Soluble leptin receptor and insulin resistance as determinant of sleep apnea.

OBJECTIVE: To investigate the possible associations between sleep apnea syndrome, hyperinsulinemia/insulin resistance and hyperleptinemia in subjects with different degrees of body mass index. DESIGN: To test for the presence or absence of sleep apnea syndromein association with hyperinsulinemia/insulin resistance and hyperleptinemia. SUBJECTS: Twenty subjects with different body mass index(mean BMI 30.9 ± 4.2). MEASUREMENTS: Insulin action and plasma soluble leptin receptorwere measured by euglycemic hyperinsulinemic glucose clamp and by ELISA method, respectively. Occurrence of sleep apnea syndromewas assessed by clinical and nocturnal monitoring using a validated sleep apnearecorder. RESULTS: The apnea/hypopnea index(AHI) was positively correlated with plasma soluble leptin receptor(0.76; P < 0.001) and negatively with the degree of insulin-mediated glucose uptake(r = - 0.73; P < 0.001). In a multivariate analysis AHI was associated with plasma soluble leptin receptorand insulin mediated glucose uptakeindependently of age, gender, BMI, plasma leptinlevels and PaCO 2 . CONCLUSION: Sleep apnea syndromeis associated with plasma soluble leptin receptorand insulin resistance independently of BMI.