Effects of acute intermittent hypoxia on glucose metabolism in awake healthy volunteers.
Open accessAbstract
Accumulating evidence suggests that obstructive sleep apnea is associated with alterations in glucose metabolism. Although the pathophysiology of metabolic dysfunction in obstructive sleep apnea is not well understood, studies of murine models indicate that intermittent hypoxemia has an important contribution. However, corroborating data on the metabolic effects of intermittent hypoxia on glucose metabolism in humans are not available. Thus the primary aim of this study was to characterize the acute effects of intermittent hypoxia on glucose metabolism. Thirteen healthy volunteers were subjected to 5 h of intermittent hypoxia or normoxia during wakefulness in a randomized order on two separate days. The intravenous glucose tolerance test (IVGTT) was used to assess insulin-dependent and insulin-independent measures of glucose disposal. The IVGTT data were analyzed using the minimal model to determine insulin sensitivity (S I ) and glucose effectiveness (S G ). Drops in oxyhemoglobin saturation were induced during wakefulness at an average rate of 24.3 events/h. Compared with the normoxia condition, intermittent hypoxia was associated with a decrease in S I [4.1 vs. 3.4 (mU/l) −1 ·min −1 ; P = 0.0179] and S G (1.9 vs. 1.3 min −1 ×10 −2 , P = 0.0065). Despite worsening insulin sensitivity with intermittent hypoxia, pancreatic insulin secretion was comparable between the two conditions. Heart rate variability analysis showed the intermittent hypoxia was associated with a shift in sympathovagal balance toward an increase in sympathetic nervous system activity. The average R-R interval on the electrocardiogram was 919.0 ms during the normoxia condition and 874.4 ms during the intermittent hypoxia condition ( P < 0.04). Serum cortisol levels after intermittent hypoxia and normoxia were similar. Hypoxic stress in obstructive sleep apnea may increase the predisposition for metabolic dysfunction by impairing insulin sensitivity, glucose effectiveness, and insulin secretion.
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One week with 5.7 h TIB compared to 8.5 h TIB affects genes associated with circadian rhythms, sleep homeostasis, oxidative stress, and metabolism.
“One week with 5.7 h TIB compared to 8.5 h TIB affected the genes associated with circadian rhythms (PER1, PER2, PER3, CRY2, CLOCK, NR1D1, NR1D2, RORA, DEC1, CSNK1E), sleep homeostasis (IL-6, STAT3, KCNV2, CAMK2D), oxidative stress (PRDX2, PRDX5), and metabolism (SLC2A5, GHRL, ABCA1), as assessed by transcriptome analysis [42]*.”
From Metabolic effects of sleep disruption, links to obesity and diabetes (2014) · cites this paper as [42]
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- Authors
- Louis, M., & Punjabi, N. M.
- Affiliations
- Johns Hopkins University (US)
- Venue
- Journal of Applied Physiology
- Publisher
- American Physiological Society
- Published
- 2009-05
- Volume
- 106
- Issue
- 5
- Pages
- 1538-1544
- ISSN
- 0161-7567 (ISSN-L)
- 8750-7587
- 1522-1601
- PMC
- PMC2681331
- OpenAlex
- W2153473929
- Cited by
- 342
- References
- 40
- Citations by year
- 2026: 9 · 2025: 13 · 2024: 14 · 2023: 11 · 2022: 14 · 2021: 20 · 2020: 17 · 2019: 17 · 2018: 28 · 2017: 24 · 2016: 30 · 2015: 29 · 2014: 26 · 2013: 28 · 2012: 23
- FWCI
- 13.74
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Journal of Applied Physiology (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institute for Health and Care Research
- Institut National de la Santé et de la Recherche Médicale
- National Institutes of Health
- National Heart, Lung, and Blood Institute (HL-07578)
- National Center for Research Resources (UL1RR025005)
- Topics
- Health Sciences › Medicine › Physiology › Obstructive Sleep Apnea Research
- Life Sciences › Neuroscience › Endocrine and Autonomic Systems › Neuroscience of respiration and sleep
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
- Keywords
- acute intermittent hypoxia, glucose metabolism, obstructive sleep apnea, insulin sensitivity, glucose effectiveness, insulin secretion, glucose tolerance, sympathovagal balance, heart rate variability, cortisol, hypoxic stress, metabolic dysfunction
- MeSH terms
- Insulin Secretion, Adolescent, Adult, Hypoxia, Blood Glucose, Electrocardiography, Glucose, Glucose Tolerance Test, Heart, Heart Rate, Humans, Insulin, Insulin Resistance, Oxyhemoglobins, Sympathetic Nervous System, Vagus Nerve, Sleep Apnea, Obstructive, Young Adult
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