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Impact of Obstructive Sleep Apnea on Insulin Resistance and Glucose Tolerance in Women with Polycystic Ovary Syndrome
Open accessAbstract
CONTEXT: Insulin resistance, impaired glucose tolerance, and type 2 diabetes are common in women with polycystic ovary syndrome (PCOS). Obstructive sleep apnea (OSA) has been linked to metabolic dysfunction. We studied women with and without PCOS to determine the extent to which OSA is responsible for insulin resistance and glucose intolerance in PCOS. METHODS: In a prospective design, 52 women with PCOS and 21 women without PCOS of similar age and body mass index had an overnight polysomnogram and a 75-g oral glucose tolerance test. RESULTS: Twenty-nine women (56%) with PCOS had OSA compared with four controls (19%) (adjusted odds ratio 7.1; 95% confidence interval, 1.7-45.7; P = 0.01). PCOS women with OSA were more insulin resistant than those without OSA [homeostasis model assessment (HOMA) index 5.7 +/- 0.4 vs. 3.5 +/- 0.4; P = 0.006] after controlling for age, body mass index, and ethnicity. Impaired glucose tolerance was found in 16 of 29 (55%) PCOS women with OSA and only six of 23 (26%) of those without OSA (unadjusted P = 0.049). Insulin resistance and glucose intolerance were highly correlated with the presence and severity of OSA. Among PCOS women with normal glucose tolerance, the presence of OSA was associated with a nearly 2-fold higher fasting insulin level and HOMA index. The severity of OSA was a highly significant predictor of the fasting concentrations of glucose and insulin as well as the 2-h glucose concentration and HOMA index. CONCLUSIONS: OSA is a highly prevalent and important determinant of insulin resistance, glucose intolerance, and type 2 diabetes in PCOS.
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“The present meta-analysis reported, for the first time, a ~5-fold higher effect estimate for AHI≥5 with symptoms compared to AHI≥5 only outcomes among individuals with PCOS (OR: 17.95 vs. OR: 3.90) (15, 17–21, 40).”
From Obstructive sleep apnea syndrome in polycystic ovary syndrome: a systematic review and meta-analysis (2025) · cites this paper as [17]
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“Past cross-sectional studies have shown that OSAS is highly prevalent in women with PCOS (15–19) compared with the general population of reproductive-aged women (17-75% vs. 9-28%) (9, 10), with lower rates in adolescents with PCOS (0-57%) (20, 21).”
From Obstructive sleep apnea syndrome in polycystic ovary syndrome: a systematic review and meta-analysis (2025) · cites this paper as [17]
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“All eight studies employed PSG to measure OSAS (as this was an inclusion criterion) (15–21, 40), five of which also assessed the presence of other OSAS-related symptoms such as excessive daytime sleepiness (15, 16, 18, 19, 21).”
From Obstructive sleep apnea syndrome in polycystic ovary syndrome: a systematic review and meta-analysis (2025) · cites this paper as [17]
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“with only five of the eight studies having adjusted or matched their control group by age, BMI and/or ethnicity (15, 17, 18, 21, 40).”
From Obstructive sleep apnea syndrome in polycystic ovary syndrome: a systematic review and meta-analysis (2025) · cites this paper as [17]
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Metadata
- Authors
- Tasali, E., Van Cauter, E., Hoffman, L., & Ehrmann, D. A.
- Affiliations
- University of Chicago (US)
- Endocrinology, Diabetes, and Metabolism (E.V.C., L.H., D.A.E.), The University of Chicago, Chicago, Illinois 60637
- Corresponding author
- Ehrmann, David A.
- ORCID
- Tasali, Esra
- Venue
- The Journal of Clinical Endocrinology & Metabolism
- Publisher
- The Endocrine Society
- Published
- 2008-10-01
- Volume
- 93
- Issue
- 10
- Pages
- 3878-3884
- ISSN
- 0021-972X (ISSN-L)
- 1945-7197
- PMC
- PMC2579653
- OpenAlex
- W2065404502
- Cited by
- 111
- References
- 49
- Citations by year
- 2026: 5 · 2025: 4 · 2024: 5 · 2023: 9 · 2022: 10 · 2021: 8 · 2020: 2 · 2019: 6 · 2018: 4 · 2017: 7 · 2016: 5 · 2015: 6 · 2014: 4 · 2013: 6 · 2012: 6
- FWCI
- 8.80
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- The Journal of Clinical Endocrinology & Metabolism (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- University of Chicago
- National Institutes of Health
- National Institute on Aging (P01AG011412)
- National Heart, Lung, and Blood Institute (R01HL075079)
- National Institute of Diabetes and Digestive and Kidney Diseases (P60DK020595)
- National Center for Research Resources (P41RR013642, M01RR000055)
- Eunice Kennedy Shriver National Institute of Child Health and Human Development (P50HD057796)
- Topics
- Health Sciences › Medicine › Reproductive Medicine › Ovarian function and disorders
- Health Sciences › Medicine › Physiology (medical) › Obstructive Sleep Apnea Research
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Keywords
- obstructive sleep apnea, polycystic ovary syndrome, insulin resistance, impaired glucose tolerance, type 2 diabetes, women, HOMA index, fasting insulin, OSA severity, metabolic dysfunction
- MeSH terms
- Adult, Arousal, Female, Glucose Tolerance Test, Humans, Insulin Resistance, Polycystic Ovary Syndrome, Prospective Studies, Case-Control Studies, Polysomnography, Glucose Intolerance, Sleep Apnea, Obstructive
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