Cited by 342Obstructive Sleep Apnea ResearchNeuroscience of respiration and sleepSleep and related disorders

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Effects of acute intermittent hypoxia on glucose metabolism in awake healthy volunteers.

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Louis, Mariam, Punjabi, Naresh M.·2009·Journal of Applied Physiology

DOI 10.1152/japplphysiol.91523.2008PMC PMC2681331

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Abstract

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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Authors: Louis, M., & Punjabi, N. M.
Affiliations: Johns Hopkins University (US)
ORCID: Louis, Mariam
Punjabi, Naresh M.
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
DOI: 10.1152/japplphysiol.91523.2008
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 (medical) › 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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Effects of acute intermittent hypoxia on glucose metabolism in awake healthy volunteers.

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