 3 groups of obese patients were comparable for gender, BMI, age, fat mass, fat free mass, hip and waist circumference, waist-to-hip ratio (WHR), systolic and diastolic blood pressure and glycometabolic parameters. Adiponectin levels were significantly reduced in obese patients compared to healthy normal weight subjects (8.1±3.5 vs 11.3±4.8 μg/ml p<0.001) In particular, adiponectin showed a trend to decrease according to the severity of OSAS. No differences in adiponectin levels were found after a whole-night control by Auto CPAP. Conclusions: OSAS is associated with reduced levels of adiponectin independently of insulin-resistance and BMI. These low adiponectin levels may contribute to the increased mortality seen in such patients.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Flegal KM, Carrol MD, Ogden CL, Johnson CL. Prevalence and trends in obesity among US adults, 1999–2000. JAMA 2002, 288: 1723–7.

    Article  PubMed  Google Scholar 

  2. Young T, Peppard PE, Gottlieb DJ. Epidemiology of obstructive sleep apnea: a population health perspective. Am J Respir Crit Care Med 2002, 165: 1217–39.

    Article  PubMed  Google Scholar 

  3. Gami AP, Pressman G, Caples SM, et al. Association of atrial fibrillation and obstructive sleep apnea. Circulation 2004, 110: 364–7.

    Article  PubMed  Google Scholar 

  4. Skomro RP, Kryger MH. Clinical presentations of obstructive sleep apnea syndrome. Prog Cardiovasc Dis 1999, 41: 331–40.

    Article  CAS  PubMed  Google Scholar 

  5. Jordan AS, McEvoy RD. Gender differences in sleep apnea: epidemiology, clinical presentation and pathogenic mechanisms. Sleep Med Rev 2003, 7: 377–89.

    Article  PubMed  Google Scholar 

  6. Tuomilehto J. Cardiovascular risk: prevention and treatment of the metabolic syndrome. Diabetes Res Clin Pract 2005, 68 (Suppl 2): S28–35.

    Article  PubMed  Google Scholar 

  7. Leung RS, Bradley TD. Sleep apnea and cardiovascular disease. Am J Respir Crit Care Med 2001, 164: 2147–65.

    Article  CAS  PubMed  Google Scholar 

  8. Tassone F, Lanfranco F, Gianotti L, et al. Obstructive sleep apnoea syndrome impairs insulin sensitivity independently of anthropometric variables. Clin Endocrinol (Oxf) 2003, 59: 374–9.

    Article  Google Scholar 

  9. Punjabi NM, Sorkin JD, Katzel LI, Goldberg AP, Schwartz AR. Sleep-disordered breathing and insulin resistance in middle-aged and overweight men. Am J Respir Crit Care Med 2002, 165: 677–82.

    Article  PubMed  Google Scholar 

  10. Vgontzas AN, Papanicolaou DA, Bixler EO, et al. Sleep apnea and daytime sleepiness and fatigue: relation to visceral obesity, insulin resistance, and hypercytokinemia. J Clin Endocrinol Metab 2000, 85: 1151–8.

    Article  CAS  PubMed  Google Scholar 

  11. Wilcox I, McNamara SG, Collins FL, Grunstein RR, Sullivan CE. “Syndrome Z”: the interaction of sleep apnoea, vascular risk factors and heart disease. Thorax 1998, 53 (Suppl 3): S25–8.

    PubMed Central  PubMed  Google Scholar 

  12. Polotsky VY, Li J, Punjabi NM, et al. Intermittent hypoxia increases insulin resistance in genetically obese mice. J Physiol 2003, 552: 253–64.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  13. Ambrosini G, Nath AK, Sierra-Honigmann MR, Flores-Riveros J. Transcriptional activation of the human leptin gene in response to hypoxia. J Biol Chem 2002, 277: 34601–9.

    Article  CAS  PubMed  Google Scholar 

  14. Ip MSM, Lam KSL, Ho C, Tsang KWT, Lam WK. Serum leptin and vascular risk factors in obstructive sleep apnea. Chest 2000, 118: 580–6.

    Article  CAS  PubMed  Google Scholar 

  15. Kadowaki T, Yamauchi T. Adiponectin and adiponectin receptors. Endocr Rev 2005, 26: 439–51.

    Article  CAS  PubMed  Google Scholar 

  16. Yamauchi T, Kamon J, Waki H, et al. The fat-derived hormone adiponectin reverses insulin resistance associated with both lipoatrophy and obesity. Nat Med 2001, 8: 941–6.

    Article  Google Scholar 

  17. Kershaw EE, Flier JS. Adipose tissue as an endocrine organ J Clin Endocrinol Metab 2004, 89: 2548–56.

    Article  CAS  Google Scholar 

  18. Goldstein BJ, Scalia R. Adiponectin. A novel adipokine linking adipocytes and vascular function. J Clin Endocrinol Metab 2004, 89: 2563–8.

    CAS  Google Scholar 

  19. Pannacciulli N, Vettor R, Milan G, et al. Anorexia nervosa is characterized by increased adiponectin plasma levels and reduced nonoxidative glucose metabolism. J Clin Endocrinol Metab 2003, 88: 1748–52.

    Article  CAS  PubMed  Google Scholar 

  20. Wolk R, Svatikova A, Nelson CA, et al. Plasma levels of adiponectin, a novel adipocyte-derived hormone, in sleep apnea. Obesity Res 2005, 13: 186–90.

    Article  CAS  Google Scholar 

  21. Zhang X, Yin K, Mao H, Wang H,YangY. Serum adiponectin level in patients with obstructive sleep apnea hypopnea syndrome. Chin Med J 2004, 117: 1603–6.

    CAS  PubMed  Google Scholar 

  22. Makino S, Handa H, Suzukawa K, et al. Obstructive sleep apnoea syndrome, plasma adiponectin levels and insulin resistance. Clin Endocrinol (Oxf) 2006, 64: 12–9.

    Article  CAS  Google Scholar 

  23. Johns MW. A new method for measuring daytime sleepiness: the Epworth Sleepiness Scale. Sleep 1991, 14: 540–5.

    CAS  PubMed  Google Scholar 

  24. Johns MW. Reliability and factor analysis of the Epworth Sleepiness Scale. Sleep 1992, 15: 376–81.

    CAS  PubMed  Google Scholar 

  25. Vignatelli L, Plazzi G, Barbato A, et al. GINSEN (Gruppo Italiano Narcolessia Studio Epidemiologico Nazionale). Italian version of the Epworth Sleepiness Scale: external validity. Neurol Sci 2003, 23: 295–300.

    CAS  Google Scholar 

  26. Guilleminault C, Tilkian A, Dement WC. The sleep apnea syndromes. Annu Rev Med 1976, 27: 465–84.

    Article  CAS  PubMed  Google Scholar 

  27. Rechtschaffer A, Kales A. A manual of standardized terminology techniques and scaring system for sleep stage of human subjects. Brain information Service, UCLA Los Angeles, 1968.

  28. Robert D, Banfi P, Leger P, Bourdon G, Langevin B, Petitjean T. Comparison of automatic continous adjust CPAP versus costant CPAP in OSAS. Am Rev Respir Dis 1994, 149: A 497.

    Google Scholar 

  29. Meurice JC, Marc I, Serier F. Efficacy of auto-CPAP in the treatment of obstructive sleep apnea/hypopnea sindrome. Am J Respir Crit Care Med 1996, 153: 794–8.

    Article  CAS  PubMed  Google Scholar 

  30. Lloberes P, Ballester E, Monserrat JM, et al. Comparison of manual and automatic-CPAP titration in patients with sleep apnea/hypopnea syndrome. Am J Respir Crit Care Med 1996, 154: 1755–8.

    Article  CAS  PubMed  Google Scholar 

  31. Lofaso F, Lorino AM, Duizabo D, et al. Evaluation of an auto-CPAP device based on snoring detection. Eur Respir J 1996, 9: 1795–800.

    Article  CAS  PubMed  Google Scholar 

  32. Series F. Auto-CPAP in the treatment of sleep apnea/hypopnea syndrome. Sleep 1996, 19: S281–3.

    CAS  PubMed  Google Scholar 

  33. Matthews DR, Hosker JP, Rudenski AS, Naylor BA, Treacher DF, Turner RC. Homeostasis model assessment: insulin resistance and beta-cell function from fasting plasma glucose and insulin concentrations in man. Diabetologia 1985, 28: 412–9.

    Article  CAS  PubMed  Google Scholar 

  34. Hoffstedt J, Arvidsson E, Sjölin E, Wåhlén K, Arner P. Adipose tissue adiponectin production and adiponectin serum concentration in human obesity and insulin resistance. J Clin Endocrinol Metab 2004, 89: 1391–6.

    Article  CAS  PubMed  Google Scholar 

  35. Ouchi N, Kihara S, Funahashi T, Matsuzawa Y, Walsh K. Obesity, adiponectin and vascular inflammatory disease. Curr Opin Lipidol 2003, 14: 561–6.

    Article  CAS  PubMed  Google Scholar 

  36. Cnop M, Havel PJ, Utzschneider KM, et al. Relationship of adiponectin to body fat distribution, insulin sensitivity and plasma lipoproteins: evidence for independent roles of age and sex. Diabetologia 2003, 46: 459–69

    CAS  PubMed  Google Scholar 

  37. Thamer C, Stefan N, Stumvoll M, Haring H, Fritsche A. Reduced adiponectin serum levels in smokers. Atherosclerosis 2005, 179: 421–2.

    Article  CAS  PubMed  Google Scholar 

  38. Yokoe T, Minoguchi K, Matsuo H, et al. Elevated levels of C-reactive protein and interleukin-6 in patients with obstructive sleep apnea syndrome are decreased by nasal continuous positive airway pressure. Circulation 2003, 107: 1129–34.

    Article  CAS  PubMed  Google Scholar 

  39. Degawa-Yamauchi M, Moss KA, Bovenkerk JE, et al. Regulation of adiponectin expression in human adipocytes: effects of adiposity, glucocorticoids, and tumor necrosis factor alpha. Obes Res 2005, 13: 662–9.

    Article  CAS  PubMed  Google Scholar 

  40. Fasshauer M, Kralisch S, Klier M, et al. Adiponectin gene expression and secretion is inhibited by interleukin-6 in 3T3-L1 adipocytes. Biochem Biophys Res Commun 2003, 301: 1045–50.

    Article  CAS  PubMed  Google Scholar 

  41. Somers VK, Dyken ME, Clary MP, Abboud FM. Sympathetic neural mechanisms in obstructive sleep apnea. J Clin Invest 1995, 96: 1897–904.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  42. Delporte ML, Funahashi T, Takahashi M, Matsuzawa Y, Brichard SM. Pre- and post-translatiuonal negative effect of β-adrenoceptor agonists on adiponectin secretion: in vitro and in vivo studies. Biochem J 2002, 367: 677–85.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  43. Harsch IA, Hahn EG, Konturek PC. Insuline resistance and other metabolic aspects of the obstructive sleep apnea syndrome. Med Sci Monit 2005, 11: 70–5.

    Google Scholar 

  44. Harsch IA, Wallaschofski H, Koebnicj C, et al. Adiponectin in patients with obstructive sleep apnea syndrome: course and physiological relevances. Respiration 2004, 71: 580–6.

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Institute of Endocrine Sciences, University of Milan, Fondazione Ospedale Maggiore Policlinico, Mangiagalli, Regina Elena, IRCCS, Via F. Sforza, 35, 20122, Milan, Italy

    B. Masserini, P. S. Morpurgo, F. Donadio, P. Beck-Peccoz & E. Orsi MD

  2. Department of Respiratory and Cardiovascular Disease, Center of Sleep Respiratory Disorders, University of Milan, Fondazione Ospedale Maggiore Policlinico, Mangiagalli, Regina Elena, IRCCS, Milan, Italy

    C. Baldessari & R. Bossi

Authors
  1. B. Masserini
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. P. S. Morpurgo
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. F. Donadio
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. C. Baldessari
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. R. Bossi
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. P. Beck-Peccoz
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. E. Orsi MD
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to E. Orsi MD.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Masserini, B., Morpurgo, P.S., Donadio, F. et al. Reduced levels of adiponectin in sleep apnea syndrome. J Endocrinol Invest 29, 700–705 (2006). https://doi.org/10.1007/BF03344179

Download citation

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF03344179

En]Keywords

Search

Navigation