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Serednytskyy O, Alonso-Fernández A, Ribot C, Herranz A, Álvarez A, Sánchez A, Rodríguez P, Gil AV, Pía C, Cubero JP, Barceló M, Cerdà M, Codina M, D Peña M, Barceló A, Iglesias A, Morell-Garcia D, Peña JA, Giménez MP, Piñas MC, García-Río F. Systemic inflammation and sympathetic activation in gestational diabetes mellitus with obstructive sleep apnea. BMC Pulm Med 2022; 22:94. [PMID: 35303833 PMCID: PMC8933971 DOI: 10.1186/s12890-022-01888-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Accepted: 03/07/2022] [Indexed: 11/10/2022] Open
Abstract
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-α, IL-1β, 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-1β was higher in patients with mean nocturnal oxyhemoglobin saturation ≤ 94%. We found positive correlations between increased sympathetic activation and IL-1β, with obstructive apneas, while time in REM showed an inverse relationship with IL-1β 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-1β 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-1β 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-1β was related with insulin resistance, and IL-10 inversely correlated with neonatal BW.
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Affiliation(s)
- Oleksandr Serednytskyy
- Institut d'Investigació Sanitària Illes Balears (IdISBa), Palma, Balearic Islands, Spain
| | - Alberto Alonso-Fernández
- Institut d'Investigació Sanitària Illes Balears (IdISBa), Palma, Balearic Islands, Spain. .,Servicio de Neumología, Hospital Universitari Son Espases, Carretera de Valldemosa 79, 07010, Palma de Mallorca, Balearic Islands, Spain. .,CIBER Enfermedades Respiratorias, Madrid, Spain.
| | - Caterina Ribot
- Institut d'Investigació Sanitària Illes Balears (IdISBa), Palma, Balearic Islands, Spain
| | - Andrea Herranz
- Institut d'Investigació Sanitària Illes Balears (IdISBa), Palma, Balearic Islands, Spain
| | - Ainhoa Álvarez
- Unidad del Sueño, Hospital Universitari de Araba, Vitoria-Gasteiz, Ávala, Spain.,Instituto de Investigación BIOARABA, Vitoria-Gasteiz, Ávala, Spain
| | - Andrés Sánchez
- Servicio de Neumología, Hospital Universitario Miguiel Servet, Zaragoza, Zaragoza, Spain
| | - Paula Rodríguez
- Instituto de Investigación BIOARABA, Vitoria-Gasteiz, Ávala, Spain
| | - Ana V Gil
- Instituto de Investigación Sanitaria de Aragón, Zaragoza, Spain
| | - Carla Pía
- Instituto de Investigación BIOARABA, Vitoria-Gasteiz, Ávala, Spain
| | - José P Cubero
- Instituto de Investigación Sanitaria de Aragón, Zaragoza, Spain
| | - María Barceló
- Institut d'Investigació Sanitària Illes Balears (IdISBa), Palma, Balearic Islands, Spain
| | - María Cerdà
- Servicio de Neumología, Hospital Palma Planas, Palma, Balearic Islands, Spain
| | - Mercedes Codina
- Servicio de Endocrinología, Hospital Universitari Son Espases, Palma, Balearic Islands, Spain
| | - Mónica D Peña
- Institut d'Investigació Sanitària Illes Balears (IdISBa), Palma, Balearic Islands, Spain.,Servicio de Neumología, Hospital Universitari Son Espases, Carretera de Valldemosa 79, 07010, Palma de Mallorca, Balearic Islands, Spain.,CIBER Enfermedades Respiratorias, Madrid, Spain
| | - Antònia Barceló
- Institut d'Investigació Sanitària Illes Balears (IdISBa), Palma, Balearic Islands, Spain.,Servicio de Análisis Clínicos, Hospital Universitari Son Espases, Palma, Balearic Islands, Spain
| | - Amanda Iglesias
- Institut d'Investigació Sanitària Illes Balears (IdISBa), Palma, Balearic Islands, Spain.,CIBER Enfermedades Respiratorias, Madrid, Spain
| | - Daniel Morell-Garcia
- Institut d'Investigació Sanitària Illes Balears (IdISBa), Palma, Balearic Islands, Spain.,Servicio de Análisis Clínicos, Hospital Universitari Son Espases, Palma, Balearic Islands, Spain
| | - José A Peña
- Institut d'Investigació Sanitària Illes Balears (IdISBa), Palma, Balearic Islands, Spain.,Servicio de Pediatría, Hospital Universitari Son Espases, Palma, Balearic Islands, Spain
| | - María P Giménez
- Institut d'Investigació Sanitària Illes Balears (IdISBa), Palma, Balearic Islands, Spain
| | - María C Piñas
- Institut d'Investigació Sanitària Illes Balears (IdISBa), Palma, Balearic Islands, Spain.,Servicio de Neumología, Hospital Universitari Son Espases, Carretera de Valldemosa 79, 07010, Palma de Mallorca, Balearic Islands, Spain
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