Metabolic syndrome, insulin resistance, fibrinogen, homocysteine, leptin, and C-reactive protein in obese patients with obstructive sleep apnea syndrome

The prevalence of obstructive sleep apnea syndrome [OSAS] and metabolic syndrome is increasing worldwide, in part linked to epidemic of obesity. The purposes of this study were to establish the rate of metabolic syndrome and to compare fibrinogen, homocysteine, high-sensitivity C-reactive protein [hsCRP], leptin levels, and homeostasis model assessment insulin resistance [HOMA-IR] in the obese patients with and without OSAS. The study population included 36 consecutive obese patients with OSAS [23 males; mean age, 50.0 +/- 19.7 years], and 34 obese patients without OSAS [17 males; mean age, 49.7 +/- 11.1 years] were enrolled as control group. Metabolic syndrome was investigated; fibrinogen, homocysteine, CRP, and leptin levels were measured, and IR was assessed. Metabolic syndrome was found in 17 [47.2%] obese OSAS patients, whereas only 29.4% of obese subjects had metabolic syndrome [P > 0.05]. Obese patients with OSAS had significantly higher mean levels of triglyceride [P< 0.001], total-cholesterol [P = 0.003], low-density lipoprotein-cholesterol [P = 0.001], fasting glucose [P = 0.01], HOMA-IR [P<0.001], thyroid-stimulating hormone [P = 0.03], fibrinogen [P < 0.003], hsCRP [P <0.001], and leptin [P = 0.03] than control group. Besides, leptin level was positively correlated with waist [r = 0.512, P = 0.03] and neck circumferences [r = 0.547, P = 0.03], and fasting glucose [r = 0.471, P = 0.04] in OSAS patients, but not in obese subjects. This study demonstrated that obese OSAS patients may have an increased rate of metabolic syndrome and higher levels of serum lipids, fasting glucose, IR, leptin, fibrinogen, and hsCRP than obese subjects without sleep apnea. Thus, clinicians should be encouraged to systematically evaluate the presence of metabolic abnormalities in OSAS and vice versa

Effects of hormone replacement therapy on insulin resistance and platelet function tests

The aim of this study was to evaluate measures of insulin resistance and platelet function in postmenopausal women with oral or transdermal hormone replacement therapy [HRT]. Eighty women divided into four groups of 20 each were enrolled in the study. Group 1: postmenopausal hysterectomized women who received only transdermal estradiol [13.9 mg/12.5 cm2]; group 2: women with intact uterus who were treated with estrogen-progestin combination [HRT]; group 3: postmenopausal women who were treated with the selective estrogen receptor modulator tibolone, and group 4: women who were not taking any drugs for HRT were chosen as a control group [group 4]. In group 2, homeostasis model assessment of insulin resistance and fasting insulin levels were 2.90 +/- 0.37 and 9.3 +/- 3.0 micro U/ml, respectively, prior to administration of HRT. These levels were reduced to 1.91 +/- 0.41 [p = 0.001] and 7.1 +/- 2.7 micro U/ml [p = 0.002], respectively, after drug therapy. Mean levels of high-sensitivity C-reactive protein [hsCRP] were decreased with HRT only in group 2 [p = 0.002]. No changes for biochemical and hematological parameters were observed in the other groups. Platelet function tests showed no differences after HRT in any group. Estrogen-progestin combination HRT decreased measures of insulin resistance and hsCRP levels, but had no effect on platelet function tests in postmenopausal women